Medicare premiums rose during the Trump administration, not fell

Medicare Part B premiums — the monthly cost for doctor visits and outpatient care — increased every year from 2017 through 2020. The premium went from $134 per month in 2017 to $148.50 in 2020. Part D premiums, which cover prescription drugs, also rose during this period, though the amount varied by plan.

The increases happened because of how Medicare premiums are set. Part B premiums are tied to the cost of providing care and the number of people using the program. When healthcare costs rise or enrollment grows, premiums rise with them. No president controls this directly — it is a mathematical result of the program's structure.

Some people remember hearing about premium freezes or reductions during 2019 and 2020. What actually happened was that the annual increase was smaller than expected in those years, not that premiums went down. A smaller increase is not the same as a lower premium.

Key Takeaways

  • Medicare Part B premiums rose from $134 monthly in 2017 to $148.50 in 2020 under the Trump administration.
  • Medicare premiums are set by a formula based on healthcare costs and enrollment, not by presidential action.
  • A slower rate of increase is different from an actual premium reduction.
  • Part D prescription drug premiums also increased during this period, though amounts varied by plan.
  • Premiums have continued to rise under subsequent administrations as well.

How Medicare premiums are actually set

Medicare Part B premiums are calculated by Congress and the Centers for Medicare & Medicaid Services (CMS) using a formula. The formula looks at the cost of providing Part B services divided by the number of people enrolled, plus an adjustment for the trust fund balance. When costs go up or enrollment grows, the premium goes up.

The president does not set these premiums and cannot lower them by executive order. Congress would have to change the formula itself, which requires legislation. This is true regardless of which party controls Congress or the White House.

Part D premiums work differently because they are set by private insurance companies that offer the plans. CMS reviews the bids to make sure they are reasonable, but the companies themselves decide what to charge. These premiums also rose during 2017–2020, though the increase varied from plan to plan.

What actually changed in 2019 and 2020

In 2019, the Part B premium increase was smaller than it had been in previous years. The monthly premium rose by only $1.50 that year. In 2020, the premium stayed the same as 2019 for most beneficiaries — the first time in a decade that the premium did not increase. However, this was not because of any policy change; it happened because healthcare costs that year were lower than expected.

The 2020 freeze was temporary. Premiums rose again in 2021 and have continued rising since. The temporary pause in increases was a result of how the formula worked that particular year, not a lasting change to how Medicare premiums are set.

Comparing premiums across administrations

Medicare premiums have risen under every administration since the program began in 1965. The increases reflect the overall growth in healthcare costs, not the policies of any particular president. Looking only at the years 2017–2020 and comparing them to other four-year periods shows that the rate of increase was not unusual.

If you want to understand whether your own premiums have gone up or down, look at your Medicare Summary Notice, which arrives each year in the mail. It shows your exact premium for that year and lets you compare it to the previous year. This document is more reliable than general statements about what happened to "Medicare premiums" as a whole.

What you can actually do about your premiums

While you cannot change the Part B premium amount — it is the same for everyone — you can control some of your Medicare costs. During the annual enrollment period from October 15 to December 7, you can switch to a different Part D plan if your current plan's premium has risen. You can also change your Medigap or Medicare Advantage plan if you are enrolled in one of those.

If your income is low, you may be able to get help paying your premiums through the Medicare Savings Program or the Low-Income Subsidy program. These are run by your state, and the income limits and benefits vary. Your local Area Agency on Aging can tell you whether you might be may be able to access and how to contact your state program.

Frequently Asked Questions

Did Trump freeze Medicare premiums?

No. The Part B premium did not increase in 2020, but this was not a freeze ordered by the administration. It happened because the formula that sets premiums resulted in no increase that year. Premiums rose again in 2021 and have continued rising since.

Why do Medicare premiums keep going up?

Medicare premiums are tied to the cost of providing healthcare services. When those costs rise, premiums rise. This happens regardless of who is president. The formula that sets Part B premiums is written into law and changes only if Congress passes new legislation.

Can I get a refund if my premium went up?

No. Once a premium increase takes effect, you cannot get money back for previous months. If you think your premium was set incorrectly, you can contact Social Security or Medicare to ask them to review it, but refunds are not available.

What if I cannot afford my Medicare premium?

Contact your state's Medicare Savings Program to see if you may have access to for help paying premiums. Income limits and benefits vary by state. You can also call 1-800-MEDICARE to be connected to your state program, or contact your local Area Agency on Aging.