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Fact check: Is it Trumps fault that the cost of medicaid and Medicare will increase or Biden for being short sided and not addressing it while in office
Executive Summary
The question of whether rising Medicaid and Medicare costs are “Trump’s fault” or due to President Biden’s inaction is not reducible to a single actor; recent policy changes, enacted legislation, and pending congressional actions under both administrations have all contributed to projected cost changes and coverage impacts. Contemporary analyses show policy decisions that increase payments or cut programs—including Trump-era regulatory and legislative moves and Biden-era expansions of coverage and benefits—both influence program spending, while congressional budget resolutions and new laws in late 2025 further change the trajectory [1] [2] [3]. Below is a concise, sourced breakdown of key claims, evidence, and competing interpretations.
1. Who changed payment rules and who raised program spending?
The Trump administration enacted regulatory changes and a tax bill that analysts and reports connect to higher payments to Medicare Advantage plans and structural changes to Medicaid funding that can raise federal spending or shift costs. Investigations and reporting show the Centers for Medicare & Medicaid Services under Trump dramatically increased Medicare Advantage plan payments in 2024–2025, a move linked to higher taxpayer costs and larger insurer profits [1]. Economists also flagged that tax and policy changes associated with the Trump agenda would increase healthcare costs or reduce revenue for programs, affecting Medicaid and ACA funding [4]. These are documented policy actions with fiscal modeling and press reports supporting the linkage [1] [4].
2. What did the Biden administration do that affects costs and coverage?
The Biden administration pursued policies expanding coverage, such as approvals for continuous eligibility for children in Medicaid and CHIP and proposals to add anti‑obesity medications to Medicare/Medicaid benefits—moves that expand access and can raise near‑term program costs while potentially reducing long‑term disease burden [2] [5]. Biden-era regulations also faced Congressional threats of rollback; legislative proposals to eliminate Biden-era Medicaid rules were estimated to reduce federal spending by large amounts over a decade, with scoring by the Congressional Budget Office pivotal to projecting net fiscal effects [6]. These facts show Biden’s choices aimed at expansion but subject to fiscal tradeoffs and political countermeasures [2] [6] [5].
3. What do recent congressional actions and 2025 laws change?
In late 2025 Congress and the White House enacted large-scale changes affecting Medicaid and Medicare, including the “One Big Beautiful Bill” and budget resolutions directing substantial cuts. The Congressional Budget Office estimated some reforms would increase the uninsured by millions, and a House budget resolution sought to cut roughly $880 billion from programs the Energy and Commerce Committee oversees, directly altering projected program costs and coverage [3] [7]. Independent academic analyses modeled excess mortality associated with major Medicaid cuts, underscoring human and fiscal consequences tied to congressional budgeting choices rather than a single administration’s unilateral action [8].
4. How do analysts apportion blame or responsibility?
Fact checks and policy analyses from 2025 show experts attribute increased costs to a mix of administrative rule changes, legislation, and budgetary priorities across administrations and Congress. Fact‑checking coverage compares approaches and effects of Biden and Trump policies in 2022–2025, noting differing aims—expansion versus market‑oriented changes—and differing fiscal outcomes depending on specific rules like MA payment rates or Medicaid eligibility flexibility [9] [1]. The consensus in analyses is that both executive actions and Congressional budgeting matter, and that timing, statutory authority, and implementation determine who bears responsibility for cost shifts [9] [6].
5. Where do projections diverge and why certainty is limited?
Projections of program costs and coverage hinge on assumptions about enrollment, payment rates, legislative offsets, and economic conditions. CBO scoring of proposed rule rollbacks or budget cuts yields large ranges; independent academic models produce stark estimates of health effects from cuts [6] [8]. Changes like adding anti‑obesity drugs to Medicare/Medicaid could raise short‑term spending but reduce chronic disease costs in the long run—showing timing matters for fiscal impact [5]. This makes single‑actor blame misleading because policy effects play out over years and interact with subsequent legislative choices [6] [5].
6. Bottom line for attribution and public messaging
Attribution of higher Medicaid and Medicare costs to “Trump” or “Biden” alone is incomplete and empirically unsupported; recent evidence shows regulatory increases in Medicare Advantage payments, legislative tax and program changes, Biden expansions, and late‑2025 congressional budget and lawmaking all contribute to the current trajectory [1] [2] [3]. Responsible accounting requires tracking specific rules, budget scores, and enacted laws: the factual record demonstrates multiple actors and policies—administrations plus Congress—combine to shape costs and coverage, rather than a single person’s unilateral responsibility [4] [7].