Major Medicare and Medicaid Changes Set for 2026 Under Trump-Era Policies
New laws could leave millions uninsured as healthcare costs rise and access becomes more restrictive.
Federal health insurance programs in the United States—Medicare and Medicaid—are preparing for a sweeping wave of changes beginning in 2026, following a package of policies and laws approved this year by the administration of President Donald Trump. These measures are expected to significantly reshape the future of healthcare coverage for tens of millions of Americans, according to Newsweek.
The changes have drawn intense attention due to the scale of the populations affected. Medicaid currently provides healthcare coverage to more than 70 million low-income Americans, while Medicare covers approximately 68 million people, most of whom are over the age of 65 or living with chronic illnesses.
Medicaid Cuts Raise Alarms Over Coverage Losses
Lawmakers and public health experts have warned that the new policies could result in millions losing health insurance, with direct and far-reaching consequences for public health outcomes nationwide.
Regarding Medicaid, the administration’s newly passed legislation—known as the “One Big Beautiful Bill”—calls for nearly $1 trillion in budget cuts. The government argues that the reductions are aimed at eliminating “waste, fraud, and abuse.” However, the cuts include scaling back Medicaid expansion enacted under former Presidents Barack Obama and Joe Biden, forcing states that adopted expansion under the Affordable Care Act to shoulder a larger share of the costs.
The Congressional Budget Office (CBO) estimates that these measures alone will increase the number of uninsured Americans by 1.3 million in 2026, with further increases expected in subsequent years.
Major Medicaid and Medicare Changes Raise Fears of Coverage Loss and Higher Costs
The changes also introduce new work or “community engagement” requirements, mandating that most beneficiaries aged 19 to 65 demonstrate at least 80 hours per month of employment, education, or volunteer activity. Experts caution that these requirements are likely to disqualify many eligible individuals due to administrative hurdles rather than actual ineligibility.
Medicare will also undergo changes, including higher premiums and deductibles, particularly under Part B, where the average monthly premium is expected to rise by about 10 percent. At the same time, the Centers for Medicare & Medicaid Services announced price reductions for several widely used medications treating chronic conditions under a previously approved negotiation mechanism—though analysts expect the savings to be limited for most beneficiaries.
Taken together, health policy specialists argue that these shifts will make access to healthcare in the United States more complex and more expensive, especially for vulnerable populations, raising concerns about a widening national healthcare coverage gap.
