President Trump’s tax bill, which passed the Senate on Tuesday, will limit access to health care for millions of Americans if it becomes law due to significant cuts to Medicaid. But what about Medicare recipients?
Medicare serves approximately 2 million people in North Carolina. It’s a federal health insurance program primarily for individuals aged 65 and older.
For one in six recipients, many of whom live on fixed incomes, the $185 monthly premiums for Medicare Part B are covered by Medicaid. Additionally, Medicaid pays for out-of-pocket Medicare costs, including deductibles and co-pays, allowing individuals near or below the poverty line to access necessary care.
Nicole Dozier is the director of the Health Advocacy Project at North Carolina Justice Center, an anti-poverty organization based in Raleigh.
"One of the key ways that people become low-income or stay low-income is because of health care costs, or because of lack of access to equitable, comprehensive health care," says Dozier. "And so when people have to make decisions between food on the table or going to the doctor, that's not such a good situation to be in."
According to the nonpartisan Congressional Budget Office, the Big Beautiful Bill reduces federal spending on Medicaid and Affordable Care Act marketplaces by approximately $1 trillion over the next decade. These changes alone would reverse many of the health coverage gains achieved during the Obama and Biden administrations, potentially leaving around 12 million people without coverage, according to the CBO.
Medicaid also allows people who are on Medicare to age in place, says Dozier.
"As the primary payer of home-based care, covering a wide array of personal care, support through Medicaid home and community-based services, Medicaid is also the primary payer of nursing facility care," she says.
Medicaid covers short-term skilled nursing facility stays, falls, and long-term hospital stays. According to Dozier, more than six in ten residents of nursing facilities rely on Medicaid for their care.