No direct benefit cuts to Social Security and Medicare, but some changes could have impacts

In 2023, as a presidential candidate, Donald Trump promised to protect major entitlement programs, saying, "I will not lay a finger on Medicare or Social Security. ... These are benefits for our seniors. We are not going to touch it. There are many other things we can do."

During his second term, Trump hasn't directly cut benefits for either program, but some of his policies could impact beneficiaries, experts say.

Social Security

The rules governing Social Security benefits remain the same as when Trump took office January 2025. But early in Trump's second term, the Department of Government Efficiency sought to cut the Social Security Administration's workforce, offices and services.

Some of these cuts have been blocked by courts or reversed, but beneficiaries still might feel the impact.

Personnel cutbacks will curtail the information and services that beneficiaries will receive from the government, said Eugene Steuerle, a fellow at the Urban Institute, a think tank on social and fiscal policy.

The cuts have led to "unnecessary obstacles for seniors trying to access their earned benefits," said Max Richtman, president and chief executive officer of the National Committee to Preserve Social Security and Medicare, an advocacy group.

Medicare

Trump has also not directly cut Medicare benefits, but some of his enacted policies could impact people who use the federal health insurance program for older Americans.

Trump's 2025 signature tax and spending law ended Medicare eligibility for certain lawfully present immigrants — "the first time in the program's history, as far as I know, that the law was changed in a way that will terminate Medicare coverage for a group of people," said Tricia Neuman, executive director for the program on Medicare policy at health-care think tank KFF.

Separately, the administration has proposed reducing federal payments to Medicare Advantage plans — the private insurance plans that function as Medicare coverage, also known as Medicare Part C. The proposal was prompted by longstanding concerns about higher costs to the government in Medicare Advantage compared with traditional Medicare.

If enacted, Neuman said insurers could respond by cutting benefits. 

On Medicare prescription drug coverage, the Trump administration has kept a price negotiation system enacted under then-President Joe Biden, but a provision of Trump's tax and spending law delayed negotiations for certain "orphan drugs" that are used for relatively rare diseases. "This change increases Medicare spending and likely increases costs for beneficiaries who take these drugs," Neuman said.

Finally, Neuman said the Social Security Administration cuts could have spillover effects on people currently using both programs or seeking to sign up for them, potentially increasing delays in receiving Medicare coverage and benefits.

In all, the changes and proposed changes under Trump would keep most Social Security and Medicare benefits in place. Some of the changes could have indirect impacts on current or future beneficiaries. We'll continue to track these policies' effects; for now, we rate this In the Works.