Tag: Medicaid

Robert F. Kennedy Jr. was grilled by senators over ideas for reforming Medicaid and Medicare on Wednesday during his first confirmation hearing as President Donald Trump’s nominee to become the next secretary of Health and Human Services.

In this role, RFK Jr. would have authority over the Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA) as well as the National Institutes of Health and the Centers for Medicare & Medicaid Services (CMS), which is responsible for the Medicare and Medicaid programs. Dr. Mehmet Oz was nominated by Trump to run the CMS. 

During the Wednesday hearing, Kennedy told senators that “Medicaid is not working for Americans.” 

“It’s specifically not working for the target population,” he said. 

Kennedy said the premiums and deductibles are too high, the “networks are narrow,” and the best doctors and healthcare systems don’t accept it. 

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Medicaid, originally designed for the poorest Americans, has been “dramatically expanded,” leading to increased financial pressures on that population, he said.

“The irony of the expansion is that the poorest Americans are now being robbed,” he continued. 

A patient waits in a room at a doctor’s office. (  / iStock)

In terms of Medicare, Kennedy believes more people would rather be on Medicare Advantage “because it offers very good services” but it’s too expensive. 

When asked what reforms he would recommend to improve service and make it more cost-effective, Kennedy said there are “many things” we can do but stopped short of offering specifics. He said the ultimate goal is to increase transparency and accountability as well as “transition into a value-based system rather than a fee-based system.” 

What to know about Medicare Part A, Medicare Part B, Medicare Advantage and Medicaid: 

Medicare 

Medicare is health insurance for people who are at least 65 years old. It is also for certain individuals under 65 that have disabilities and conditions. There are various plans within Medicare. When you sign up for Medicare, you can choose which way to get your Medicare coverage. 

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There are two main options for consumers. One is original Medicare, which includes Part A and Part B, or Medicare Advantage (also known as Part C). 

A doctor writes a prescription for a patient. (  / iStock)

Medicare Part A 

Part A, otherwise known as hospital insurance, helps cover inpatient care in hospitals, skilled nursing facility care, hospice care and home health care, according to the CMS. 

Medicare Part B 

It is medical insurance that covers services from doctors and other healthcare providers, outpatient care, home healthcare and durable medical equipment such as wheelchairs, walkers, hospital beds, and other equipment. It will also cover many preventive services such as screenings, shots or vaccines, and yearly “Wellness” visits, according to CMS. 

You can use Medicare Part A and Part B at any doctor or hospital that takes Medicare in the U.S. Consumers can also buy supplemental coverage that helps pay for their out-of-pocket costs. 

Medicare Part D

It helps cover the cost of prescription drugs and includes many recommended shots or vaccines. However, consumers have to add this plan in order to get Medicare drug coverage.

Medicare Advantage 

It is a Medicare-approved plan from a private company that offers an alternative to original Medicare for your health and drug coverage. It is known as Part C and usually bundles Part A, Part B, and usually Part D plans. 

Typically, this has different out-of-pocket costs than original Medicare or supplemental coverage like Medigap, which is supplemental insurance consumers can buy from a private company that helps pay your share of costs in original Medicare.

With Part C, consumers may also have an additional premium, according to CMS. 

Robert F. Kennedy Jr. testifies during his Senate Finance Committee confirmation hearing on Jan. 29, 2025, in Washington, D.C. (Win McNamee / Getty Images)

However, the plans may offer benefits that Original Medicare doesn’t.

Medicaid 

This is a joint federal and state program designed to provide health coverage for individuals with limited income and resources. It offers benefits such as nursing home care, personal care services, and help with paying Medicare premiums and other costs. 

The state will pay your monthly premiums, and depending on the level of Medicaid eligibility, it may also cover Medicare costs, such as deductibles, coinsurance and copayments. In some cases, it could also cover Part A premiums, according to CMS.

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Recipients will also receive assistance with prescription costs. Medicaid may cover medications and services that Medicare doesn’t, as noted by CMS.

However, each state has different rules around who’s eligible for this program. To qualify, you must meet your state’s rules for your income and resources, in addition to other rules such as being a resident of the state. 

However, sometimes a state will offer loopholes. For instance, some states will let a consumer “spend down” the amount of their income that’s above the state’s Medicaid limit.