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One older adult is seen holding the door open for another as they exit a cooling center.
Seniors leave a cooling center in the Bronx borough of New York City during a heat wave on July 11, 2024. (Getty/Angela Weiss)

Project 2025 is a plan to gut America’s system of checks and balances in order to enact an extreme, far-right agenda that would hurt all Americans. The plan proposes taking power away from everyday people to give politicians, judges, and corporations more control over Americans’ lives. Here are specific ways that Project 2025 would harm American seniors.

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Limiting seniors’ access to health care and putting Medicare’s future at risk

Project 2025 proposes to make Medicare Advantage—privatized Medicare—the “default option” for all Medicare enrollees. Nearly all Medicare Advantage plans require enrollees to obtain prior authorization to receive certain health care services, which gives insurance companies control to interfere with choices made by patients and their doctors and makes it harder for patients to access care. Medicare Advantage plans also can restrict enrollees’ choices of physicians and hospitals. Medicare Advantage costs the Medicare program more than traditional Medicare, so a new Medicare Advantage default scheme would put Medicare’s financial health in danger. Under this proposal, an increase the proportion of seniors in Medicare Advantage plans to 75 percent from the current 51 percent would cost the Medicare program an additional $2 trillion over a decade, putting the long-term financial health of this vital program at risk. These changes would ultimately accrue to the benefit of insurance companies, who would reap a multibillion-dollar windfall from an increase in Medicare Advantage enrollment.

Increasing the cost of prescription drugs

Project 2025’s prescription drug reforms would raise the cost of prescription drugs for up to 18.7 million people on Medicare Part D by eliminating out-of-pocket Medicare drug cost limits. Those beneficiaries could see an average of nearly $400 in lost drug savings in 2025 alone under the Inflation Reduction Act’s redesign of Medicare Part D. Overall, Medicare Part D enrollees across the nation could lose out on up to $7.4 billion in out-of-pocket savings next year. Finally, in what would amount to a huge windfall for Big Pharma, Project 2025 would bar the federal government from negotiating for lower drug prices.

Increasing taxes on seniors

Project 2025 shifts the tax burden from the wealthy onto the middle class. Based on analysis using U.S. Census income data, the median household headed by someone over age 65 would see a tax increase of $900 per year under the plan, assuming the household is a married-couple household. Meanwhile, 45,000 households in America reporting more than $10 million in income would each see an average annual tax cut of $1.5 million.

Cutting access to long-term care

Project 2025 proposes capping Medicaid payments to states with no regard for their actual spending needs on health and long-term care. It also gives states the power to deny coverage of particular services, including long-term services and supports such as home- and community-based care. According to KFF data, more than 21 million seniors and nonelderly adults with disabilities were enrolled in Medicaid in 2021; this accounted for nearly one-quarter of Medicaid recipients yet more than half of all Medicaid spending. Additionally, the proposed funding caps could force states to restrict eligibility for long-term services and supports, according to KFF. Alternatively, Medicaid funding caps could force states to outright deny coverage of particular benefits, especially costly services such as long-term care.

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Author

Colin Seeberger

Senior Adviser, Communications

Department

Communications

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