Healthcare costs strain older Americans' finances ahead of midterm elections

Medicare enrollees confront higher caps and expiring subsidies during open enrollment

Barbara Weigand stayed healthy and saved diligently for years to prepare for retirement. This year, a shoulder surgery and a bladder cancer diagnosis have tested those preparations, and she recently withdrew $4,000 from her retirement account to cover medical expenses associated with her cancer treatment.

“On my monthly income, I would not be able to afford my new medical expenses,” said Weigand, 83, who lives in North Canton, Ohio. She is currently on a Medicare Advantage plan and was searching for new coverage as Medicare’s open enrollment period began in October.

For older adults in the United States, the rising cost of healthcare is landing on household budgets as Medicare costs, prescription drug prices and long-term care expenses climb — and the concerns could carry significant political weight heading into Tuesday’s midterm elections. Older adults are a reliable voting bloc: an AARP poll conducted in early October found 83% of voters over age 50 say they are extremely motivated to vote in the midterms.

Open enrollment for Medicare plans began in mid-October, and enrollees are facing a series of changes that will go into effect in 2027. People choosing plans are weighing higher Part D out-of-pocket caps, the end of temporary federal Part D premium subsidies and new drug price negotiations. In some states, insurers have capped the number of people who can enroll in Advantage plans, pulled out of markets or eliminated plans that people have come to rely on.

Juliette Cubanski, director of KFF’s program on Medicare policy, told The Associated Press that the open enrollment period offers enrollees “an opportunity to evaluate the coverage they have and see if there might be better options for them in terms of accessing the care that they need, at possibly a lower cost.”

Weigand said she is grateful to have the mental acuity to do the research and the spiritual community she relies on, but worries about other older people who are struggling to plan for the year ahead. “There are so many changes, and a lot of people my age who don’t know where to start,” she said. “What do they do?”

Prescription drug affordability is a second major concern. The Trump administration has made lowering drug prices a priority, and President Donald Trump has struck multiple most-favored-nation drug deals with pharmaceutical companies and launched the discount drug website TrumpRx, among other steps. In September, the administration said all 50 states would join a program set to provide most-favored-nation pricing to some drugs within the Medicaid program, bringing the net price of selected drugs down to prices paid in certain other countries.

Cost still prevents some people from filling prescriptions. A KFF survey from March found about 4 in 10 U.S. adults say they have not taken their medication as prescribed in the past year due to costs, and the KFF report says about 1 in 5 people surveyed had cut pills in half or skipped doses of medicine in the prior year because of the cost.

Weigand said she is considering rationing her drugs to save money. “I’ve been thinking — if I could just do this every other day rather than every day to make the medicine last longer,” she said. “Isn’t that sad?”

The costs of receiving long-term care — whether from spouses, home-care aides or friends — have risen steeply for retirees. An AARP report released Wednesday examining out-of-pocket caregiving expenses found family caregivers are spending nearly 60% more supporting a family member or friend than five years ago: an average of $11,508 a year, compared with $7,242 in 2021.

Nancy LeaMond, AARP’s executive vice president and chief advocacy officer, said “we’re already hearing from our members about healthcare affordability — its prescription drug costs, caregiver costs, co-pays, premiums.” “Not only are we trying to help family caregivers with their finances, but also to get them the kind of information they need to help their loved ones,” LeaMond said. About one-third of Americans over 50 provide regular care to an adult relative or friend with a health issue or disability, according to a national poll on healthy aging conducted in September 2025 by the University of Michigan.

Social Security adds a fourth worry. The Social Security Administration announced this month that the annual cost-of-living adjustment for older adults and people with disabilities will rise by 3.6% beginning in 2027 — an extra $75 per month for the nearly 72 million people who receive monthly Social Security benefits and about 7.3 million beneficiaries who get Supplemental Security Income.

The agency faces an approaching bankruptcy date if a funding shortfall is not addressed by Congress. The Social Security and Medicare trustees’ report from June states that Social Security’s combined trust funds, which cover old age and disability recipients, will be unable to pay full benefits beginning in 2034, after which incoming revenue would cover about 83% of scheduled benefits. With 2034 approaching, the incoming Congress will be responsible for determining how to shore up the program.

Matt Hogan, a partner at the polling firm Impact Research, offered this advice to candidates in the closing days of the midterm campaign: “Regardless of party, to make inroads with these voters, Social Security and Medicare should definitely be part of their messaging.”