The Takeaway
- Medicare Part B premiums are projected to rise nearly 10%.
- Primary-care access may tighten as practices close or consolidate.
- Telehealth and in-home care programs could shrink.
- Rural + inner-city hospitals may see growing strain.
- Seniors may feel the squeeze in both cost and availability.
When Medicare premiums rise, seniors don’t see it as a policy debate — they feel it in their budgets. And with Part B premiums expected to jump nearly 10%, millions of older adults living on fixed incomes are asking the same question: What’s this going to mean for my care?
To help make sense of what’s ahead, Smart Senior Daily spoke with Dr. Peter Kowey, a longtime cardiologist and national health-policy observer. He says several changes tied to the administration’s new One Beautiful Bill (OBB) could create real challenges for seniors.
1. Primary care may get harder to find
According to Dr. Kowey, the biggest pressure point will be access to primary-care doctors — the clinicians who keep small issues from becoming big ones.
Low reimbursement rates and capped federal loan programs, he says, could push new doctors away from primary care and toward higher-paying specialties. Over time, that means:
- Fewer independent practices
- More clinics owned by private-equity groups
- Longer waits for appointments
- More reliance on NPs and PAs with limited supervision
“When access shrinks, hospitalizations rise,” Kowey notes.
2. Telehealth and in-home care could shrink
During the pandemic, telemedicine was a lifeline for seniors — especially those who struggle with mobility or live far from care.
But Dr. Kowey says some OBB provisions could reduce funding for these services, leaving many homebound seniors with fewer options.
This would hit rural and inner-city communities first.
3. Hospitals may feel the strain
Hospitals in vulnerable areas may see fewer subsidies and more uninsured or under-insured patients walking into ERs.
The result could be:
- longer emergency-room waits,
- fewer specialty services, and
- more hospital closures — especially in rural counties.
That means delayed care for seniors who already face transportation and mobility challenges.
4. Seniors may face higher out-of-pocket costs
As healthcare prices rise, insurers may increase premiums across the board. Dr. Kowey also warns that:
- Medicare Advantage plans may tighten approvals, and
- more seniors may be pushed toward MA plans where insurers control access.
He also notes long-term concerns that Medicare may eventually seek to draw from Social Security reserves to stabilize payments.
For seniors living on fixed incomes, even small increases create real pressure.
5. What seniors can do now
Dr. Kowey emphasizes that seniors still have tools and a voice. He recommends:
- Staying informed on Part B changes
- Reviewing Medicare or MA coverage before the next enrollment period
- Asking your doctor whether practice changes will affect access
- Contacting local aging-services offices for transportation and telehealth support
- Reaching out to elected representatives to share how these changes affect you
“Our healthcare system works best when patients and practitioners speak up early — not after cuts take effect,” he says.
Bottom Line
None of these changes happen overnight — but seniors should pay attention now. Rising premiums, shrinking access, and shifting insurance rules may combine to make the next few years more challenging, especially for those managing chronic conditions.
Smart Senior Daily will continue watching these developments and breaking them down in plain English so you can protect both your health and your wallet.
Health Disclaimer: This article is for educational purposes only and is not a substitute for professional medical advice. Always consult your healthcare provider about your specific situation.
About Dr. Peter Kowey
Dr. Peter Kowey is Professor of Medicine and Clinical Pharmacology at Thomas Jefferson University and the Emeritus Chief of Cardiovascular Diseases at the Lankenau Heart Institute. He also holds the William Wikoff Smith Chair in Cardiovascular Research at the Lankenau Institute for Medical Research.
He is an internationally recognized expert in heart rhythm disorders, with more than 450 scientific papers, 150 research grants, and five co-edited textbooks. His clinical and regulatory work has helped guide the development of several major arrhythmia therapies.
Dr. Kowey is a Fellow of the American Heart Association, the American College of Cardiology, the American College of Physicians, and the Heart Rhythm Society. He has served on multiple FDA advisory committees and is the recipient of several national awards.
He is also the author of Failure to Treat, a new book examining how gaps in the U.S. healthcare system affect patients and clinicians. (Available on Amazon.)
He and his wife, Dorothy, live in Pennsylvania and have three daughters, six grandchildren, and two dogs.
