Rising health costs and coverage changes are big concerns for older adults as Election Day nears

WASHINGTON (AP) — Barbara Weigand could not have prepared more for retirement. She stayed healthy and saved diligently for years.

This year, though, a shoulder surgery and a bladder cancer diagnosis have really tested her finances. 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,” says 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 hitting where it hurts most — their pocketbooks. With Medicare costs, prescription drug prices and long-term care expenses weighing on household budgets, their concerns could carry significant political weight heading into Tuesday’s elections.

Weigand is part of a reliable voting bloc; 83% of voters over age 50 say they’re extremely motivated to vote in the midterms, according to an AARP poll conducted in early October. Their concerns over managing healthcare costs put the issue of affordability squarely in the spotlight.

Here are some of their biggest healthcare concerns — and how Weigand sees them.

Worry No. 1: Changes to Medicare plans

THE SITUATION: Open enrollment for Medicare plans began in mid-October, and enrollees are facing a slew of changes that will go into effect in 2027.

During the enrollment period, people are considering higher Part D out-of-pocket caps, the end of temporary federal Part D premium subsidies, and new drug price negotiations. Additionally, in some states, insurers put caps on the number of people who can enroll in Advantage plans, pulling out of markets or eliminating 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.”

While Weigand is grateful to have the mental acuity to do the research and the spiritual community that she relies on, she 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 says. “What do they do?”

Worry No. 2: The affordability of prescription drugs

THE SITUATION: The Trump administration has made lowering drug prices a priority in its effort to show Americans that it is tackling soaring costs. Republican President Donald Trump has struck multiple most-favored-nation drug deals with pharmaceutical companies and has launched the discount drug website TrumpRx, among other steps.

In September, his administration said all 50 states would join in on 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.

Still, the cost of prescription drugs prevents some people from filling prescriptions. A KFF survey from March found that about 4 in 10 U.S. adults say they have not taken their medication as prescribed in the past year due to costs.

Weigand 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 says. “Isn’t that sad?“

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.

Worry No. 3: The costs of long-term support

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 that examines out-of-pocket caregiving expenses finds that family caregivers are spending nearly 60% more supporting a family member or friend than five years ago. They spend an average of $11,508 a year supporting a family member or friend, compared with $7,242 in 2021, according to the report.

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,” she said. “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.”

These worries are top of mind for older people. 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.

Worry No. 4: The solvency of Social Security

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. That translates to $75 extra 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 that, incoming revenue would cover about 83% of scheduled benefits.

With 2034 not far away, the upcoming Congress will be on the hook to determine how to shore up the program.

Matt Hogan, a partner at the Impact Research polling firm, has 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.”