Biden’s Trap Set for Trump: Seniors’ Care on the Chopping Block

Paul Riverbank, 12/4/2025Biden-Trump faceoff: Medicare rule threatens seniors’ care, sparking political blame and looming uncertainty.

For years, these niche pharmacies have quietly kept the country’s most vulnerable—elderly residents in nursing homes—supplied with vital medications. Now, pharmacist managers and patient advocates warn that a tweak to Medicare rules, set in motion by President Biden’s Inflation Reduction Act, could shut their doors come January. The Senior Care Pharmacy Coalition (SCPC) paints a stark picture: “If something doesn’t change, there won’t be anyone left to fill prescriptions for entire facilities,” one coalition member tells me, sounding exhausted. The chain reaction, SCPC claims, could force some nursing homes to wind down altogether.

There’s more than just hand-wringing here. Economists at SCPC argue that if closures push seniors into hospital beds or pricier institutional care, taxpayers could be facing billions in extra Medicare costs over the next decade—possibly as much as $4.8 billion. Meanwhile, the cost of simply keeping these pharmacies afloat would be a fraction of that sum. You might expect a quick fix, but in Congress, nothing’s ever straightforward or timely.

Finger-pointing is already in full swing. Some in former President Trump’s camp allege the Biden administration “left trap doors” in policy—seemingly to draw their opponents into unwinnable political terrain. “They set up a mess, hoping we’d stumble in the thick of an election,” confides one adviser, only half-joking. In this town, it's rarely about the next fiscal year—more often about the next campaign ad.

The rules themselves are a tangle, but the narrative is simple: if funding lapses under Trump, Democrats can charge he’s neglecting older Americans. If he patches the system, critics say he’s just propping up the last administration’s handiwork. Either way, both sides seem to have a script ready.

Yet, health care policy is rarely free of surprises. Over at the Government Accountability Office, investigators recently played their own part in this drama—quietly sending “phantom” applicants through the Affordable Care Act’s insurance system over the past two years. The results are almost comic, if not so costly: one Social Security number, the GAO found, managed to rack up coverage for more than 71 years—over a century’s worth if you count it across 125 insurance policies. Then there’s the 58,000 cases where the insurance holder had passed away long before the policy kicked in. It defies belief, but the watchdogs insist the loopholes are real and the financial toll, in the billions, could land squarely on taxpayers.

Lawmakers lost little time capitalizing on the news. “This is the smoking gun,” thundered Jason Smith, a Republican from Missouri. “Democrat policies have left taxpayers on the hook for waste and fraud—health care costs keep rising for everyone else.” It's a familiar song, but one sung a little louder in an election year.

Democrats, for their part, aren’t in flawless harmony either. Rep. Sam Liccardo of California, on CBS’s “The Takeout,” openly questioned his party’s calculus, pointing out the political convenience of a three-year extension on ACA subsidies. “Three years—it’s just long enough to make sure it expires during the next presidential race,” he remarked, almost chuckling at the machinations. His proposal, along with Rep. Kevin Kiley’s, to shorten the extension by a year, stands as an olive branch for bipartisan compromise—though such gestures seldom bear fruit in this climate.

This back-and-forth—between cost and care, urgency and delay, party and principle—feels endless. Behind the numbers and strategies, millions of families just want the reassurance that their loved ones won’t be left scrambling for medicine or a bed. With November’s contest looming, the only constant in this complicated stage play is uncertainty. Whatever reforms or reversals come next, one hopes ordinary Americans won’t have to pay the price for Washington’s endless game of political chess.

Once in a while, behind the pristine reception desks of America’s nursing homes, you’ll hear stories that sound less like policy debates and more like family emergencies. These are the voices at the center of Washington’s latest battle over health care funding—voices that may soon be left out if specialized long-term care pharmacies can’t weather looming federal rule changes.For years, these niche pharmacies have quietly kept the country’s most vulnerable—elderly residents in nursing homes—supplied with vital medications. Now, pharmacist managers and patient advocates warn that a tweak to Medicare rules, set in motion by President Biden’s Inflation Reduction Act, could shut their doors come January. The Senior Care Pharmacy Coalition (SCPC) paints a stark picture: “If something doesn’t change, there won’t be anyone left to fill prescriptions for entire facilities,” one coalition member tells me, sounding exhausted. The chain reaction, SCPC claims, could force some nursing homes to wind down altogether.There’s more than just hand-wringing here. Economists at SCPC argue that if closures push seniors into hospital beds or pricier institutional care, taxpayers could be facing billions in extra Medicare costs over the next decade—possibly as much as $4.8 billion. Meanwhile, the cost of simply keeping these pharmacies afloat would be a fraction of that sum. You might expect a quick fix, but in Congress, nothing’s ever straightforward or timely.Finger-pointing is already in full swing. Some in former President Trump’s camp allege the Biden administration “left trap doors” in policy—seemingly to draw their opponents into unwinnable political terrain. “They set up a mess, hoping we’d stumble in the thick of an election,” confides one adviser, only half-joking. In this town, it's rarely about the next fiscal year—more often about the next campaign ad.The rules themselves are a tangle, but the narrative is simple: if funding lapses under Trump, Democrats can charge he’s neglecting older Americans. If he patches the system, critics say he’s just propping up the last administration’s handiwork. Either way, both sides seem to have a script ready.Yet, health care policy is rarely free of surprises. Over at the Government Accountability Office, investigators recently played their own part in this drama—quietly sending “phantom” applicants through the Affordable Care Act’s insurance system over the past two years. The results are almost comic, if not so costly: one Social Security number, the GAO found, managed to rack up coverage for more than 71 years—over a century’s worth if you count it across 125 insurance policies. Then there’s the 58,000 cases where the insurance holder had passed away long before the policy kicked in. It defies belief, but the watchdogs insist the loopholes are real and the financial toll, in the billions, could land squarely on taxpayers.Lawmakers lost little time capitalizing on the news. “This is the smoking gun,” thundered Jason Smith, a Republican from Missouri. “Democrat policies have left taxpayers on the hook for waste and fraud—health care costs keep rising for everyone else.” It's a familiar song, but one sung a little louder in an election year.Democrats, for their part, aren’t in flawless harmony either. Rep. Sam Liccardo of California, on CBS’s “The Takeout,” openly questioned his party’s calculus, pointing out the political convenience of a three-year extension on ACA subsidies. “Three years—it’s just long enough to make sure it expires during the next presidential race,” he remarked, almost chuckling at the machinations. His proposal, along with Rep. Kevin Kiley’s, to shorten the extension by a year, stands as an olive branch for bipartisan compromise—though such gestures seldom bear fruit in this climate.This back-and-forth—between cost and care, urgency and delay, party and principle—feels endless. Behind the numbers and strategies, millions of families just want the reassurance that their loved ones won’t be left scrambling for medicine or a bed. With November’s contest looming, the only constant in this complicated stage play is uncertainty. Whatever reforms or reversals come next, one hopes ordinary Americans won’t have to pay the price for Washington’s endless game of political chess.