Medicare and Presidents: Who Has Done the Best?

When it comes to Medicare and Presidents, who really has done the best job? Every election season there seems to be a debate about Medicare and which President has done the best job helping seniors control this cost.

By looking at the annual changes between Medicare's Part B premium and the rate of inflation since Medicare's inception, one may conclude that regardless of who wins the debate, the public is still losing.

The numbers behind the debate

• In Medicare's 58 years, the Part B premium has grown at a rate of 7.80% annually.
• During the same time period, the average annual rate of inflation has been just 4.04%.

Why the Part B premium outpacing inflation matters

Under federal regulations, a retiree's Social Security benefit automatically pays for their Medicare Part B premium. Meanwhile, the annual increase in that Social Security benefit — the cost-of-living adjustment (COLA) — is determined by the rate of inflation for the year.

So if Medicare's Part B premium increases faster than the rate of inflation, seniors will have less and less income from Social Security each year. Ultimately, the public has been losing since inception, as their Social Security benefit loses more and more purchasing power annually. To understand how the premium itself is set each year, see how Medicare premiums are calculated.

Who has done the best job?

The data shows that when it comes to the lowest overall Part B premium growth during a full term in office, President Donald J. Trump is the best on record. In President Trump's 2017–2021 term, the Part B premium grew at an annual rate of just 2.63%.

Which President has the best record for a single year?

President Barack Obama in 2012 holds the title for the largest reduction in the Part B premium on record. The premium dropped by 13.43%, falling to $99.90 a month from $115.40 a month in 2011.

Who has been the worst?

The data shows that when it comes to just how fast the Part B premium grew over one term, the "winner" would be President Ronald Reagan in his second term (1985–1989). During that term the Part B premium went from $15.50 a month in 1985 to $31.90 a month in 1989 — a 20.67% average annual increase.

And the worst one-year performance in terms of the premium inflating faster than the rate of inflation? That belongs to President Obama in 2016. That year the Part B premium grew roughly 20 times faster than inflation — the premium rose 16.11% while inflation was only 0.80%.

Below is the breakdown of each U.S. President and the difference between Medicare's Part B premium and the rate of inflation, starting with the program's creation.

Medicare and President Johnson (D), 1967–1969

During President Johnson's term in office the Medicare program was established, but it was not made available to the public until 1967. Congress passed the Medicare Act in 1965; the Part B premium began at $3.00 a month in 1967. The very first increase came in 1968, when the premium rose to $4.00 a month — a 33.33% increase while inflation sat at 3.63%. In 1969 the premium remained at $4.00.

Verdict: the Part B premium grew 4.59 times faster than the rate of inflation during Johnson's last term as President.

Medicare and President Nixon (R), 1969–1973

In President Nixon's first year administering the Medicare program (1970) the Part B premium remained constant, but over the next three years the premium increased annually — including a 32.50% jump in 1971, when the premium grew 6.55 times faster than inflation.

Verdict: the Part B premium on average grew 2.21 times faster than the rate of inflation during Nixon's first term in office.

Medicare and Presidents Nixon / Ford (R), 1973–1977

Challenges existed in President Nixon's second term, and with President Ford stepping in, the Part B premium for the first time didn't increase faster than the rate of inflation — but it did go up. From 1974 through 1976 the premium's growth stayed below inflation, before edging 1.2 times ahead of it in 1977.

Verdict: the Part B premium grew by 5.61% on average annually, but that growth rate was substantially lower than the rate of inflation, which averaged 8.23% annually.

Medicare and President Carter (D), 1977–1981

President Carter's first three years were marred by record inflation, but even with that hurdle his administration — though increasing the Part B premium each year — kept the cost for seniors below the rate of inflation during that time. Only in 1981 did premium growth outpace inflation, by 1.31 times.

Verdict: the Part B premium grew by 7.47% on average annually, substantially lower than the 10.66% average rate of inflation. When it comes to keeping the Part B premium in line with — or even below — the rate of inflation, President Carter ranks #1.

Medicare and President Reagan (R), 1981–1985

Under President Reagan's administration the Part B premium experienced some of the largest percentage increases on record, but when comparing with the rate of inflation, his first term is on par with the majority of other Presidents. The premium grew 1.85 times faster than inflation in 1982, 2.96 times in 1983, 4.93 times in 1984, and 2.66 times in 1985.

Verdict: the Part B premium on average grew 2.66 times faster than the rate of inflation during Reagan's first term in office.

President Reagan (R), 1985–1989

President Reagan's second term in office, from a historical point of view, is absolutely jaw-dropping when considering how seniors took it on the chin with the rising cost of Medicare's Part B premium. After a flat 1986, the premium grew 5.86 times faster than inflation in 1987, 9.32 times faster in 1988, and 6.03 times faster in 1989.

Verdict: the Part B premium on average grew 5.86 times faster than the rate of inflation during Reagan's second term — the fastest premium growth of any presidential term on record.

President Bush Sr. (R), 1989–1993

In President Bush Sr.'s very first year in office he did the unthinkable: the Part B premium decreased, from $31.90 a month in 1989 to $28.60 a month in 1990 — the first reduction in the program's history. The premium stayed below inflation in 1991 as well, before growing 2.09 times faster than inflation in 1992 and 4.93 times faster in 1993.

Verdict: the Part B premium on average grew 0.96 times as fast as the rate of inflation during Bush Sr.'s only term in office — one of the few terms where premium growth trailed prices.

President Clinton (D), 1993–1997

The first two years of President Clinton's administration told the exact same story as past Presidents' handling of the Part B premium — the cost continued to climb, growing more than four times faster than inflation in both 1994 and 1995. BUT, in his third year he followed former President Bush Sr.'s lead and decreased the monthly Part B premium by 7.81%.

Verdict: the Part B premium on average grew 1.80 times faster than the rate of inflation during Clinton's first term. President Clinton became only the second U.S. President to decrease the Part B premium and the first as a Democrat. It would not happen again until President Obama, another Democrat, did it 16 years later in 2012.

President Clinton (D), 1997–2001

The first three years of President Clinton's second term brought a little bit of stability to the Medicare program, as the Part B premium remained relatively flat compared to the previous three decades — flat in 1998 and 2000, with a modest 3.88% increase in 1999. The term closed with a 9.89% increase in 2001, about 3 times the rate of inflation.

Verdict: the Part B premium on average grew 1.39 times faster than the rate of inflation during Clinton's second term in office.

President Bush Jr. (R), 2001–2005

In President Bush Jr.'s first term in office the Part B premium consistently grew at a larger and larger rate each year, all the while the rate of inflation stayed consistently low — the premium grew roughly 4 to 6 times faster than inflation every single year of the term.

Verdict: the Part B premium on average grew 5.13 times faster than the rate of inflation during Bush Jr.'s first term in office.

President Bush Jr. (R), 2005–2009

The second term in office for President Bush Jr. was the exact opposite, as the Part B premium grew slower and slower each year — from a 13.17% increase in 2006 down to a freeze in 2009, with premium growth actually falling below inflation in 2008 and 2009.

Verdict: the Part B premium on average grew 2.06 times faster than the rate of inflation during Bush Jr.'s second term. It is worth noting that 2007, in the middle of this term, is also when IRMAA first took effect — higher-income beneficiaries began paying more than the standard Part B premium shown in these tables.

President Obama (D), 2009–2013

President Obama's first term in office brought extremes. In 2010 the premium grew 9.90 times faster than inflation, but the one great aspect of his time in office is that the monthly Part B premium decreased for the third time in the program's history in 2012 — the greatest decrease in the monthly Part B premium on record.

Verdict: the Part B premium on average grew 1.30 times faster than the rate of inflation during Obama's first term in office.

President Obama (D), 2013–2017

The second term in office for President Obama started off outstanding, as the Part B premium did not move for the first two years — but unfortunately the last two were the complete opposite. In 2016 the Part B premium grew roughly 20 times faster than the rate of inflation (16.11% vs. 0.80%), the largest difference between the premium and inflation on record, followed by another 10.02% increase in 2017.

Verdict: the Part B premium on average grew 5.42 times faster than the rate of inflation during Obama's second term in office.

President Trump (R), 2017–2021

Even with Covid-19 causing a worldwide pandemic, President Trump produced the slowest four-year average rate of growth for the Part B premium on record. The premium was frozen in 2018, rose just 1.12% in 2019, and grew slower than inflation again in 2021 — only 2020's 6.72% increase outpaced prices.

Verdict: the Part B premium on average grew 1.20 times faster than the rate of inflation during Trump's term in office — and its 2.63% average annual growth is the lowest of any full presidential term.

President Biden (D), 2021–2025

Following the lead of President Obama's final year in office, President Biden increased the Part B premium by 14.55% in his first year. This may seem excessive, but when comparing it to the rate of inflation (7.69% in 2022) he was on track — and he followed it up by dropping the monthly premium in 2023, from $170.10 to $164.90.

*When this analysis was originally written in August 2024, the Medicare Board of Trustees was projecting a $185.00 monthly Part B premium for 2025 — a figure CMS later confirmed. The 2024 inflation figure was the average through July 2024. See the final 2025 Medicare premiums for the confirmed numbers.

Verdict: the Part B premium was on pace to grow on average 1.37 times faster than the rate of inflation during Biden's term in office.

Overall, Medicare's Part B premium since 1967 has been growing at a rate of 7.80% annually, while the rate of inflation during the same time has averaged only 4.04%.

This should not be counted as a win for any political party or even any President, because retirees are losing purchasing power with their Social Security benefit every single year the premium outruns inflation. And keep in mind these tables show only the standard premium — since 2007, higher-income retirees have paid even more through IRMAA surcharges, which are layered on top of every premium increase shown above. Understanding how IRMAA is calculated is the first step toward planning around it.

For financial advisors, the lesson in six decades of data is simple: no matter who occupies the White House, Medicare costs should be projected to grow faster than inflation in every retirement income plan. RetirementAdvisorPro helps advisors model healthcare cost inflation, Social Security COLAs, and IRMAA surcharges together, so clients can see the real trajectory of their retirement income instead of an optimistic average.