Medicare Part A exhausted 12 years sooner: The Hospital Insurance Trust Fund that pays for Medicare Part A (hospital care, skilled nursing, hospice) is now expected to be depleted by 2040 instead of 2052 — triggering automatic benefit cuts starting at 8% in 2040 and climbing to 10% by 2056.

Social Security crisis hits in 2032: The Social Security trust fund will run out by October 2031 (fiscal year 2032), and without Congressional action, a typical couple turning 60 today would face an $18,400 annual cut to their retirement benefits when the fund runs dry.

Tax cuts are the culprit: Trump's "One Big Beautiful Bill" significantly reduced revenue to these trust funds by lowering tax rates and creating temporary deductions for those 65+ — while politically popular, these tax cuts "starved the safety net of critical future funding" and accelerated the path to insolvency.

Forced plan changes skyrocket: The rate of forced disenrollments where Medicare Advantage beneficiaries had to find a new plan jumped from just 1% (2018-2024 average) to nearly 7% in 2025 and 10% in 2026 — meaning millions of enrollees must switch to another MA plan or traditional Medicare, potentially limiting access to providers and benefits.

Rural areas hit hardest: In 12 states, more than 20% of MA enrollees were forced to switch plans, including 92% of beneficiaries in Vermont and over 40% in Idaho, North Dakota, South Dakota, and Wyoming — those affected are more likely to be in smaller carrier plans, lower star-rated plans, and rural areas.

Why insurers are leaving: Medicare Advantage insurers are exiting markets due to falling profits, increased medical spending, and unfavorable regulatory changes — for example, UnitedHealthcare, the nation's largest MA insurer, saw enrollment drop 9% from October to February (from 10.3 million to 9.4 million enrollees).

Benefits favor the wealthy: The current system sends only 7% of benefits to the poorest 20% of seniors while the richest 20% receive 29% — yet despite paying out $1.6 trillion last year, around 6% of seniors still live in poverty, showing the system is inefficient.

A flat benefit could solve everything: If everyone over 65 received a flat annual benefit worth 150% of the poverty line (about $32,500 for a couple), the program would no longer be insolvent AND senior poverty would be eliminated — high earners currently get benefits 2-4 times higher than in countries like Britain and Canada.

Cutting high earners' benefits could grow the economy: The CBO found that reducing benefits across the board would make people work, save, and invest more, growing the economy by 5% in the long run — the author suggests cutting benefits for high earners while protecting or raising them for low earners, plus increasing the retirement age given that life expectancy has risen from 62 to 79 since 1935.