The Trump administration is setting its sights on hospice care, aiming to tighten the reins on a Medicare-funded sector plagued by fraud and uneven quality. As of March 13, 2025, officials are rolling out plans to ramp up scrutiny, a move that could reshape end-of-life services for millions. It’s part of a broader push to slash waste in federal health programs, but insiders warn the fix might bring as many headaches as it solves.
Hospice care, which supports terminally ill patients with comfort rather than cures, has ballooned under Medicare. Spending hit $24 billion in 2024, up from $19 billion five years ago, per CMS data. Enrollment has surged too—1.7 million beneficiaries tapped the benefit last year. But growth has a dark side: Federal watchdogs have flagged widespread abuse, from fake patient rosters to providers pocketing funds for nonexistent care. A 2023 inspector general report found that 20% of audited hospices had serious lapses, like untrained staff or missing visits.
Enter Trump’s fix. The administration wants stricter eligibility checks and more frequent audits, leaning on the Department of Government Efficiency (DOGE) to execute. “We’re draining the swamp in healthcare too,” a senior official told Axios, echoing Trump’s cost-cutting mantra. The goal? Weed out bad actors and save billions. Hospice trade groups, though, are crying foul. They argue legit providers—especially small, rural ones—could get crushed by red tape. “Compliance costs will skyrocket,” says Ellen Carter of the National Hospice Alliance. “Some might shut down.”
Patients could feel the squeeze too. Tighter rules might delay access for those nearing life’s end, a prospect that worries advocates. “Hospice is about dignity,” says Dr. Maria Lopez, a palliative care expert. “If oversight slows that down, it’s a loss.” On the flip side, supporters say curbing fraud protects vulnerable seniors from neglectful or predatory firms.
The plan’s still taking shape—no formal regulations yet—but it’s already stirring debate. Medicare’s hospice benefit, launched in 1983, was never built for today’s scale or scrutiny. Trump’s team sees a chance to modernize; critics see a sledgehammer where a scalpel might do. Either way, the stakes are high for a program touching nearly half of all U.S. deaths.