A newly introduced House bill could significantly expand Medicare by allowing the program to cover food and nutrition services, a shift supporters say could help prevent chronic illness among older Americans and people with disabilities.
If enacted, the bill would require Medicare to cover specified food and nutrition services, with similar changes made to Medicaid.
The proposal, H.R. 8391, was introduced on Monday by Representative Raul Ruiz, a Democrat from California. The law would amend the Social Security Act, which governs Medicare and Medicaid.
Why Lawmakers Want Food and Nutrition Covered by Medicare
Supporters argue that expanding coverage to include food and nutrition services could improve health outcomes and potentially reduce long‑term health care costs by addressing conditions before they worsen.
Historically, poor nutrition has been linked to higher rates of chronic illness, hospitalizations and health care spending.
What Medicare and Medicaid Recipients Should Know About the Bill
H.R. 8391 would add “food and nutrition services” to the list of covered Medicare services under Title XVIII of the Social Security Act.
The bill does not spell out exactly which services would qualify. Instead, it gives Robert F. Kennedy Jr., Secretary of Health and Human Services (HHS), the authority to define what food and nutrition services are covered and what requirements they must meet.
Newsweek reached out to Ruiz’s office for comment.
Under the proposal, Medicare would pay 80 percent of the actual charge for these services, matching the standard Medicare Part B cost‑sharing structure used for many outpatient services.
“I believe that Ruiz, as a physician, understands that an ounce of prevention is worth a pound of cure. Almost 90 percent of healthcare spending is to treat chronic conditions, many of which are considered to be the result of diet and exercise choices,” Drew Powers, founder of Illinois-based Powers Financial Group, told Newsweek. “With this proposal, Ruiz is suggesting food should be our medicine, and therefore covered to some extent under Medicare and Medicaid.”
When the Medicare and Medicaid Changes Could Take Effect
The bill includes an identical operational timeline for both Medicare and Medicaid: The new coverage would apply to services furnished 180 days after the bill is enacted into law, if it advances through Congress and is signed by President Donald Trump.
As with Medicare, the specific services covered under Medicaid would be defined by the HHS secretary, and the same 180‑day implementation timeline would apply.
Who Would Benefit Most If Medicare Coverage Expands
At the moment, Medicare generally does not cover food as a medical benefit, outside of limited circumstances such as tube feeding or inpatient hospital stays. H.R. 8391 would formally recognize food and nutrition services as reimbursable health care services under Medicare for the first time.
Because the bill leaves definitions to the HHS secretary, the scope of the benefit, such as whether it would include medically tailored meals or nutrition counseling tied to chronic illness, would be determined later through regulation rather than in the law itself.
“On the surface, that sounds like increased access and better support. But the devil is still in the details…what qualifies, who gets it, and how it’s actually implemented,” Kevin Thompson, CEO of 9i Capital Group and host of the 9innings podcast, told Newsweek.
“My main concern is the delegating significant authority to the Secretary of Health and Human Services, which may not always align with the desires of the people.”
The legislation would also amend Title XIX of the Social Security Act, making food and nutrition services a mandatory Medicaid benefit. That means states would be required to provide these services as part of their Medicaid programs, rather than offering them as optional benefits.
“For seniors dealing with chronic conditions, access to medical nutrition therapy could be a meaningful win,” Thompson said. “If done correctly, it has the potential to improve long term health outcomes and reduce costs tied to preventable issues. The opportunity is there…execution is what matters.”
The proposal does not specify which food or nutrition services would qualify or set income limits or eligibility rules beyond existing Medicare and Medicaid eligibility.
It’s also unclear how much the expansion would cost.
“Many Americans would more than likely welcome the move, but the question isn’t about popularity but rather if such a proposal could actually pass,” Alex Beene, financial literacy instructor for the University of Tennessee at Martin, told Newsweek. “With concerns over budgets continuing to weigh heavily in future financial decisions, it will be interesting to see if this expansion of Medicaid and Medicare funds is actually given consideration or is shut down.”
How This Fits Into Broader Social Security Changes
Lawmakers in Washington have introduced a wave of proposals aimed at reshaping Social Security, driven by projections that the program’s main trust fund could run short of money within the next decade if Congress does not act.
In the final year of his presidency, President Joe Biden signed the Social Security Fairness Act, which eliminated the Windfall Elimination Provision and the Government Pension Offset. Those rules had lowered benefits for millions of people who worked in jobs not covered by Social Security, such as teachers, firefighters, and police officers, but who also qualified for Social Security through other work.
The repeal applied retroactively to benefits payable beginning in January 2024 and affects an estimated 2.8 million current and future beneficiaries.
“Americans who have worked hard all their life to make an honest living should be able to retire with economic security and dignity,” Biden said during the signing ceremony at the White House.
Beyond that change, there have been several proposals, but nothing signed into law to fix the impending insolvency crisis.
Without congressional action, incoming payroll taxes would be enough to pay only about three‑quarters of scheduled benefits, triggering an automatic cut of roughly 19 to 23 percent for beneficiaries.
Several Democratic‑backed bills, including the Social Security Expansion Act, would require higher earners to pay payroll taxes on income above $250,000, while leaving the cap intact for most workers.
Some policymakers have also floated the idea of placing limits on how much Social Security wealthy retirees can receive. These proposals would cap total annual benefits, often at around $50,000 for individuals or $100,000 for couples.
Is Social Security Really Going Bankrupt?
Social Security is not going bankrupt, but it does face the depletion of its trust fund as early as the start of the 2030s.
Social Security will continue paying benefits even if its trust fund is depleted, because the program is largely funded on a pay‑as‑you‑go basis through payroll taxes from current workers.
However, current projections indicate the Old‑Age and Survivors Insurance trust fund could be depleted as early as 2032, triggering automatic benefit reductions. Under those estimates, incoming revenue would cover roughly three‑quarters of scheduled benefits, absent congressional action.
Congress stepped in in the early 1980s when Social Security faced a similar funding crisis, enacting tax increases and gradual benefit changes that extended the program’s life for decades.
What Happens Next With the Medicare Proposal
H.R. 8391 has been referred to the House Committees on Energy and Commerce and Ways and Means, which have jurisdiction over Medicare and Medicaid policy.
As of now, the bill has one sponsor and no cosponsors, and no hearings or votes have been scheduled.
For the proposal to take effect, it would need to advance through committee review and pass the full House and Senate.
Even if enacted, the practical impact on beneficiaries would depend heavily on how HHS defines “food and nutrition services.”
