Tariffs Are About to Hit Lifesaving Medical Equipment

For millions of disabled people, essential health devices known as durable medical equipment, or DME—think of CPAP machines or in-home dialysis equipment—help them both remain at home and stay alive. Donald Trump’s recent wave of tariffs, extremely broad in both the imports and countries they target, are still at a new 10 percent baseline in many cases—but they’re likely to raise the costs of medical devices, putting people’s ability to afford it (and providers’ ability to supply it) in jeopardy. That’s especially true for people who are low-income, including disabled people on Medicaid, or on fixed incomes, like many retirees on Medicare.

DME can include oxygen equipment, suction pumps, some diabetes supplies, and mobility devices like wheelchairs—all indispensable to the day-to-day lives of people who use them. Although states are compelled to cover such devices through Medicaid, they have flexibility in how far that coverage extends: like how often equipment will be replaced, how many items will be sent during a given time period, and how much the co-pay.

That’s particularly true of Medicare, which isn’t required to cover as many of the costs associated with letting disabled people remain in their homes. If tariffs drive up the cost of a piece of home medical gear, and if states don’t agree to quickly negotiate, people under Medicaid could be sent fewer supplies in a period, or may face greater co-pays. For Medicaid users, even a cost increase that an insurer or provider would treat as marginal—say, around $50 more per month for medical equipment—can be devastating.

Research from data analytics and consulting firm GlobalData found that around 75 percent of US-marketed medical devices are, at least in part, manufactured abroad. It also found that respiratory devices—one of the most common medical device imports, and very much not optional for those who rely on them—are likely to be one of the more seriously impacted products. Unlike with some consumer products, says Andrew Thompson, a director on GlobalData’s medical devices team, “the demand doesn’t go away” for medical devices.

Given that China is a major supplier of medical devices and is the target of massive US tariffs in Trump’s escalating trade war with the country, Thompson said firms may be incentivized to look at even cheaper factories in other countries. “The FDA inspects and approves the factories where these devices are made, in the US and overseas,” he said. If a company switches from China to Vietnam, Thompson says, “you have to go for the approvals again”—and due to thousands of layoffs at the FDA, that process is likely to take even longer.

The US instituting a 10 percent tariff should not, on its own, be a major problem when it comes to supply chains and costs, Thompson told me; the United Kingdom does the same. What causes issues, he says, is the “moment of uncertainty.”

To anticipate the potential impact of further tariff-driven caps to DME, Harvard University assistant professor of health policy and management Ari Ne’eman looks to the past.

“Some state Medicaid agencies in the 1990s put in place a prescription drug cap that really limited the extent to which people with disabilities enrolled in Medicaid could access prescription medications,” Ne’eman says. “One of the things we saw come out of that was people were forced into nursing homes in order to be able to bypass the prescription drug cap and get the medication they needed.”

Around a quarterof American adults with diabetes below the age of 65 are on Medicaid. Outside of medicine like insulin, durable medical equipment that people with diabetes need includes blood glucose meters, test strips, syringes and continuous glucose monitors.

Washington state chapter #Insulin4All organizer Kevin Wren is worried about having to ration continuous glucose monitors; he also sources his insulin pumps from China, where exporters are still coming to grips with a wide variety of tariffs that can stack in unpredictable ways.

“If you ration this thing [CGM] at the top, then you’re really making it much harder to manage an already difficult disease,” Wren said, who is on Medicaid; he has already been without his CGM sensors for some stretches because he had been through three in less than a month.

The tariff saga and its impact on disabled people cannot be separated from the administration’s brutal cuts to Medicaid, said Allie Gardner, a senior policy analyst at the Center on Budget and Policy Priorities. Both houses of Congress passed a budget reconciliation bill in April that will result in up to $880 billion in cuts to Medicaid over the next decade. According to a KFF brief, these cuts “would represent 29 percent of state-financed Medicaid spending per resident.”

“All of that is likely going to have put pressure on states to make difficult decisions about reassessing eligibility benefits and reimbursement rates, all of which would directly affect people’s coverage and access to care,” Gardner said.

In addition, Ne’eman says, “anytime you’re taking hundreds of billions of dollars away from Medicaid, disabled people will be impacted.”

If states are prioritizing keeping their eligibility levels the same, Gardner says, “they could increase out-of-pocket costs”—a reality that is already on the table for DME in some states, if tariffs raise the cost of medical devices.

If people do die as a consequence of tariff-driven cost increases and supply issues with medical equipment, then their deaths, Wren is concerned, will be written off as expected.

“The full impact won’t be captured,” Wren said. “It’s really the most vulnerable of the most vulnerable Medicaid patients who need technologies to live.”