Under the leadership of Mehmet Oz, the Centers for Medicare & Medicaid Services, or CMS, is seeking to heavily restrict traditional Medicare enrollees’ use of remote monitoring devices for their health conditions. A proposed rule would eliminate coverage for these services unless the service is provided at a physician’s office. This rule would particularly hurt enrollees who have difficulty traveling to in-person appointments, such as rural seniors. And it would undercut a key Republican effort to alleviate the harms of last year’s “big, beautiful bill.”

Remote monitoring programs allow patients to collect their health data themselves (such as taking their own blood pressure, oxygen levels or blood sugar) and transmit the data to healthcare providers, who can use the information to help manage the patient’s health. These programs aren’t just convenient; they make it easier to proactively manage chronic diseases before there is an emergency. Patients and providers don’t have to rely on a single data point at a scheduled appointment or waiting until the condition worsens.

Consequently, reliance on remote monitoring has expanded in recent years. Almost 1 million Medicare enrollees received it in 2024 alone. Remote monitoring has proved particularly valuable to those who have chronic medical conditions but face obstacles to in-person appointments. For instance, residents in rural communities and areas with shortages of health professionals don’t need to travel long distances for appointments as frequently. Transportation is a critical social determinant of health, and if one has poor vision or limited mobility, in-person appointments are especially challenging.

To justify the new restrictions, the CMS cites a 2025 report by the Department of Health and Human Services’ inspector general. Those findings raised concerns about suspicious billing practices and patients not receiving treatment. But the report called for a measured approach: closer monitoring of billing while preserving Medicare enrollees’ ability to benefit from this program. CMS would go much further: Because most medical practices lack the bandwidth to launch and oversee their own remote monitoring programs, requiring the service to be provided by someone at a physician’s office practically eliminates the benefit. In short, where the HHS inspector general suggested a scalpel, CMS would use a hammer.

Already, a bipartisan group of House members is calling on Oz to reconsider the rule, but it fits within a broader context of the Trump administration’s quiet campaign to curtail Medicare’s effectiveness.

Much of the attention on H.R. 1 — what Trump called the “big, beautiful bill” — focused on its draconian cuts to Medicaid, but the law also triggered an automatic $500 billion cut from Medicare between 2026 and 2034. The law also delayed until late 2034 the implementation of finalized rules that would help very low-income Medicare enrollees access programs to help cover premiums and cost-sharing of benefits.

Since then, CMS has allowed a subsidy program for Medicare Part D prescription-drug costs to expire. And it introduced a pilot program in six states that uses artificial intelligence to review the medical necessity of prescribed care. The practice, also known as prior authorization, previously was rarely used in traditional Medicare. The pilot program has already resulted in significant delays in care.

The new CMS proposal, however, is particularly curious in light of how the “big, beautiful bill” came to be. To stanch the proverbial bleeding that rural communities are projected to face from the bill’s cuts, Republicans created a $50 billion fund for rural healthcare. Technological innovation was a central pillar of this effort, known as the Rural Health Transformation Program.

Restricting remote monitoring does anything but foster innovative technologies. And the effects will be felt in the years to come. The RHTP is a relative pittance compared to H.R. 1’s Medicaid cuts and will do little to prevent closures of rural hospitals or key hospital services. And when a rural hospital closes, the driving time to the next hospital increases by 20 to 40 miles on average, regardless of whether one is on Medicaid or Medicare — which makes the ability to monitor one’s health at home all the more important.

While remote monitoring programs are imperfect and deserve oversight, they help provide healthcare in typically underserved areas. What’s more, by facilitating earlier detection, these programs can result in better patient outcomes, which are less costly to treat. In other words, remote monitoring is good for patients and for the healthcare system itself.

Along with Social Security, Medicare is considered the “third rail” of American politics. Not only is the program popular, but seniors (roughly 90% of its enrollees) vote at high rates, and younger voters prefer to protect the program for when they age into it. The politics of Medicare retrenchment may ultimately prove to be less visible than the consequences of slashing health programs. Elected officials understand the political costs of reducing Medicare spending.

Yet under Oz’s leadership, CMS is demonstrating how to weaken Medicare through a series of administrative decisions that preserve the appearance of coverage while weakening access to care. Medicare’s greatest vulnerability may not be outright cuts, but rather the quiet erosion of the benefits on which seniors have been counting.