by A recent study published in the Proceedings of the National Academy of Sciences by researchers at Yale School of Public Health (YSPH) reveals that proposed modifications to the United States’ Medicare and Medicaid programs could lead to thousands of additional deaths annually.
The study comes as lawmakers consider various cost-saving measures, such as raising the Medicare eligibility age and implementing work requirements for Medicaid coverage. While neither of these proposals has been adopted, changes to Medicaid enrollment have already begun.
The expiration of a provision that required states to maintain existing Medicaid recipients during the COVID-19 pandemic has resulted in many individuals losing coverage. Alison Galvani, the Burnett and Stender Families Professor of Epidemiology (Microbial Diseases) at YSPH and senior author of the study, warns that these changes will increase the number of uninsured people in the U.S., leading to significant consequences for individual and public health.
Without health insurance, people might delay or forgo necessary medical care or ration prescription medications. This can worsen health conditions and ultimately result in more costly treatments. In the case of infectious diseases, forgoing care can also lead to transmission to others.
Medicare is a federal health insurance program for individuals aged 65 and older, while Medicaid provides coverage for individuals with limited income. Together, these programs covered over 160 million people in 2023.
To assess the impact of raising the Medicare eligibility age, the researchers calculated the potential increase in uninsurance rates and estimated that 9,646 additional lives would be lost each year. The Congressional Budget Office has evaluated different strategies for gradually increasing the eligibility age, reporting that these approaches could result in an additional 17,244 or 25,847 deaths during the transition.
Galvani emphasizes that the elderly, who are most in need of health care, will be disproportionately affected by any delay in receiving care at age 65. The proposed work requirement for Medicaid recipients, meanwhile, would lead to an additional 613 deaths per year among U.S. adults.
Further, the study found that the ending of continuous Medicaid enrollment in 2023 could result in 7,900 additional deaths each year.
The loss of health insurance would also have far-reaching consequences beyond the risk of death, particularly for individuals with chronic illnesses like diabetes and heart disease. The researchers specifically evaluated the impact of proposed policy changes on people with diabetes and found that 456,966 individuals under the age of 65 and 325,613 seniors could lose access to care. Many of these individuals would also depend on insulin, and losing health insurance would exacerbate the problem of insulin affordability in the U.S.
Galvani emphasizes that these changes would not only affect individuals but also shift costs from the federal government to state governments and employers. She encourages policymakers to consider evidence-based solutions, such as a single-payer universal health care model, which could save more than 68,000 lives and $450 billion annually.
In light of these findings, Galvani and her colleagues urge policymakers to carefully consider the potential consequences of proposed changes to Medicare and Medicaid and to explore alternative health care models.
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1. Source: Coherent Market Insights, Public sources, Desk research
2. We have leveraged AI tools to mine information and compile it.
