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Cutting Back Medicare & Medicaid Would Kill Tens of Thousands

Analysis by a team based at Yale University finds that proposals to delay Medicare eligibility, undo COVID Medicaid growth, and impose work requirements on Medicaid would result in an estimated 25,000 – 33,000 additional deaths in coming years, as well as increasing morbidity for hundreds of thousands.

May 1, 2024

Study: Proposed changes to Medicare, Medicaid could cost thousands of lives
Yale News
April 22, 2024
By Mallory Locklear

Proposed changes to the United States’ Medicare and Medicaid programs could lead to thousands of additional deaths each year, a new Yale study reveals.

Recent proposals to reduce program costs include a recommendation to raise the eligibility age for Medicare from 65 to 67 – put forward by a 2022 report from the House of Representatives’ Republican Study Committee – and a proposed work requirement for Medicaid coverage – a recurring Congressional consideration during federal budget negotiations.

While neither of those have yet been adopted, one major change to Medicaid is already underway: A provision authorized at the start of the COVID-19 pandemic that required states to keep existing Medicaid recipients enrolled in the program expired last year. Since then, states have begun disenrolling Medicaid recipients who no longer qualify or are unable to complete the renewal process.

Such changes will drive up the number of uninsured people in the U.S., said Alison Galvani, the Burnett and Stender Families Professor of Epidemiology (Microbial Diseases) at Yale School of Public Health(YSPH) and senior author of the study. The study was published April 22 in the Proceedings of the National Academy of Sciences.

The Congressional Budget Office has assessed two strategies for raising the eligibility age over time – by two months or three months each year until the eligibility age reaches 67. According to the new study, the approaches would result in an additional 17,244 deaths or 25,847 deaths respectively during the transition.

A separate proposal to institute work requirements for Medicaid recipients, meanwhile, would lead to an additional 613 deaths per year among U.S. adults, the researchers report. Further, the ending of continuous Medicaid enrollment in 2023 could lead to 7,900 additional deaths each year.

They found 456,966 people with diabetes under the age of 65 could lose access to health care following the end of continuous Medicaid enrollment, and 325,613 seniors would lose care if the Medicare age were raised.

“Working in the field of public health, it can be frustrating to see policymakers propose strategies that ignore evidence-based solutions capable of saving lives, boosting prosperity, and reducing health care costs,” said Galvani.

In a previous study, Galvani and her colleagues found that a single-payer universal health care model would save more than 68,000 lives and $450 billion annually, while the current proposal to raise Medicare eligibility age would save a maximum of $25.5 billion across five years and cost thousands of lives.

“It’s disheartening to see people in positions of power who have access to all of this information argue that retractions in health care are for the benefit of the country,” she said. “If policymakers want to save lives and costs, our analyses have shown single-payer universal health care is the solution.”


Comment by: Don McCanne

No comment need be appended to these excerpts since Alison Galvani and her team have said it all. Ridiculous proposals that reduce health care and cost lives should be rejected, especially when we know that the single-payer universal health care model, structured properly, would save both lives and money. If only Congress and the President could get on our wavelength.

About the Commentator, Jim Kahn

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Jim (James G.) Kahn, MD, MPH (editor) is an Emeritus Professor of Health Policy, Epidemiology, and Global Health at the University of California, San Francisco. His work focuses on the cost and effectiveness of prevention and treatment interventions in low and middle income countries, and on single payer economics in the U.S. He has studied, advocated, and educated on single payer since the 1994 campaign for Prop 186 in California, including two years as chair of Physicians for a National Health Program California.

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