Yale scientists warn Medicaid cuts could cause 51,000 preventable deaths – Yale Daily News

Report on Projected Health Policy Impacts and Sustainable Development Goals

Introduction

A recent letter authored by researchers from Yale University and the University of Pennsylvania highlights the significant human toll associated with proposed health policy changes in the United States. This scientific communication quantifies the potential increase in mortality linked to provisions in the House-passed budget reconciliation bill, emphasizing the critical intersection with Sustainable Development Goals (SDGs), particularly SDG 3: Good Health and Well-being.

Key Findings of the Yale and University of Pennsylvania Letter

1. More than 51,000 preventable deaths could occur annually if the proposed budget reconciliation bill provisions are enacted.
2. The letter was addressed to Senators Ron Wyden and Bernie Sanders and focuses on the consequences of cuts to Medicaid and Affordable Care Act (ACA) coverage as well as the rollback of nursing home staffing regulations.
3. The analysis utilized Congressional Budget Office projections to estimate the mortality impact of reduced health insurance coverage.

Focus Areas of the Analysis

• Disenrollment of approximately 7.7 million individuals from Medicaid or ACA Marketplace plans.
• Loss of Medicaid coverage for 1.38 million dual-eligible Medicare beneficiaries.
• Repeal of minimum staffing requirements in nursing homes, affecting care quality and safety.

Scientific and Policy Implications

The researchers, including Yale School of Public Health experts Alison Galvani, Abhishek Pandey, and Yang Ye, emphasize the importance of understanding policy decisions’ effects on mortality rates. Their conservative estimates suggest that the actual impact could be even greater, highlighting the urgency for informed policymaking aligned with SDG 3 targets.

Supporting Research and Evidence

• A related medRxiv study titled “Quantifying the Mortality and Morbidity Impact of Medicaid Retractions” projects over 20,000 additional deaths annually due to Medicaid cuts alone.
• When combined with ACA coverage losses and nursing home staffing rollbacks, preventable deaths exceed 51,000 per year.
• The study forecasts over 138,000 cases of worsening chronic illnesses, underscoring the broader health deterioration risks.

Expert Commentary

Dr. Howard Forman, a Yale physician and health policy expert, supports the validity of the mortality projections, citing robust evidence that health insurance coverage significantly reduces mortality rates. This aligns with SDG 3’s objective to ensure healthy lives and promote well-being for all ages.

Contextualizing the Findings within Sustainable Development Goals

• SDG 3: Good Health and Well-being – The projected increase in preventable deaths and chronic illness cases directly challenges the goal of reducing mortality from non-communicable diseases and achieving universal health coverage.
• SDG 10: Reduced Inequalities – Cuts to Medicaid and ACA disproportionately affect vulnerable populations, exacerbating health disparities.
• SDG 1: No Poverty – Loss of health coverage can increase financial hardship due to medical expenses, undermining efforts to eradicate poverty.

Legislative and Public Response

1. Senator Bernie Sanders condemned the bill as a “death sentence for struggling Americans,” highlighting the trade-off between essential health protections and tax benefits for the wealthy.
2. The Congressional Budget Office projects an increase of at least 13.7 million uninsured Americans by 2034 if the bill is enacted.
3. President Donald Trump has expressed a desire for Senate passage of the bill by July 4, intensifying the urgency of the debate.

Conclusion

The Yale and University of Pennsylvania letter provides a critical scientific assessment of the human health consequences of proposed legislative changes, emphasizing the need for policy decisions that support the Sustainable Development Goals. Ensuring access to health coverage and maintaining care standards are essential to achieving SDG 3 and related goals, thereby safeguarding public health and reducing preventable mortality.

1. Sustainable Development Goals (SDGs) Addressed or Connected

1. SDG 3: Good Health and Well-being
   • The article focuses on health policy changes, access to healthcare, mortality rates, and preventable deaths, which are central to SDG 3.
2. SDG 10: Reduced Inequalities
   • The discussion of Medicaid and Affordable Care Act coverage cuts highlights issues of inequality in healthcare access, affecting vulnerable populations such as low-income seniors and dual-eligible Medicare beneficiaries.
3. SDG 16: Peace, Justice and Strong Institutions
   • The article references legislative processes, policy decisions, and the role of scientific evidence in policymaking, which relate to effective, accountable institutions.

2. Specific Targets Under Those SDGs Identified

1. SDG 3: Good Health and Well-being
   • Target 3.8: Achieve universal health coverage, including financial risk protection and access to quality essential health-care services.
   • Target 3.4: Reduce by one third premature mortality from non-communicable diseases through prevention and treatment.
   • Target 3.c: Substantially increase health financing and recruitment, development, training, and retention of the health workforce.
2. SDG 10: Reduced Inequalities
   • Target 10.2: Empower and promote the social, economic and political inclusion of all, irrespective of age, sex, disability, race, ethnicity, origin, or economic or other status.
3. SDG 16: Peace, Justice and Strong Institutions
   • Target 16.6: Develop effective, accountable and transparent institutions at all levels.

3. Indicators Mentioned or Implied to Measure Progress

1. Mortality Rates
   • The article quantifies the projected number of preventable deaths (over 51,000 annually) linked to policy changes, which can serve as an indicator for health outcomes and effectiveness of healthcare coverage.
2. Health Insurance Coverage
   • Number of people disenrolled from Medicaid or Affordable Care Act Marketplace plans (7.7 million), and increase in uninsured Americans (projected 13.7 million by 2034) are indicators of access to healthcare coverage.
3. Health Workforce Standards
   • Reversal of nursing home staffing regulations implies an indicator related to healthcare workforce adequacy, linked to quality of care and patient safety.
4. Chronic Illness Morbidity
   • Projected cases of worsening chronic illness (more than 138,000) serve as an indicator of health deterioration linked to policy changes.

4. Table of SDGs, Targets, and Indicators

Source: yaledailynews.com