Quantifying the Mortality and Morbidity Impact of Medicaid Retractions

Recent U.S. legislative proposals include sweeping Medicaid retractions and the expiration of enhanced ACA Premium Tax Credits, threatening health insurance coverage for millions of Americans. Using a validated simulation model, we estimate that 7.7 million individuals becoming uninsured due to the proposed Medicaid changes would lead to a median of 11,308 excess deaths annually. When combined with the 5 million projected to lose coverage due to ACA policy expirations, over 20,000 additional deaths may occur each year. In addition to mortality, coverage loss is projected to result in substantial increases in uncontrolled chronic conditions, including 138,851 additional cases of uncontrolled diabetes, 165,165 cases of uncontrolled hypertension, and 46,200 cases of uncontrolled high cholesterol annually. These projections underscore the wide-reaching public health consequences of limiting access to healthcare.