YuLin Zhen, Photography Editor

More than 51,000 preventable deaths could occur annually if provisions in the House-passed budget reconciliation bill are enacted, according to a June 3 letter signed by Yale and University of Pennsylvania scientists. 

The letter, sent to Sens. Ron Wyden and Bernie Sanders, estimates the potential death toll that would arise due to provisions in the budget bill that would cut access to Medicaid and Affordable Care Act coverage and roll back nursing home staffing regulations. 

The authors, including Yale School of Public Health researchers Alison Galvani, Abhishek Pandey and Yang Ye, used recent projections from the Congressional Budget Office to estimate how depleted access to health insurance coverage would translate into lives lost. 

Their analysis focused on three key provisions: the projected disenrollment of 7.7 million people from Medicaid or Affordable Care Act Marketplace plans, the loss of Medicaid coverage for 1.38 million dual-eligible Medicare beneficiaries and the repeal of a rule that set minimum staffing requirements in nursing homes. 

“We believe it is crucial for policymakers and the public to understand the ramifications of policy decisions on mortality rates,” Galvani told the News. “Our letter was in response to requests for technical assistance from congressional committees interested in objective, science-based projections.” 

She emphasized that the estimate of over 51,000 deaths is likely a conservative one, pointing out that several aspects of the analysis are restrained. She also told the News that lawmakers had already responded with interest and that the research is currently being used in legislative discussion. 

The estimates in the letter are backed by a related medRxiv study titled “Quantifying the Mortality and Morbidity Impact of Medicaid Retractions,” co-authored by the same Yale researchers. The study projects that Medicaid cuts alone could result in over 20,000 additional deaths per year — and that number climbs above 51,000 when Affordable Care Act coverage losses and the repeal of nursing home staffing requirements are considered. The study also forecasts a sharp rise in preventable health deterioration, including more than 138,000 cases of worsening chronic illness.

Dr. Howard Forman, a Yale physician and health policy expert, said the mortality projections in the letter are grounded in sound modeling practices. He noted that while the results depend heavily on assumptions and data inputs, the scenario is well supported by existing evidence that justifies the researchers’ concerns. 

“There is such strong evidence that health insurance saves lives,” Forman wrote in an email to the News. “The effect is modest to moderate, but meaningful — and well documented across numerous studies.” 

Forman added that the estimate of over 51,000 preventable deaths annually does not strike him as exaggerated. 

The letter arrives amid ongoing debate over Medicaid funding and eligibility, with both lawmakers and health experts weighing the consequences of shifting federal support. 

Congressional Budget Office estimates released in May project that these policy changes would collectively increase the number of uninsured Americans by at least 13.7 million in 2034. Although the budget office did not assess mortality impacts model mortality, the Yale and Penn scientists aimed to fill that gap by translating coverage losses into human consequences.

Sanders, the ranking member of the Senate Health, Education, Labor and Pensions Committee, issued a sharp response to the June 3 letter from Yale and University of Pennsylvania researchers. Sanders described the bill as a “death sentence for struggling Americans,” criticizing its tradeoff of essential health care protections for tax breaks benefiting the wealthy. 

“If this bill becomes law, more than 51,000 Americans will die unnecessarily each and every year,” Sanders said. Citing the budget office’s estimate that 13.7 million Americans could lose health coverage, he warned that legislation would also raise prescription drug costs for low-income seniors and weaken nursing home safety standards. “Not only will some of the most vulnerable people throughout our country suffer, but tens of thousands will die,” he added. “We cannot allow that to happen.” 

President Donald Trump has indicated that he wants the Senate to pass the budget bill by July 4.