Medicare for All could save 100,000 American lives & cost $1 trillion less a year

A single-payer universal health care system could cover every American, save more than 100,000 lives a year, and still cost $1 trillion less than the system it would replace, according to a new preprint study led by researchers at the Yale School of Public Health (YSPH).

For the study, which has not yet been peer-reviewed, the researchers modeled what would happen if the United States adopted a national public insurance program like the one proposed in the Medicare for All Act.

Using 2024 spending, insurance coverage, and mortality data, they estimate that the universal coverage would reduce annual health expenditures by $1.04 trillion, or nearly 20% — even after accounting for the additional care that uninsured and underinsured people would receive.

“Healthcare costs have been rising faster than inflation, and a staggering share of that spending is consumed by administrative middlemen, soaring drug prices, and emergency care for conditions that should have been treated earlier and for less,” said senior author Alison Galvani, the Burnett and Stender Families Professor of Epidemiology at YSPH and the director of the Yale Center for Infectious Disease Modeling and Analysis. “Medicare for All strips out those sources of waste while providing everyone with healthcare, saving over a trillion dollars and 114,000 lives every year.”

Healthcare costs have been rising faster than inflation, and a staggering share of that spending is consumed by administrative middlemen, soaring drug prices, and emergency care for conditions that should have been treated earlier and for less.

Professor Alison Galvani, PhD

The researchers say Medicare for All would take the existing single-payer insurance program—currently covering Americans 65 and older—and extend it to everyone.

It’s a favorite policy among the political left, and Senator Bernie Sanders of Vermont, a strong advocate for universal health care, has already highlighted the study.

In a statement, Sanders, who has introduced numerous Medicare for All bills during his tenure, said the study “confirms what we have known for years: Medicare for All saves lives and saves money.”

“At a time when 15 million Americans are being thrown off the healthcare they have and 20 million Americans have already seen their premiums double, on average, as a result of Trump’s so-called ‘Big Beautiful Bill,’ we need Medicare for All now more than ever,” said Sanders. “The time is now to end the greed of the big insurance and drug companies and pass Medicare for All.”

“President Trump and the Republicans in Congress created a health care crisis and stuck Americans with the bill,” said New Jersey anti-establishment Democrat Lisa McCormick. “Premiums are skyrocketing after they passed the largest cut to Medicaid in history and took away Affordable Care Act (ACA) tax credits from working families to give tax breaks to billionaires and big corporations.”

McCormick said, with each passing day, more working families are paying more, losing coverage, and struggling to access lifesaving care — and it’s only going to get worse, even for families with employer-based insurance.

“New reports show that health care costs are projected to rise by double digits again in 2027 for employer health plans and ACA plans alike, which nearly 200 million people across the country rely on to access health care,” said McCormick. “For families stretched past the breaking point, a routine checkup or the flu could mean choosing between medicine and rent.”

“When millions lose coverage and turn to costly emergency room care, the burden of uncompensated treatment surges—driving up costs for everyone,” said McCormick. “Families who forego a routine checkup or a bout with the flu could become much worse, but that’s the choice Republicans are forcing families to make, and hard-working Americans are sick of it.”

The Yale model identified five main ways to save money: getting lower drug prices, paying providers at Medicare rates, cutting down on administrative costs, reducing fraudulent billing, and avoiding unnecessary ER visits and hospital stays.

Even with more cautious estimates on drug prices and fraud reduction, researchers predicted savings of at least $663 billion annually. These projections also factor in about $304 billion in extra spending to address unmet medical needs, cover unpaid care, and offer universal dental coverage.

The researchers project that a universal healthcare policy would also save tens of thousands of lives. They estimate that adequate coverage for all could avert about 62,863 deaths annually — and that nearly half, or 29,631, would be among people who are already covered by insurance that is inadequate.

These are the underinsured: the more than 45 million working-age adults whose deductibles and cost-sharing put care beyond financial reach anyway. Reversing coverage rollbacks and other health policies enacted since 2025 would avert a further 51,311 deaths each year, the researchers project, bringing the annual total to 114,174.

The study builds on findings Galvani, co-author Meagan Fitzpatrick, and other colleagues published in The Lancet in 2020, which projected that universal health care would save $450 billion and more than 68,000 lives annually. The larger estimates in the new study reflect ballooning health expenditures, a widening gap between commercial and Medicare payment rates, and new estimates on recent policy changes and the underinsured.

The authors caution that direct estimates of excess mortality among underinsured adults are unavailable, requiring them to model that risk. Their spending analysis also does not account for transition costs, administrative job losses, or how providers might respond to Medicare payment rates.

A system that covers everyone, costs $1 trillion less, and averts more than 100,000 deaths annually requires no new discovery to implement, only enactment.

Even with those limitations, the researchers argue that the United States already spends enough to provide universal coverage. The problem, they conclude, is how that money is allocated.

Although health care expenditure per capita is higher in the United States than in any other country, more than 37 million Americans do not have health insurance, and 41 million more have policies that provide inadequate access to care.

“A system that covers everyone, costs $1 trillion less, and averts more than 100,000 deaths annually requires no new discovery to implement, only enactment,” they wrote.

The study’s other authors are Abhishek Pandey, senior research scientist in epidemiology (microbial diseases); Chad Wells, postdoctoral research associate; and Yang Ye, associate research scientist in epidemiology (microbial diseases), at YSPH.