A mature man caregiver with stethoscope and older, senior patient looking out through window.
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Raising the age of Medicare eligibility, among other proposed changes to Medicare and Medicaid, could cause more deaths, according to a research article published this week in the Proceedings of the National Academy of Sciences.

One of the ideas to lower program costs is raising Medicare eligibility from age 65 to 67. Other proposals include adding work requirements for Medicaid coverage. Along with the so-called Medicaid unwinding that has resulted in the disenrollment of Medicaid recipients following the end of the pandemic’s public health emergency, these changes will increase the number of people in the United States who do not have any insurance coverage. 

Alison Galvani, PhD, a senior author and professor of epidemiology at Yale School of Public Health, said the proposals could have serious consequences.

“Without insurance people might forgo healthcare when they need it or ration prescription medications,” Galvani, who is also the director of the Center for Infectious Disease Modeling and Analysis at YSPH, said in a statement. “That can cause a condition to become both more serious and ultimately more costly. In the case of infectious diseases, forgoing healthcare can lead to transmission to other people that may have been prevented.”

Not having insurance can raise the risk of death, her team found. In fact, the team calculated that raising the Medicare age could result in 9,646 additional deaths per year. 

One proposed method to raise the Medicare age over time is to increase it by two months each year until eligibility hits 65 and the other is to increase it by three months. If that happens, it would lead to an additional 17,244 deaths or 25,847 deaths, respectively, during the transition.

“The elderly are those who need healthcare the most and any delay to receiving health care at 65 will have a disproportionate impact on lives lost,” said Galvani.

Adding work requirements for Medicaid recipients would lead to an additional 613 deaths every year among adults in the US, the data showed. 

The researchers focused on the health effects of the proposals on people with diabetes. According to their data, 325,613 older adults will lose care if they increase the Medicare eligibility age. And 456,966 people with diabetes under the age of 65 could lose healthcare access following the end of continuous Medicaid enrollment and. Losing coverage could make it harder for people to access insulin, and affordable insulin options, the team wrote.

“And these changes would have effects that ripple throughout the health care system and society, shifting costs from the federal government to state governments and employers,” said Galvani, who hopes policymakers will consider the findings of her study when they evaluate proposals.