NBC News
Medicaid’s cuts in the president’s fiscal plan, Donald Trump, could cause more than 1,000 additional deaths every year, according to a report published Wednesday in the scientific journal Jama Health Forum.
In addition, they could also lead to almost 100,000 additional hospitalizations each year, according to the report, and around 1.6 million new patients could delay the search for medical care.
The projections do not agree with the comments of the Secretary of Health and Human Services (HHS, in English), Robert F. Kennedy Jr., who fell importance on Monday to the impact of the law during an interview with presenter Larry Kudlow of the conservative chain Fox Business Network.
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“We are not going to cut Medicaid and nobody is going to die for it,” said Kennedy.
The HHS did not respond immediately to the request for comments.
This Wednesday’s study reached a conclusion similar to that of an analysis published in June by the magazine Annals of Internal Medicine, which also concluded that the cuts could cause thousands of deaths avoidable per year because people delay attention and get sick.
Medicaid is financed jointly by the states and the federal government.
Trump’s legislation, nicknamed “great and beautiful law”, includes cuts of almost a billion dollars in the program, mainly through work requirements and the reduction of federal financing. Most of the changes will not take effect until 2027 or 2028.
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The forecasts of the new report are based on an earlier estimate of the Congress Budget Office, according to which changes in Medicaid could cause 7.6 million people in the United States to lose their medical insurance in 2034.
Dr. Sanjay Basu, author of the Waymark report and medical director, a company whose objective is to improve access and care for Medicaid patients, said that the loss of coverage is expected to lead people to delay the search for medical care because they can no longer afford it. For many, he added, that delay would make people get more ill, which would lead to hospitalizations and death.
“People tend to worry about cost or coverage,” he said, so they avoid attention until “they end up hospitalized or found dead at home by an unofficial disease.”
Basu added that the projections of the report are probably “a underestimation”, pointing out that it does not take into account the changes of the affordable assistance law.
The estimates also assumed that the states will be able to make the necessary changes in their Medicaid programs – such as the creation of systems to monitor the work requirements – within two to three years, he added.
In the worst case, the report foresaw twice as additional annual deaths – around 2,000 – and calculated that up to 2.5 million people will delay the search for health care.
“Actually, this issue is quite complicated for a state, and the deadlines are not very long,” Basu specified. “We are not sure how many people will be discharged, not because they no longer meet the requirements, but because, from the point of view of the procedure, they cannot move forward.”
Other health repercussions
Jennifer Tolbert, deputy director of the Medicaid program and the un insured of the KFF Health Policy Research Group, said that other studies have repeatedly demonstrated that people without insurance are less likely than those who do have it to receive preventive care and treatments for the main health conditions and chronic diseases.
A KFF report indicated that almost a third of adults without insurance claim to have delayed or renounced to receive medical care due to the cost, compared to 6% of insured adults.
“The consequences (of delaying attention) can be serious,” he said, “especially when preventable conditions or chronic diseases are detected.”
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The new report, in addition to the people who delay attention, are expected to be 1.9 million people to skip, delay or do not take their medication according to the prescribed.
The cuts are also expected to cause additional medical debt of 7.6 billion dollars in the country.
In 2034, more than 100 rural hospitals could run the risk of closing, added the report, which stipulated that more than 300,000 jobs could be lost and the economy could be reduced by about 135,000 million dollars. In the worst case, the loss of jobs would be 408,000 and the economy would suffer an impact of 182,000 million dollars.
Dr. Benjamin Sommers, a health doctor and economist at the Harvard’s threat School of Public Health, pointed out that people often do not find out that they have lost the coverage until he will see his doctor and can face huge accounts.
Sommers published a study at the New England Journal of Medicine in 2019 that analyzes the impact of the work requirements of Medicaid de Arkansas. The program ended after only 10 months, before there were clear data on hospitalizations or deaths.
“There are many different ways in which people can suffer this type of bureaucracy,” he said. “The bureaucracy, starting with even understanding what politics means and how it applies to them.”
