Yale Model: Medicare for All Could Save $1T and 114K Lives Yearly

A Yale School of Public Health study projects that a single-payer ‘Medicare for All’ system would cut U.S. health spending by more than $1 trillion annually while preventing roughly 114,000 deaths a year. The savings come from five modeled sources: lower drug prices, Medicare-level provider payments, reduced administrative overhead, less fraudulent billing, and fewer avoidable ER visits and hospitalizations. Under more conservative assumptions on drug pricing and fraud, the net savings still reach at least $663 billion. Both figures already net out an estimated $304 billion in new spending to cover unmet needs, reimburse currently unpaid care, and add universal dental coverage.

On mortality, the researchers estimate about 62,863 deaths averted per year from universal adequate coverage — with nearly half (29,631) occurring among people who are already insured but underinsured, meaning high deductibles and cost-sharing still price them out of care. Reversing coverage rollbacks enacted since 2025 would avert a further 51,311 deaths, bringing the total to 114,174. The work updates a 2020 Lancet analysis by the same lead authors (which projected $450 billion and 68,000 lives), with the larger numbers reflecting rising expenditures, a widening gap between commercial and Medicare payment rates, and the growing underinsured population.

The authors flag real limitations: direct data on excess mortality among the underinsured doesn’t exist, so that risk is modeled rather than measured, and the spending analysis excludes transition costs, administrative job losses, and how providers might react to lower Medicare payment rates.