Study Claims Medicare for All Could Save Thousands of Lives

America spends more on health care than any other country, yet millions of people remain uninsured or unable to afford the care their insurance supposedly provides. A new analysis now claims a single-payer system could save more than $1 trillion annually and prevent over 114,000 deaths each year.

Those numbers have quickly entered the political debate around Medicare for All. But while the study’s overall direction is supported by many previous economic models, critics argue that some of its biggest assumptions may be far too optimistic.

A New Analysis Puts The Savings Above $1 Trillion

The latest estimate comes from Alison Galvani, a Yale epidemiologist, and her research team. Their updated analysis was posted as a preprint in July 2026, meaning it had not yet been through peer review.

The researchers modeled a health care system resembling the Medicare for All Act, where a single public insurer would replace the current patchwork of private and public coverage.

Their calculations suggest that annual health spending could fall from roughly $5.2 trillion to about $4.2 trillion.

That would represent savings of around $1.041 trillion each year. Senator Bernie Sanders quickly cited the findings in support of Medicare for All, while economists and analysts began examining the assumptions behind the headline figure.

Millions Still Cannot Afford The Care They Need

The study begins with the gaps in America’s current insurance system. In 2024, an estimated 27.5 million Americans had no health insurance at all, while more than 45 million adults aged 19 to 64 were considered underinsured.

Underinsurance means someone may technically have coverage but still cannot afford deductibles, copayments, or other costs when medical care is needed. The researchers argue that universal coverage could allow many of those people to receive treatment earlier and more consistently.

Their model also considers projected coverage losses linked to recent policy changes. According to the analysis, Medicaid reductions and expired subsidies could push millions more people off insurance over the next decade.

Five Major Changes Drive The Projected Savings

Most of the estimated trillion-dollar reduction comes from a small number of major changes. The figures are substantial, but each depends on assumptions about how providers, patients, insurers, and drug companies would respond to a new system.

The model identifies five major sources of savings:

• Lower prescription drug costs: A single national buyer could negotiate prices more aggressively, producing an estimated $377.5 billion in savings.
• Medicare-level provider payments: Paying hospitals and physicians at Medicare rates could save around $295.6 billion.
• Simplified administration: Replacing multiple insurers with one system could reduce administrative costs by $286.3 billion.
• Reduced fraudulent billing: The model assigns $285.7 billion in savings to preventing fraudulent claims.
• Fewer emergency visits: Better access to routine care could save another $100 billion, according to the analysis.

The researchers also added roughly $304 billion in new spending. That includes increased medical use by people who are currently uninsured or underinsured, universal dental coverage, and payment for treatment hospitals already provide without reimbursement.

The Study Estimates More Than 114,000 Deaths Could Be Prevented

The mortality figure is even more dramatic than the financial estimate. According to the model, universal coverage could prevent approximately 114,174 deaths every year.

That number combines two separate estimates. About 62,863 deaths are linked to providing adequate coverage to people who are currently uninsured or underinsured, while another 51,311 are connected to projected coverage losses.

The figure should not be treated as a literal annual headcount. It is a model-based estimate built from earlier research examining how insurance coverage affects access to care and mortality.

The Yale announcement also noted an important limitation. The researchers counted excess deaths associated with underinsurance only among adults aged 19 to 64, which they said could make their estimate conservative in one respect.

Oregon’s Medicaid Experiment Complicates The Argument

One of the study’s assumptions involves emergency room use. The researchers estimate that expanded access to regular care could reduce avoidable emergency department visits by enough to save $100 billion.

A major experiment in Oregon, however, produced a result that complicates that theory. In 2008, the state used a lottery to distribute limited Medicaid coverage, creating a rare opportunity for researchers to compare people who gained insurance with those who did not.

Researchers later found that gaining Medicaid did not reduce emergency room visits. Instead, emergency department use increased by around 40%, with higher use appearing across several categories of medical conditions.

That finding does not prove expanded coverage always increases emergency visits. It does raise questions about assuming that broader insurance coverage will automatically produce enormous savings by keeping people out of emergency rooms.

Critics Say The Biggest Numbers Depend On Optimistic Assumptions

Health economists raised similar concerns when Galvani’s team published an earlier Medicare for All analysis in 2020. Many of those objections have returned with the updated model.

Gerard Anderson, a health economist at Johns Hopkins, told KFF Health News that “The assumptions are unrealistic.” He questioned whether providers could realistically lose as much revenue as the model assumes while the system continued functioning as intended.

The $285.7 billion assigned to reducing fraudulent billing has also attracted criticism. Independent analyst Alexander Muse argued that the evidence used to support the estimate, including data related to Taiwan’s move toward single-payer health care, does not clearly justify such a large projected reduction.

The dispute matters because the fraud estimate represents more than one-quarter of the study’s headline savings. If several of the model’s most contested assumptions fail, the final number could fall dramatically.

Most Major Models Still Predict Savings

Criticism of one study does not erase the broader research on single-payer financing. A 2020 systematic review examined 22 economic models produced by government agencies, consultants, and academic researchers.

Nineteen of those 22 analyses projected net savings during the first year. The estimated savings ranged from 3% to 27%, showing major disagreement over the size of the potential benefit.

The common explanations included lower administrative costs, stronger bargaining power over drug prices, and changes to provider payments. Even so, the review also found less optimistic scenarios, including one model projecting that a single-payer system could increase costs by around 7%.

That range reveals the real disagreement. The debate is less about whether America’s health care system contains major inefficiencies and more about how much money a different financing system could realistically save.

The Trillion-Dollar Headline Is Only Part Of The Story

The study’s most attention-grabbing figure is $1.041 trillion in annual savings. But the researchers also tested their model under different assumptions and reported that projected savings remained above $663.3 billion in every variation they examined.

Critics dispute whether that lower figure would survive more skeptical assumptions. Still, the wider body of research suggests that simplified administration and lower prices could produce significant savings under some form of single-payer financing.

The researchers wrote that “The obstacle to universal coverage has never been the absence of resources, but the way they are allocated.” That argument sits at the center of the entire Medicare for All debate.

America is already spending trillions on health care while millions of people remain uninsured or unable to afford treatment. The exact savings figure may change as economists continue picking apart the model, but the underlying question is becoming harder to ignore: how much longer can the world’s most expensive health care system keep delivering such uneven access?