Yale Study: Universal Health Coverage Could Save $1T and 114,000 Lives a Year

A preprint study led by researchers at the Yale School of Public Health projects that adopting a single-payer, universal health care system in the United States could cut annual health spending by about $1.04 trillion — nearly 20 percent — while covering everyone and saving more than 100,000 lives each year. The study, which has not yet been peer reviewed, models a national public insurance program along the lines proposed in the Medicare for All Act, using 2024 spending, coverage and mortality data.

Where the savings come from

The researchers identify five main sources of savings: lower pharmaceutical prices, Medicare-level payments to providers, reduced administrative overhead, less fraudulent billing, and fewer avoidable emergency department visits and hospitalizations. Even under more conservative assumptions about drug prices and fraud reduction, projected savings still reach at least $663 billion a year. Both figures account for an estimated $304 billion in additional spending to meet unmet medical needs, reimburse care that currently goes unpaid, and provide universal dental coverage.

Lives spared — including among the insured

The model estimates that adequate coverage for all would avert about 62,863 deaths annually, and that nearly half of them — 29,631 — would be among people who already hold insurance. These are the underinsured: more than 45 million working-age adults whose deductibles and cost-sharing put care beyond financial reach. Reversing coverage rollbacks and other health policies enacted since 2025 would avert a further 51,311 deaths each year, bringing the total to 114,174.

Limits of the model

The authors caution that direct estimates of excess mortality among underinsured adults are unavailable, so that risk had to be modeled. The spending analysis also excludes transition costs, administrative job losses and how providers might respond to Medicare payment rates. The study builds on work published by the same group in The Lancet in 2020, which projected $450 billion in savings and more than 68,000 lives saved annually; the larger figures reflect rising health expenditures and a widening gap between commercial and 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," the authors write. Senior author Alison Galvani, director of the Yale Center for Infectious Disease Modeling and Analysis, argues the country already spends enough for universal coverage and that the problem is how that money is allocated.