Abstract<br>The US spends more on health care than any other nation, yet tens of millions of Americans are uninsured or underinsured, and coverage retractions enacted in 2025 are widening these gaps. The misalignment between the for-profit insurance architecture and optimal patient care, together with the inefficiencies of a fragmented system, contributes to both unnecessary costs and preventable mortality. We update our previous analyses with the most recent data to project the economic benefits and the number of lives saved that would be achieved by single-payer universal coverage, as proposed in the Medicare for All Act. We estimate that such a system would reduce national health expenditure by $1,041 billion annually. Sources of savings include reductions in administrative overhead, pharmaceutical prices, fraudulent billing, and avoidable emergency care. Combined with the reversal of recent retractions, universal coverage would save over 114,000 lives annually." />

Projected economic gains and lives saved under universal healthcare in the United States | medRxiv

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Projected economic gains and lives saved under universal healthcare in the United States

View ORCID ProfileAbhishek Pandey, View ORCID ProfileChad R. Wells, Yang Ye, View ORCID ProfileMeagan Fitzpatrick, Alison P. Galvani

doi: https://doi.org/10.64898/2026.07.22.26358689

Abhishek Pandey<br>1Center for Infectious Disease Modeling and Analysis (CIDMA), Yale School of Public Health, New Haven, CT, USA<br>PhD<br>Find this author on Google Scholar<br>Find this author on PubMed<br>Search for this author on this site<br>ORCID record for Abhishek Pandey

Chad R. Wells<br>1Center for Infectious Disease Modeling and Analysis (CIDMA), Yale School of Public Health, New Haven, CT, USA<br>PhD<br>Find this author on Google Scholar<br>Find this author on PubMed<br>Search for this author on this site<br>ORCID record for Chad R. Wells

Yang Ye<br>1Center for Infectious Disease Modeling and Analysis (CIDMA), Yale School of Public Health, New Haven, CT, USA<br>PhD<br>Find this author on Google Scholar<br>Find this author on PubMed<br>Search for this author on this site

Meagan Fitzpatrick<br>2Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, MD, USA<br>PhD<br>Find this author on Google Scholar<br>Find this author on PubMed<br>Search for this author on this site<br>ORCID record for Meagan Fitzpatrick

Alison P. Galvani<br>1Center for Infectious Disease Modeling and Analysis (CIDMA), Yale School of Public Health, New Haven, CT, USA<br>PhD<br>Find this author on Google Scholar<br>Find this author on PubMed<br>Search for this author on this site<br>For correspondence:<br>alison.galvani{at}yale.edu

Abstract<br>Full Text<br>Info/History<br>Metrics<br>Supplementary material<br>Data/Code<br>Preview PDF

Abstract<br>The US spends more on health care than any other nation, yet tens of millions of Americans are uninsured or underinsured, and coverage retractions enacted in 2025 are widening these gaps. The misalignment between the for-profit insurance architecture and optimal patient care, together with the inefficiencies of a fragmented system, contributes to both unnecessary costs and preventable mortality. We update our previous analyses with the most recent data to project the economic benefits and the number of lives saved that would be achieved by single-payer universal coverage, as proposed in the Medicare for All Act. We estimate that such a system would reduce national health expenditure by $1,041 billion annually. Sources of savings include reductions in administrative overhead, pharmaceutical prices, fraudulent billing, and avoidable emergency care. Combined with the reversal of recent retractions, universal coverage would save over 114,000 lives annually.

Competing Interest Statement<br>The authors have declared no competing interest.<br>Author Declarations<br>I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.<br>Yes<br>I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.<br>Yes<br>I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).<br>Yes<br>I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material,...