Sept. 22, 2017 – Physicians and public health researchers Drs. Steffie Woolhandler and David Himmelstein estimate that implementation of the proposed Graham-Cassidy legislation would push an additional 32 million Americans off their health insurance over the next decade, resulting in 41,600 additional deaths in 2027.
Since the Congressional Budget Office could not conduct a timely analysis of the bill before its expected vote, the researchers—who have studied the effects of insurance coverage on health outcomes—analyzed the bill’s impact on insurance coverage and mortality.
“The Graham-Cassidy bill—what we’re calling ‘The Undertaker Full Employment Act’—would cut health coverage by 14 million Americans in 2020, rising to at least 32 million in 2027,” said Dr. Woolhandler, an internist in the South Bronx, Distinguished Professor of Public Health at the City University of New York at Hunter College (CUNY) and lecturer in medicine at Harvard. “That means 18,200 extra deaths in the first year, climbing to 41,600 annually within a decade.”
Drs. Woolhandler and Himmelstein studied CBO projections of previous GOP “repeal and replace” bills, and then extrapolated how many individuals would lose coverage per $1 billion in health spending cuts in the Graham-Cassidy bill between 2020 and 2027.
From there, the researchers projected the number of associated deaths based on their recent study published in the Annals of Internal Medicine, “The Relationship of Health Insurance and Mortality: Is Lack of Insurance Deadly?” The study concludes that for every 769 people who lose health coverage, one person will suffer preventable death. Health insurance prevents deaths in part by improving the diagnosis and treatment of high blood pressure; uninsured and under-insured Americans with hypertension are known to be less likely to have their blood pressure under control. Lack of coverage also increases death rates in several other conditions, including breast cancer and major trauma.
“We became doctors to save lives,” said Carol Paris, M.D., president of Physicians for a National Health Program. “As physicians, we cannot be silent while Congress plays political games with the lives of our patients.”
The Graham-Cassidy bill eliminates insurance subsidies provided through the Affordable Care Act to about 8 million Americans, and makes substantial cuts to state Medicaid programs that today insure more than 70 million Americans. The bill also allows insurers to charge more for patients with pre-existing conditions who would likely be priced out of the insurance market altogether.
Dr. Paris notes that instead of cutting coverage to millions of Americans, Congress should cut the number of uninsured to zero through a universal, single-payer health plan like Rep. John Conyers’ H.R. 676, the Expanded and Improved Medicare for All Act or Sen. Bernie Sanders’ S. 1824, The Medicare for All Act of 2017.
Dr. Steffie Woolhandler is an internist in the South Bronx, Distinguished Professor of Public Health at the City University of New York at Hunter College (CUNY) and lecturer in medicine at Harvard. Dr. David Himmelstein is also an internist, Distinguished Professor at CUNY and lecturer at Harvard. They are co-founders of Physicians for a National Health Program (PNHP). Dr. Carol Paris is a retired psychiatrist and president of PNHP, a nonprofit research and educational organization of more than 21,000 doctors and health professionals who support a single-payer national health program. It was founded in 1986.