A new analysis provides evidence that reductions in access to Medicaid could increase deaths and cause financial hardship to people currently covered under an expansion of Medicaid that was implemented under the Affordable Care Act (ACA). In a peer-reviewed research letter published in The Lancet, researchers from the Keck School of Medicine of USC, Boston University and the University of Amsterdam found that reductions in Medicaid coverage or access could lead to thousands of additional deaths among working-age Americans, disastrous financial burden for hundreds of thousands, and delays in necessary care for millions. Based on the reductions in mortality resulting from the expansion of Medicaid found in a 2022 USC study, the scientists determined that additional deaths among those aged 25 to 64 years old could reach 14,660 within a single year among – a number that ranks as the equivalent of the seventh leading cause of death in that age group across states which expanded coverage. The team estimated that more than 600,000 additional Americans between ages 25 and 64 could face catastrophic health care expenditures — a term defined by economists as out-of-pocket costs exceeding 30% of household income. The research letter’s authors found that reversing the Medicaid expansion could lead up to 8.7 million people to avoid needed medical care, which can lead to worse outcomes and higher costs down the line. Reducing coverage could also touch the lives of people not currently enrolled in Medicaid by leading hospitals in underserved rural areas that depend on Medicaid funds to close, potentially leaving entire communities without reliable access to care.