Republican Lawmakers Ignore Rising Premature Deaths in US

Mothers in the US are dying from pregnancy-related causes at much higher rates than mothers in any other affluent country.

The recent legislation passed by the US Congress, oddly named the One Big Beautiful Bill (OBBB), and signed by the US President reveals that Republican lawmakers in the nation’s capital do not care about excessive and premature mortality in the United States.

If Republican representatives and senators were genuinely concerned about the expected increase in deaths, the OBBB would not have shown such disregard for its potentially harmful impact on human life and wellbeing.

In the coming months, the OBBB is likely to result in a rise in excess and premature deaths in the United States, particularly affecting vulnerable groups such as low-income individuals and families, children, people with disabilities, and seniors.

The lack of concern from Republican lawmakers about the expected excess and premature mortality resulting from the OBBB is evident in a candid remark made by an Iowa Republican senator during a recent town hall meeting.

Millions of US citizens without health insurance coverage and access to care will likely skip preventative care, treatments, and prescriptions, all of which will contribute to increased illness and preventable deaths.

When a constituent expressed concerns about potential deaths resulting from cuts to Medicaid in the proposed budget bill, the Republican senator responded by saying, “People are not… well, we’re all going to die, so for heaven’s sakes.”

The senator’s comment exemplifies the lack of concern and empathy among federal Republican officials toward the life-threatening impact of the OBBB’s cuts to Medicaid, food assistance (SNAP), changes to the Affordable Care Act (ACA), and other crucial government services.

In fact, the budget cut to Medicaid — approximately a $1 trillion reduction over the next 10 years — far exceeds any other cut the United States has made in its social safety net. The US Congressional Budget Office predicts that the cuts to Medicaid will result in millions of people losing health insurance coverage.

The various cuts and changes resulting from the OBBB are expected to increase uninsured rates, reduce access to healthcare services, exacerbate health disparities, and lead to higher mortality rates nationwide. The millions of US citizens without health insurance coverage and access to care will likely skip preventative care, treatments, and prescriptions, all of which will contribute to increased illness and preventable deaths.

Public health and policy researchers from Yale University and the University of Pennsylvania have informed Congressional lawmakers that the OBBB could lead to over 51,000 preventable deaths in the US annually. This would result from disenrollments from Medicaid and the Health Insurance Marketplace coverage, reductions in nursing home care, and the loss of drug subsidies for low-income seniors.

Additionally, imposing work requirements on individuals receiving health insurance through programs like Medicaid has not been shown to increase employment levels. Instead, it restricts access to necessary medical care.

With expanding subsidies for fossil fuels and biofuels, the OBBB could also lead to an increase in greenhouse gas emissions, potentially causing more life-threatening weather events and contributing to an estimated 900 annual premature US deaths from local air pollution by 2035.

Apart from the OBBB, budget cuts by the US administration have also been implemented in agencies and departments related to justice, health, education, housing, environment, basic scientific research, and weather forecasting.

The administration has laid off meteorologists, frozen critical positions at the Federal Emergency Management Agency, and reduced coordination grants at the National Oceanic and Atmospheric Administration. Additionally, they have reduced staff, including call centre workers, and cut funding for agencies essential for issuing emergency warnings of extreme weather events and coordinating timely responses, likely leading to more deaths.

The cuts to Medicaid, which is the dominant source of coverage for children in the US, are expected to devastate paediatric care in rural and underserved areas. US administration officials are dismantling science-based vaccine policies and paediatric care, which will result in increased deaths, especially among children, from preventable causes.

With the anticipated increase in deaths resulting from the OBBB, the mortality ranking of the United States among developed countries will likely deteriorate. Even before the adoption of this problematic budget legislation, the US’s position on mortality levels among wealthy developed countries was mediocre at best.

For example, consider deaths that occur during the first year of life. The US infant mortality rate is significantly higher than the average of other developed nations. In recent years, the United States has ranked 33rd out of 38 OECD countries on this crucial mortality measure. In 2023, the US infant mortality rate was 6 infant deaths per 1,000 births, compared to about 2 for Italy, Japan, and Sweden.

Additionally, the US has the highest maternal mortality rate among wealthy nations. Mothers in the US are dying from pregnancy-related causes at much higher rates than mothers in any other affluent country. In 2022, the US maternal mortality rate was 22.3 deaths per 100,000 live births, far above rates for other high-income countries. For example, the maternal mortality rate was 3.4 in Japan, 7.6 in France, and 8.4 in Canada.

Regarding longevity, life expectancy at birth in the US in 2023 was 78 years. However, life expectancy varied significantly based on income levels, with the gap widening. In 2023, the richest individuals in the top 1% of US counties lived 84 years, while those in the bottom 50% of counties averaged 77 years.

Many countries surpass the US in terms of life expectancy. For example, Japan has a life expectancy of 87 years, Italy 84 years, and Sweden 83 years.

If one is fortunate enough to reach the age of 65 in the US, life expectancy at that age is lower compared to many other wealthy developed countries. While life expectancy in the US at age 65 is nearly 20 years, it is higher in other countries, such as Australia, France, Japan, and Sweden, where it is approximately 22 years.

It is crucial to acknowledge that the expected increase in excess and premature mortality in the United States is not due to a foreign government or overseas enemy. Instead, it is self-inflicted by the policies, actions, and choices of a Republican-led government.

How will the Republicans respond to the anticipated rise in premature deaths? History suggests they will probably react with their three D’s: Denial, Dismissal, and Distraction.

In conclusion, considering the expected increase in excess and premature deaths due to the OBBB and related policies of the US administration, as well as the likely response from Republican lawmakers, including the president, it appears that they simply do not care about mortality in the United States. (Fertility, on the other hand, is a completely different matter.)

Joseph Chamie is a consulting demographer, a former director of the United Nations Population Division, and author of many publications on population issues, including his recent book, “Population Levels, Trends, and Differentials”.