Public health and policy researchers at Yale University and the University of Pennsylvania sent a letter to Senate leaders this week warning that provisions in President Donald Trump's "big, beautiful bill" could lead to more than 51,000 deaths per year if passed.

The federal budget bill has already passed through the House of Representatives — but not without resistance on both sides of the aisle.

The letter from the universities presented science-based projections of the human toll of eliminating key health protections, such as mass insurance losses and cuts to nursing home standards.

The bill passed by the House would result in 7.7 million people losing health care coverage through Medicaid or the Affordable Care Act (ACA), which the universities said would result in 11,300 deaths.

RELATED STORY | Trump tax bill will add $2.4 trillion to the deficit and leave 10.9 million more uninsured, CBO says

Ending the Medicare Savings Program for 1.38 million low-income citizens would lead to 18,200 deaths because of the limited access to subsidized prescriptions, the universities claimed.

Taking away the Centers for Medicare & Medicaid Services nursing home staffing rules would lead to 13,000 deaths. Another 8,811 deaths would be caused by the bill's failure to extend the ACA's enhanced premium tax credits, according to the letter.

“These are not abstract numbers,” said Dr. Alison Galvani, PhD, Director of the Yale Center for Infectious Disease Modeling and Analysis at the Yale School of Public Health. “Every data point represents a human life. These cuts would disproportionately harm the most vulnerable communities in America, including older adults, low-income families, and people already at the margins of our health care system.”

To estimate mortality, the research team used peer-reviewed studies that looked at how insurance coverage, access to prescription drug subsidies and nursing home staffing levels relate to overall death rates. Those estimates were combined with population loss projections released by the Congressional Budget Office in May 2025.

The researchers were from Yale School of Public Health and the University of Pennsylvania Leonard Davis Institute of Health Economics.

The letter was addressed to Senate Finance Committee Ranking Member Sen. Ron Wyden and Senate Health, Education, Labor and Pensions Committee Ranking Member Sen. Bernie Sanders.