A study published in JAMA Network Open reveals that Medicaid beneficiaries with autism have a life expectancy of 64.9 years, which is nearly 14 years shorter than the general United States public. This gap is particularly severe for women with autism, who live 16 years less than women in the general population. Meanwhile, nationwide Medicaid work requirements set to take effect in January 2027 face legal challenges and disputes over medical frailty exemptions, with several states banning self-attestation.
Life expectancy of autistic Medicaid beneficiaries
- ▪Women with autism on Medicaid lived 8.2 years less than other women on Medicaid and 16 years less than women in the general United States population.
- ▪A JAMA Network Open study of United States Medicaid beneficiaries in 2000-2020 found those with autism had a 64.9-year life expectancy, 5.6 years shorter than Medicaid beneficiaries overall and nearly 14 years shorter than the general United States public.
Mortality rates and causes of death
- ▪Medicaid beneficiaries with autism were more than 10 times as likely as other Medicaid beneficiaries to die of influenza.
- ▪The age- and sex-adjusted mortality rate for Medicaid beneficiaries with autism was 44% higher than for the general Medicaid beneficiary population.
- ▪A study in JAMA Network Open identified preventable causes of excess mortality in autistic individuals, including malnutrition, pneumonitis due to solids and liquids, accidental drowning, pneumonia, falls, and sepsis.
Impact of COVID-19 on autistic individuals
- ▪Columbia University researcher Guohua Li stated that the disproportionate impact of the COVID-19 pandemic on autistic individuals underscores their exceptional vulnerability during public health emergencies.
- ▪In 2020, the COVID-19 pandemic reduced the life expectancy for people with autism by 4.1 years, which was nearly twice the reduction experienced by the general United States population.
New Medicaid work requirements and impact
- ▪The new Medicaid work mandate applies to up to 20 million lower-income, childless adults enrolled in Medicaid through optional expansions in 40 states and the District of Columbia.
- ▪Starting in January 2027, new work mandates for select Medicaid recipients will take effect nationwide under President Donald Trump's 2025 tax and policy legislation.
- ▪The Congressional Budget Office's 2025 estimate projected that the new Medicaid work requirements will save the federal government $887 billion over the next decade and result in 7.5 million fewer people with health insurance.
Exemptions from Medicaid work requirements
- ▪In June 2026, the Centers for Medicare and Medicaid Services published a rule requiring that an enrollee's condition must 'significantly impair' their ability to work, volunteer, or attend school to qualify for an exemption.
- ▪Although federal guidelines allow self-attestation of medical frailty for the first 12 months, Arkansas, Idaho, Indiana, New Hampshire, North_Carolina, and Ohio have barred self-attestation for work requirement exceptions starting in 2027.
- ▪Under the new mandate, Medicaid beneficiaries must work or volunteer at least 80 hours monthly or attend school at least half-time to qualify, unless they meet exemptions such as medical frailty.
Opposition to Medicaid changes
- ▪Democratic officials across 25 states have filed lawsuits arguing that the new federal Medicaid work requirement regulations are unreasonably restrictive.
- ▪Care workers protested at the United States Capitol on June 23, 2025, to denounce Medicaid cuts.
Debatable claims
- ▪The shorter life expectancy of autistic Medicaid beneficiaries represents a systemic failure of primary care
- ▪The federal government should impose work requirements on Medicaid beneficiaries
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