The Best Savings Plan for Medicare and Medicaid Is Investment in Science
A person wearing a green winter coat and black gloves holds a handmade cardboard sign at a protest. The sign reads in colorful, bold letters: “Science Saved my Life!” In the background, other protest signs are visible laid out on the ground and steps.
The False Dichotomy
Every year, we get the same story out of Washington: we can save money, or we can save lives - but probably not both.
Federal budget fights - like the one now underway for FY2026 - often experience the same tired script: lawmakers point to the rising cost of Medicare and Medicaid, declare them unaffordable, and propose cuts. Together these programs now account for about a quarter of the federal budget, and their costs keep climbing as more Americans live longer with chronic disease. Rather than investing in science and technology that could mitigate rising costs associated with healthcare - like improving prevention, managing chronic disease, and funding new treatments - lawmakers may default to the blunt tool of cutting benefits and services. Cutting benefits may look like savings on paper today, but it doesn’t reduce tomorrow’s illness, and it ensures higher Medicare and Medicaid bills later as untreated diseases grow more severe.
Recently, the One Big Beautiful Bill (OBBB) Act signed into law in July offset tax cuts to corporations and wealthy individuals, and increases in defense and border enforcement spending in part by slashing funding to Medicare (- $900 billion in the next ten years) and Medicaid (- $500 billion in the next ten years). The true scope of the impact of these cuts is uncertain, but recent work estimating the projected impacts of the Medicaid cuts have estimated the impacts to be around 51,000 added annual deaths after factoring in Medicaid disenrollment, market subsidy loss, and reductions in staffing capacities at nursing homes.
This cruelty is treated as if it is a sensible path forward. Yet, wouldn’t it be something if we could slow spending growth for Medicaid and Medicare while reducing - instead of increasing - hospitalizations, illness, and death?
Investment in science can do that.
The Case for Science Funding
We do not have to choose between cutting costs and saving lives - science can give us the tools to do both. New scientific discoveries and technological advancements are opening opportunities for future savings in health costs - from early detection and prevention to cutting-edge treatment - building a pipeline of innovations that can shift the balance of care away from expensive late-stage interventions toward far less costly early action.
Early detection and prevention, for example, are strong safety nets against rising medical costs. Recent work has shown that preventative strategies - from regular screenings to adherence to prescribed treatments - can slash hospitalization risk by 37.7% to 38.3%, protecting both lives and taxpayer dollars. Medicare and Medicaid primarily serve older adults, people with disabilities, and low-income Americans - groups that face heightened risks of chronic illness and hospitalization. Thus, the fiscal gains of prevention flow directly into sustaining these programs. Recent scientific breakthroughs show how these fiscal gains can be realized in practice. Ongoing progress in artificial intelligence driven medical image analysis, for instance, may help streamline diagnostics and improve efficiency for clinical care. Additionally, recent work shows that biomarker-based interventions to slow biological aging could generate large healthcare savings and substantially improve quality and length of life.
The positive fiscal impact of science discovery on medical treatment does not end with prevention. Once disease is present, treatments informed by research can simultaneously restore health and reduce cost. The development of antiretroviral therapy for HIV transformed what was once a fatal disease into a manageable chronic condition, drastically reducing hospitalizations and disability expenditures. For Medicare and Medicaid, these breakthroughs mean fewer prolonged hospital stays, fewer disability payments, and lower long-term care expenditures - costs that would otherwise fall disproportionately on these public programs.
Other examples include cancer therapies and psychiatric medications. Breakthrough cancer immunotherapies not only extend survival but, in many cases, replace years of costly inpatient care with targeted, more efficient outpatient treatment. Precision medicine approaches that tailor drugs to a patient’s genetic profile prevent wasted spending on ineffective treatments while improving outcomes. In psychiatry, federally funded research has produced long-acting injectable medications and digital therapy platforms that reduce relapse rates and costly hospital readmissions. In each of these cases, discovery has delivered healthier patients and fewer bills for Medicare and Medicaid.
The stakes are especially clear in prevalent chronic diseases, where costs quickly become overwhelming. Diabetes, heart disease, and stroke, for example, not only burden Americans via treatment costs, but also lost productivity, family caregiving, and other cascading complications. Medicaid is the primary payer for long-term nursing care, disability services, and mental health treatment, leaving the program to absorb much of the nation’s most expensive and complex care. Left unaddressed, these trends could push health care programs to consume a continuously larger share of the federal budget - leaving the nation to continuously battle on an impossible choice: higher taxes, deeper cuts to other programs, or reduced benefits and access.
We know that investment in science bends these costs down - because it already has. Childhood vaccines deliver an estimated $11 in societal savings for every $1 invested. Tobacco research funded by the National Institutes of Health (NIH) helped cut smoking rates by half since the 1960s, preventing millions from developing tobacco-linked cancer and heart attacks. Each of these breakthroughs illustrate a clear pattern - investing in research more than pays for itself.
According to the Congressional Budget Office, spending on the major federal health programs is projected to rise steadily as a share of the economy and of the federal budget, driven by an aging population and rising health care costs. Without new approaches to prevention and treatment, these programs will place growing pressure on the federal budget, crowding out other priorities. By contrast, scientific advances that reduce the burden of disease can help keep these programs sustainable over the long term.
The Austerity Trap
And yet, under the Trump administration, slashing science budgets is sold as “savings" when in fact it guarantees higher bills and worse outcomes downstream. Cuts to science funding have become a recurring theme - not only in budget proposals but also in agency rules and funding decisions. Whether through attempts to cap indirect cost reimbursements, trim NIH and CDC budgets, or reduce support for health services, the throughline is clear: science is being treated as expendable.
Key areas for further health research discovery are facing substantial funding cuts under the Trump administration - take neurodegenerative diseases as an example. By 2050, the U.S. population over 65 will swell to roughly 84 million - nearly double today’s number. Each year adds more Medicare beneficiaries, and longer lives often mean more years with illness, disability, and expensive care. Alzheimer’s and dementia alone cost $321 billion in 2022, with projections topping $1 trillion annually by 2050. Medicare and Medicaid cover most of that burden. Brain diseases already cost the U.S. an estimated $800 billion each year in direct care, lost wages, and caregiving - costs carried heavily by Medicare and Medicaid.
Yet, despite the growing need for science discovery in prevention and treatment, research for neurodegenerative disease is being directly defunded under the Trump administration. Thus far this year, the NIH has taken action to terminate 2,100 research grants, including hundreds tied to neuroscience and neurodegenerative disorders. A federal judge later ruled that many of these termination were “void and illegal”, but the Supreme Court has since paused that order, leaving funding for many projects in limbo while appeals processed. In total, about $323 million in neuroscience research and training grants have been paused or rescinded, with nearly $68 million specifically from Alzheimer’s disease research.
Cuts to science funding that look like savings today only guarantee larger Medicare and Medicaid bills tomorrow - paid in both federal dollars and human suffering, - all while simultaneously cutting funding to care.
A Different Ending
The story does not have to end with bigger bills and further suffering. With sustained investment in science, we can change the future of American health. At Stand Up for Science, we are fighting for the funding needed to develop the knowledge and technology that saves lives. With your support, we can continue to take action against the shortsighted cuts, defend science from political attacks, and ensure lifesaving discoveries continue to reach Medicaid, Medicare, and the millions of Americans who depend on them.