- Posted November 10, 2025
More Americans, Especially Black Adults, Dying Before They Qualify For Medicare
People pay into Medicare throughout their lifetime — a cut taken from every paycheck with the expectation that it will lead to affordable health care in their old age.
But a growing number of people — especially Black Americans — are dying before they turn 65 and become eligible for Medicare, according to a new study.
Premature deaths among adults younger than 64 increased by 27% between 2012 and 2022, meaning these people paid into a system they never got to use, researchers reported Nov. 7 in JAMA Health Forum.
It’s even worse for Black adults, who saw a 38% increase in these premature deaths compared to a 28% rise among white Americans, researchers found.
“These are people who contribute to Medicare their entire lives yet never live long enough to use it,” said lead researcher Irene Papanicolas, a professor of health services, policy and practice at the Brown University School of Public Health in Providence, Rhode Island.
“When you look through the lens of race, it’s clear that one group is increasingly dying before they ever see the benefits of the system they helped fund,” she said in a news release.
Today, about 69 million Americans are enrolled in Medicare, which is primarily funded through payroll taxes, researchers said in background notes.
For the new study, researchers analyzed Medicare enrollment files and death records collected by the U.S. Centers for Disease Control and Prevention (CDC). The team tracked deaths among adults 18 to 64, subtracting those already on Medicare due to disability or other reasons.
Nationally, premature deaths rose from 243 per 100,000 adults in 2012 to 309 in 2022, the study showed.
Researchers found that Black Americans consistently had higher rates of early death than whites:
In 2012, the premature death rate was 309 per 100,000 for Black adults, compared to 247 for white adults.
By 2022, the numbers had risen to 427 per 100,000 for Black adults and 316 for their white counterparts.
Nearly every state showed higher rates of early deaths among Black Americans, researchers found. Only New Mexico, Rhode Island and Utah had no statistically meaningful racial difference.
“Because premature mortality disproportionately affects Black Americans, the current design of the Medicare program effectively bakes structural inequity into a system that was meant to be universal,” senior researcher Dr. Jose Figueroa, an associate professor of health policy at Harvard University in Boston, said in a news release. “What’s most troubling is that these inequities aren’t shrinking — they’re deepening across nearly every state.”
U.S. life expectancy has been falling for much of the past decade, and there has been a rise in preventable deaths among the middle-aged, Papanicolas said.
“What we're increasingly seeing is that Americans have increased health needs during midlife,” Papanicolas said. “Which raises the question for policymakers: Does the system still work if more people are getting sick and dying before the age of 65?”
In short, the timing of Medicare’s health coverage no longer aligns with when many Americans need it most, researchers concluded.
“Even when people die before they can access the care they pay for, that money still stays in Medicare,” Papanicolas said. “Moving forward, aligning health care access to need — not just to age — should be a policy imperative.”
More information
The U.S. Centers for Disease Control and Prevention has more on U.S. life expectancy.
SOURCE: Brown University, news release, Nov. 7, 2025
