Challenges and Investments in the US Healthcare System as Federal Subsidies End
In January 2025, federal subsidies for Obamacare marketplaces ended, putting coverage for about 20 million people at risk due to rising premiums. This change comes amid Republican cuts exceeding $850 billion to Medicaid and CHIP over a decade, which also jeopardize approximately $500 billion in Medicare funding. Despite these financial challenges, private investment in longevity startups has reached about $12.5 billion over the past 25 years. Notable figures like OpenAI founder Sam Altman have invested roughly $180 million in Retro Biosciences, while Eric Schmidt and Vinod Khosla have committed hundreds of millions to NewLimit, a company focused on reversing cell aging. Mark Zuckerberg has also realigned his philanthropic foundation to concentrate on biology and artificial intelligence with the goal of curing all diseases.
The US healthcare system is marked by high spending concentrated in a private, profit-driven model that charges patients and insurers per interaction without guaranteed health benefits. Consequently, US life expectancy at birth in 2023 remains lower than in 2010, trailing peers in the EU, Japan, and Canada, and is even shorter than in Albania and Czechia. It is about four years shorter than in Puerto Rico. There exists a stark longevity gap within the country: the richest 1% of men live 14.6 years longer than the poorest 1%, while for women, the gap is 10.1 years. The disparity between the top 5% and bottom 5% widened by more than two years from 2001 to 2014. Infant mortality rates and deaths related to despair are closely linked to poverty, highlighting deep inequalities in health outcomes.
