A large study of more than 2 million autistic Medicaid beneficiaries found a life expectancy at birth of about 64.9 years, nearly 14 years shorter than the U.S. population. Increased deaths were spread across influenza, malnutrition, aspiration pneumonitis, pneumonia, respiratory and neurological diseases, and accidental drownings — suggesting systemic, potentially preventable factors rather than autism itself. Modest pre-pandemic gains were partly reversed during the first year of COVID‑19. Results may not apply to all autistic people because Medicaid enrollees often have greater disability and socioeconomic disadvantage.
Large U.S. Study Finds Autistic Medicaid Beneficiaries Live Nearly 14 Years Less Than General Population
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A major new study linking Medicaid records with national death data finds that autistic people enrolled in Medicaid have substantially shorter life expectancy than the general U.S. population. The research, published in JAMA Network Open, analyzed more than 2 million autistic Medicaid beneficiaries across all 50 states and Washington, D.C., from 2000–2020.
Key Findings
The study reports a life expectancy at birth of about 64.9 years for autistic Medicaid beneficiaries — roughly 13.8 years shorter than the U.S. general population and about 5.6 years shorter than the overall Medicaid population.
Rather than being driven by a single cause, the mortality gap reflects elevated risks across a wide range of conditions. Compared with expectations from the general population, autistic Medicaid beneficiaries were:
- More than 10 times as likely to die from influenza
- More than 7 times as likely to die from malnutrition
- Nearly 7 times as likely to die from aspiration pneumonitis (inhaling food, liquid or other substances into the lungs)
- Substantially more likely to die from pneumonia, other respiratory and neurological diseases, and accidental drowning or non-transport accidents
Why This May Not Be Autism Itself
Jessica McCarthy, founder and clinical director of Elements Psychological Services, emphasized that autism per se is not necessarily the direct cause of early death. She said many deaths stem from lack of access to care, poor coordination among providers, untreated feeding and swallowing problems, accidents, and misattribution of medical symptoms to behavior.
The authors and clinicians highlight that many of these risks appear potentially modifiable through improved preventive care, better coordination between medical and behavioral health providers, targeted feeding and swallowing interventions, and enhanced safety supports for people at risk of falls or drowning.
Trends, Sex Differences and Limitations
Life expectancy for autistic Medicaid beneficiaries improved by about 1.7 years from the early 2000s to 2015–2019, but those gains were partly reversed in the first year of the COVID-19 pandemic, when this group experienced one of the largest declines in life expectancy among groups studied.
The study also found sex differences: while overall life expectancy for autistic men and women was similar, autistic women experienced a larger gap relative to women in the general population than autistic men did compared with men. The authors suggest this may relate in part to higher rates of psychiatric comorbidities and associated mortality among autistic women.
Important limitations: Medicaid primarily serves low-income people and those with disabilities, so these findings may not generalize to all autistic individuals. Medicaid enrollees in the study may have greater medical complexity, higher support needs and more socioeconomic disadvantage than the broader autistic population.
Citation: Li G, DiGuiseppi CG, Blanchard A, Russell MT, Ing C. Autism Spectrum Disorder and Life Expectancy Among Medicaid Beneficiaries. JAMA Netw Open. 2026;9(9):e2633251. doi:10.1001/jamanetworkopen.2026.33251.
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