Three Not-So-Bad Things on Aging and Longevity

A Weekly Newsletter

There’s no denying it: we are constantly bombarded with bad news. A pandemic, climate change, inflation, war, political discord—the list goes on.  Here at the Longevity Project, we understand that bad news can be enough to take years off your life, so we want to do our part (however small) to balance the scales. 

At the end of the day, though, we’re realists. Good news is hard to come by, no matter how hard you look. So we’ll aim a little lower and without further ado, we are pleased to share our first weekly newsletter: Three Not-So-Bad Things on Longevity and Aging. Feel free to share with others and send us items you want to see included. With some luck, you will see this newsletter (and some more not so bad news) every Wednesday.

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Medicaid is one of the largest targets for cost reductions in the Trump plan, with the goal of reducing spending by $900 billion over 10 years. There are more than 7 million adults over the age of 65 who are currently on Medicaid. These “dual-eligible” (eligible for both Medicare and Medicaid) rely on Medicaid for long-term care, including in-home nursing services. Across all age groups, Medicaid participation is projected to fall by about 10% if the bill is enacted in its current form. 

Seniors are expected to take their fair share of that reduction, which is a bit puzzling, since the primary mechanism for reducing Medicaid coverage and expenses under the Trump bill is a new work requirement for eligibility, but those requirements (at least under the House version) end at age 64. But experts cite two other factors that they believe will reduce participation under Medicaid: 

• The bill reduces the rate of Medicaid spending from the federal government below what is projected to be needed to maintain current levels of services, and shifts more responsibility to the states to manage funds and services. In theory, states could choose to increase their contributions to the Medicaid program to make up for the federal shortfall but in practice, most experts believe that many states will not increase their spending and instead tighten eligibility, thereby reducing the numbers of seniors served under the program. 

• Currently, many eligible seniors do not participate in Medicaid, because of the significant paperwork associated with eligibility including asset verifications and frequent eligibility redeterminations. This “red tape” has proven to be a barrier to participation for many low-income seniors, which is why the Biden Administration adopted a rule last year to allow states to streamline eligibility determinations and reduce the number of redeterminations. The new budget would repeal that rule and add additional paperwork requirements that would likely lead to even more reductions in participation, something the cynical among us might suspect is the point.  

In total, these changes, and others such as increasing the co-pays for some seniors on Medicaid, would signal a sharp loss for health care coverage for low-income seniors in the United States. To be clear, this is the estimated impact of the House version of the bill, and it is not yet known what the final version of the budget will look like. 

Next week: Tax cuts and seniors: who wins? 

2. From the Department of "We Can't Seem To Look Away."

Bryan Johnson, the winner of the annual Nathan’s supplement chugging contest, is now reporting that he has spent 5,400 minutes spread over three months in a hyperbaric oxygen therapy (HBOT), and that the results are positive and dramatic: “My microbiome improved dramatically. My skin health dramatically improved, and my telomere lengthened. This may be the most efficacious whole body rejuvenation therapy I’ve ever done.”  

Hyperbaric oxygen therapy allows a patient to breathe pure oxygen—as opposed to everyday air, which is mostly nitrogen and just 21% oxygen. Hyperbaric oxygen is also highly pressurized, allowing the lungs to take more in. The FDA has been regulating HBOT chambers since 1976, and has officially cleared it for 13 medical conditions, from decompression sickness to burns, for such treatment. But it’s used off-label for many other reasons, including concussions, traumatic brain injury, long COVID, age reversal, stroke recovery, fibromyalgia, and improved brain function. Johnson’s report adds to a growing belief in some quarters that HBOT can substantially increase longevity. But before you rush out and plunk down $36,500 on an OxyRevo Space60 chamber, remember that there are some risks involved and the evidence of long-term benefit from HBOT is still largely lacking. 

3. And From the Department of "What Could Possibly Go Wrong With This?"

A new era of designer babies may be upon us. This week, startup company Nucleus Genomics launched a new service called Nucleus Embryo. For a mere $5,999, users of IVF can dig deep into the full genetic blueprint of their embryos before choosing which one to implant. The tool lets customers evaluate the genetic risk profile of up to 20 embryos, providing polygenic risk scores for more than 900 conditions. The 900 conditions include risks for Alzheimer's, type 2 diabetes, and schizophrenia, but also cognitive traits like IQ and physical traits such as height, eye color, and baldness (ouch, that one hurts). 

No returns if the baby is not up to standards, since Nucleus Embryo is only calculating the probability, not the guarantee, of various genetic outcomes. And not surprisingly, the launch of this new company has not been met with universal approval. While screening for certain conditions such as Down Syndrome is widely accepted, the idea of giving wealthier parents more opportunities to score their potential offspring on routine physical characteristics raises concerns over fairness at best and echoes of eugenics at worst. 

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