Joined January 2010
- Tweets 62,668
- Following 433
- Followers 20,043
- Likes 41,425
4,703 Photos and videos
Pinned Tweet
When we talk about health insurance premiums, we typically frame them as financial burdens, because they often are!
But—absent auto-pay—paying premiums is also a hassle, and I had this nagging question: what do tiny premiums do to enrollment?
We try to answer that here. 🧵
4
12
47
27,190
"States are going to be asked to make a determination using information that doesn’t exist in their systems"
Still lots of confusion over whether/how frailty determinations for work requirements can be automated
And states don't have the luxury of time for CMS to figure it out
2
10
20
2,415
Full story: abcnews.com/US/wireStory/sic…
1
4
1,149
"nepo parent" is an innovation, I guess
Scoop: HHS plans to appoint ER doc Mark Shirley as chair of the U.S. Preventive Services Task Force. He was picked by his daughter, HHS employee Malia, who has been in charge of screening USPSTF candidates. notus.org/healthcare/hhs-us-…
2
14
2,221
Adrianna McIntyre (@adrianna.bsky.social) retweeted
Jun 11
President Trump has taken a pro-tobacco regulatory stance in office.
There has also been an extraordinary flow of money between Trump and the tobacco industry, including as much as $1.64 million in Philips Morris stock.
My latest, at @KFFHealthNews: kffhealthnews.org/courts/fda…
2
1
426
Adrianna McIntyre (@adrianna.bsky.social) retweeted
Jun 11
Trump administration says taking Medicaid away from millions will *reduce* poverty
I ran that prediction by some health policy scholars
They were gobsmacked
Read all about it here thebulwark.com/p/donald-trum…
4
23
41
4,742
Do read @CitizenCohn on that ASPE report, quoting three former top appointees of the office.
"If you read the report itself... you can detect the whiff of serious, longtime HHS analysts trying their best to produce a truthful document."
thebulwark.com/p/donald-trum…
2
13
1,203
Adrianna McIntyre (@adrianna.bsky.social) retweeted
Jun 10
Congrats to my colleague @jrovner! There is no better recipient of this award than Julie, who has deftly covered health policy for decades, with an encyclopedic knowledge of the issues like Robert. (Minus some of Robert's quirks, like taking notes in multiple colors.)
Jun 10
Honored to have been named the first recipient of the Robert Pear award for journalism from the National Academy of Social Insurance!
1
3
32
3,224
Adrianna McIntyre (@adrianna.bsky.social) retweeted
Jun 9
If you’re covering the Medicaid work requirements issue, you should read this.
Even if you take the ASPE report's lit review at face value — and you shouldn't, it skips critical relevant work — the rosiest 1990s work requirements study in their technical appendix suggests an effect size < 10% of what the report's "model" projects
donmoynihan.substack.com/p/t…
1
3
1,068
Even if you take the ASPE report's lit review at face value — and you shouldn't, it skips critical relevant work — the rosiest 1990s work requirements study in their technical appendix suggests an effect size < 10% of what the report's "model" projects
donmoynihan.substack.com/p/t…
2
4
9
2,003
Adrianna McIntyre (@adrianna.bsky.social) retweeted
New paper in JHE! Major health events can trigger a cascade of adverse housing outcomes — potentially contributing to tens of thousands of cases of housing instability for Medicaid enrollees annually. Press release below, and full paper here: doi.org/10.1016/j.jhealeco.2…
New Columbia Mailman research suggests that health crises can be an important driver of housing instability and homelessness, expanding our understanding of the relationship between health and housing. tinyurl.com/mpkv9ydp
1
6
9
1,942
Adrianna McIntyre (@adrianna.bsky.social) retweeted
Jun 4
On this week's #WTHealth podcast: new Medicaid work rules, the politics of grant funding, and fixing the "no surprises" act. with @sangerkatz, @AliceOllstein and @l_e_whyte. Plus the latest Bill of the Month.
kffhealthnews.org/podcast/wh…
4
4
1,007
Every time I open this report, I find a new methodological choice to marvel at.
If your model assumes sunshine and rainbows, your result will be sunshine and rainbows.
Jun 2
In their release of the Medicaid work requirements rule, CMS touts an ASPE report as evidence that work requirements increase employment. In fact, the report assumes “illustrative” impacts that are “not necessarily what is or will occur in the real world”. tinyurl.com/2czhrtcw
16
38
6,827
Was glad to have the chance to join @selenasd on All Things Considered yesterday to chat about the new work requirements regulation, which is will dial up paperwork — and, as a result, coverage losses — for some of the most vulnerable Medicaid enrollees
npr.org/2026/06/02/nx-s1-584…
3
10
18
2,078
Adrianna McIntyre (@adrianna.bsky.social) retweeted
Earlier today, @DrOzCMS claimed that large numbers of Marketplace enrollees aren’t “legit” on the grounds that some enrollees don't file a claim in any given year. Re-upping this thread on why this argument is seriously flawed.
21 Aug 2025
New data from CMS show that many individual market enrollees (35%) had no claims in 2024. That’s led some (eg @WSJ and @BrianBlase) to argue the individual market is awash in “phantom” enrollees, costing the federal government tens of billions. This argument is deeply flawed. 🧵
5
24
36
9,368
Adrianna McIntyre (@adrianna.bsky.social) retweeted
This choice comes as a big surprise to states. As recently as last month, CMS was telling them in regular meetings that it would allow them to exclude people based on medical diagnoses alone. That's what Nebraska--already live with its requirement--is doing.
1
8
18
1,635
ICYMI, the work requirements regulation dropped yesterday evening.
I think the biggest departure from initial expectations is around medical frailty — conditions like cancer and HIV *only* exempt people if they're severe enough to impair compliance with the new rules.
The IFR confirms rumors that CMS is restricting medical frailty exemptions to individuals for whom medical conditions impair the ability to work, a narrower read of the statute than most states and stakeholders I've been in conversation with had initially expected (pp. 83-84)
2
5
16
3,872
Of course, many of these conditions can only be well-managed and not interfere with work capacity *if* one has health insurance to cover treatments (and the scheduling flexibility to get to doctor's visits, radiation appointments, etc)
8
500
In addition to the work requirements reg dropping today, I also got student evals on my new regulatory policy class, and this is maybe the feedback I'm proudest of ever having received in any context:
"She [...] somehow made rulemaking feel exciting."
1
31
2,061
The interim final rule on Medicaid work requirements — the regulation that dictates how states must implement them in the next seven months — is out.
It includes some things that are likely a departure from how states thought they were implementing the policy, adding chaos.
4
18
40
11,440
Finally, the rule does stipulate that states will need to report eligibility redetermination outcome data. (p. 249)
However, as best I can tell — and I might be missing something — it's silent on whether data will be made *publicly available* or are only for internal monitoring
1
3
778
There's more on the SUD exemption that I haven't had a chance to unpack yet, but the full rule is available here:
public-inspection.federalreg…
2
669