Adrianna McIntyre (@adrianna.bsky.social)

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. 🧵

Amy Finkelstein is tired of people misinterpreting the Oregon Health Insurance Experiment to support Medicaid cuts, she writes in @statnews First Opinion: statnews.com/2025/07/03/ore…

"The program has cost more than $100 million, with only $26 million spent on health benefits and more than $20 million allocated to marketing contracts, according to a KFF Health News analysis of state reports." #Medicaid #WorkRequirements #GAleg

The temporary $50 billion rural health fund in the Republican tax and spending bill gets distributed from 2026 to 2030. But, 63% of the Medicaid cuts hit after 2030.

Somehow the name of the HBS phd student extraordinaire didn't make it into this tweet: It's Bohan Li, and she's awesome! Stay tuned for a health affairs podcast she did about our paper coming out soon.

Great @tradeoffspod interview on the implementation challenges state Medicaid programs are staring down. "There have been exactly zero successes at implementing work requirements in this country… we've got two relatively well-documented struggle buses." tradeoffs.org/2025/07/10/big…

The ACA was not popular when it passed (remember death panels), but it was more popular than the “ OBBB” is today.

What's remarkable is that health care spending as a share of the economy has indeed stabilized since the Affordable Care Act, coming in far below projections & after decades of rapid growth. All while the uninsured rate dropped by nearly half.

NPR doing some stories from the weekend on how people don't know if they're losing Medicaid coverage because the plans are confusingly named. @onceuponA, Danielle Pavliv and I have a paper on this:

We have a moral obligation to our children to protect them from completely preventable but potentially deadly or debilitating illnesses by training their immune system to fight said illnesses.

This is original House bill, but the same effect. OBBB is the largest cut to health care in history, cutting Medicaid by 2x what Reagan did. Medicaid backstops everything from nursing homes to rural hospitals; uncharted territory for how much health care access people will lose.

One of the most urgent questions now is how states can minimize the damage (coverage losses) from these policies. The venn diagram of answers to that question and answers to "how will system vendors try to extract as much profit as possible?" is going to have a lot of overlap.

A good summation of the danger of tightening Medicaid access, from a Republican pollster who has spent a lot of time studying working-class voters who backed the GOP in '24. On paper, they say they back spending cuts. And then you start getting into specifics and ...

... I can't believe this is in the final bill.

We still don’t even final estimates for: -how many people lose health insurance -how many people lose SNAP -who wins/loses and by how much -total Medicaid cuts -total health care cuts -total SNAP cuts Because knowing that didn’t matter to the people who supported it

This is the Trump health care plan we waited an infinite "two weeks" for. It'll increase the number of uninsured people in this country by about 50% over the next decade.

The Republican megabill has many parts and was never framed for the public as a health care bill. But, it is the biggest cutback in federal support for health coverage ever.

As of a couple weeks ago, fewer than one in ten people knew there were Medicaid cuts in this bill. Folks are in for a very rude surprise. priorities.org/news-and-press…