This proposal is worth engaging for an under-appreciated reason.... H.R.1., passed this past summer, eliminates tax credit overpayment safe harbors for advance credits that end up too large relative to realized income the individual has during the coverage year www.wsj.com/politics/pol...

@allanmjoseph.bsky.social has been telling me there needs to be a "Dartmouth Atlas, but for pediatrics" for maybe a literal decade? And now there is! (h/t to coauthor @johngraves.bsky.social)

When is the point of no return for extending ACA tax credits? They expire 12/31, so that’s a drop dead date. Open enrollment starts November 1. If they’re not extended by then, enrollees may start dropping out. Even if open enrollment is extended, people could be hard to reach.

What's at stake in the debate over enhanced subsidies? The "average" American will spend about five years of their pre-Medicare lives in privately-purchased coverage. But these are often short spells, where marketplace plans provide a critical "bridge" at key transitional moments in life.

A new paper led by Harvard Health Policy PhD student Ye Shen finds that, in the current policy environment, more than six in ten kids will have been enrolled in Medicaid for some period of time by their 18th birthday; the program is absolutley critical for children. jamanetwork.com/journals/jam...

Excited to share new research led by Jessica Harvey exploring the budget impact of gene therapies for sickle cell disease, with a focus on Medicaid programs. Co-As: @ankurfactorial.bsky.social, @leah-rand.bsky.social, @akesselheim.bsky.social, & George Goshua. 🔗: link.springer.com/article/10.1...

Overall, we estimate that longer hospital stays for Medicare Advantage patients are contributing to close to 2 million extra hospital bed days occupied by people who don't need to be there any more annually. This is a huge waste and bad for patient care. Why is this happening?

Next year, Marketplace enrollees are going to have a pay a larger percentage of their income in premiums (assuming Congress doesn't extend the current subsidy enhancements). Here's my overview of how it all works, including examples: www.healthinsurance.org/faqs/is-the-...

Until this year, consumers were largely shielded from rising premiums in exchange plans because enhanced premium tax credits capped premiums at no more than ~9% income for everyone. But not next year: premium tax credits will be lower & consumers will additionally shoulder the premium increases.

New teaching hook for covering "job lock" in health economics courses just dropped.

Nearly everything I do today is empirics and coding. But my English degree is unquestionably the most important thing I took from (liberal arts) undergrad.

Decades of mechanistic talk about university degrees as if they were bundles of 'skills' and 'prep' are about to be proved completely wrong (obviously). Want to get a real boost? Do History or English.

Trump's bill could strip Medicaid from 12 million Americans. Repeal isn't enough. Democrats must use this opportunity to propose bold reforms that truly fix Medicaid’s core problems. In @thebulwark.com, I share how to build a system that actually works: www.thebulwark.com/p/democrats-...

Eric Roberts and @joefigs.bsky.social led a groundbreaking new study on Medicaid and Medicare, out today in NEJM. I’m lucky to have been a part of it. Medicare saves lives. But is it enough to save lives of the most vulnerable Americans? The study suggests no; Medicaid still matters. (1/11)

ADVISEES: YOUR MENTORS WANT TO KNOW HOW YOU'RE DOING. (And, yes, I know I could do better with reaching out to you, but leave that aside for the moment.) Please don't ever think you're bothering your former mentors with requests to catch up. They are not a bother. They want to hear from you.

The Value Zeitgeist — Considering the Slowdown in Health Care Spending Growth | New England Journal of Medicine www.nejm.org/doi/full/10.... @melindabbuntin.bsky.social , Carrie Colla, and I argue it's too soon to give up on value-based care.

New article out in Health Affairs Scholar with a great group of co-authors led by Jane Zhu providing a novel view on provider networks & adequacy from the carrier perspective Medicaid managed care organizations' experiences with network adequacy doi.org/10.1093/hasc... #HAScholar

Indeed -- from our recent JAMA viewpoint jamanetwork.com/journals/jam...

An influential recent finding in health economics is that the welfare benefit of Medicaid to beneficiaries may be less than the cost to the gov't for providing it. This indicates we need a strong social appetite for redistribution to justify that $ transfers involved. (1/2)

🚨 Rethinking Moral Hazard: Moral hazard in health insurance—the increased spending that comes when you get insured—is usually seen as wasteful due to insurance’s price distortion. This paper challenges that view.

Instead, people are just really bad at estimating percentages They systematically overestimate smaller %s and underestimate larger %s, including ENTIRELY NON-POLITICAL %s, such as the % of the population that owns an Apple product, has a passport, or has indoor plumbing

Not too much goin' on today, so thought I'd tell you about a new paper out in @nejm.org w/Angrist, Gao, and Yeh We explain & demonstrate why instrumental variable methods are essential for trials of medical interventions that fail to play out as intended Check it: www.dropbox.com/scl/fi/lsnmm...

New: ACA enrollment has more than doubled since 2020, with the greatest growth in states won by President Trump. If enhanced premium aid is allowed to expire at the end of this year, those states will see big out-of-pocket premiums hikes and loss of health coverage. www.kff.org/policy-watch...

Thread: Obviously I'm very pleased at this recognition, but I'm sharing this for other reasons. 1st, many have the impression that people who have been successful professionally have walked a straight path - got the right degree, right 1st job, succeeded right away.

Using a personal example, AHRQ funded my dissertation research (it was NCHSR then) for $15K in 1981. 44 years later, between policy relevant research, 2 terms of public service (@FTC @DOJ), founding a health care data repository (@HCCI) & teaching health economics, I think the investment paid off.

With the Agency for Healthcare [sic] Research and Quality on the chopping block, I thought it might be useful to highlight a few ways in my own research on efficiency and access in the U.S. health care system has benefited from AHRQ data, collaboration and funding.

One dynamic to watch is that Medicaid eligibility is based on current monthly income. For many, it serves as a bridge after losing a job. Something to keep in mind as Congress aims to trim Medicaid spend & as tens if not hundreds of thousands of fed workers are laid off.

Four primary levers to *reduce* Medicaid costs are: 1. ↓ Eligibility 2. ↓ Benefits 3. ↓ Payment rates 4. ↑ "Ordeals" (frequent redetermination, more paperwork / hoops, like work reqts, ↑ prior auth / utilization mgmt) The primary lever to *shift* fed costs to states is ↓ matching rates.

J-PAL North America is on Bluesky! @j-palna.bsky.social

Trump & Musk have somehow managed to frame recent events as a binary: Either you want to burn it all down, or you support the status quo It’s a false choice, obviously. But Dems/Trump critics have done a poor job articulating that failure in logic and existence of option #3: actually fix things

Four primary levers to *reduce* Medicaid costs are: 1. ↓ Eligibility 2. ↓ Benefits 3. ↓ Payment rates 4. ↑ "Ordeals" (frequent redetermination, more paperwork / hoops, like work reqts, ↑ prior auth / utilization mgmt) The primary lever to *shift* fed costs to states is ↓ matching rates.

Update: we may have a solution on this -- grateful to those who shared and reached out.

a good Q for an enterprising labor economics PhD student would be to evaluate how many of the 65k had planned to resign anyway

I work with a talented researcher impacted by recent Δ at NIH. She has demonstrated expertise in the development of multicomponent chronic disease behavioral interventions. Her work leverages innovative methods and mutlidisciplinary collaborations. Please DM if you're hiring in this space! (1/2)

I spend an *insane* amount of my time thinking about how to integrate AI into teaching, research, etc. The secret sauce is in who can use AI tools most creatively. As I come to this realization, at no time have I been more thankful that I can lean on my liberal arts (English LIt & Econ) degree.

I tell my patients: it is extremely difficult to control other chronic conditions until we tackle mental health problems. New study shows that accelerating mental health care saves Veterans’ lives, and vast majority of gain is not from mental health causes of death.

Hello World! The Editorial Board of Health Economics is pleased to announce that we are now live on the happier, friendlier, and all-together Blue-er place. Please follow us (and repost) for updates on articles and journal issues as they come out.

👋 Just getting connected here! I made a starter pack of researchers who study patient-centered and economic outcomes of genomic and precision medicine. Hope to grow this list over time, so reach out if you’d like to be included! 🧬 go.bsky.app/7q8UwB2

The lifetime dynamics of health coverage have changed *dramatically* since the ACA's major provisions went into effect in 2014. An impt. part of the coming health policy debate is going to understanding how these major changes will impact the availability, stability and affordability of coverage. 🧵

🚨Thrilled to share our new JAMA Neurology publication! Building on previous work, we compare the past vs. future impact of stroke care improvements. Timely tPA drove 20 years of gains, but untapped potential lies in carotid imaging and broader tPA access. jamanetwork.com/journals/jam...

PSA to job market candidates: if you didn't get a particular flyout, it may have had nothing to do with the quality of your interview. Departments have a myriad of internal constraints and goals that are unobservable to you, and the process is a lot more complex than you think.

I was incredibly honored to be awarded the CSWEP Carolyn Shaw Bell Award. When I accepted the award, I talked about the importance of mentoring. The lessons I pass on are kind of obvious. But they are important, so I am going to share them yet again. (A🧵)

The evidence-based policy movement is as much about learning what not to fund as what to fund. Resources at the state/local level for social programs are always tight. Rigorous program evaluations help ensure scarce dollars are optimized to actually improve outcomes. 10/12

This is great work. I would also add my concern that due to lack of attention/action on risk-adjustment, optimizing HCC coding became an obvious, lucrative, and largely costless (in terms of member complaints) lever to pull--fueling growth while shielding benes from true MA-TM choice tradeoffs

Nothing like a publication date that hits right after everyone shuts down for the holidays. That said, if you want to read about Medicare Part D premiums and what we might want to do about them, please take a look! I really enjoyed writing this piece.

100%. One of the most professionally rewarding dimensions of my job the last few years has been in working with clinical teaching colleagues to integrate systems and policy thinking into our med student curriculum.

Those of us who regularly use CMS administrative data for research would swoon over this degree of innovation and efficiency in protected data access:

All of Us aims to genotype ~1 million people from diverse backgrounds, esp. in rural areas and in historically marginalized populations. If allowed to continue, would really lay the groundwork for important discovery of precision therapies better tailored for vulnerable groups.