Coleman Drake

What fraud? State Obamacare officials don’t see the problem GOP subsidy opponents do State health care exchanges say they have few problems with fraud. Instead of killing the subsidies, policy experts suggest fixing the federal exchanges instead.

“If you have a problem with car thieves in your community, the policy solution is not to make cars more expensive for residents to buy,” @sabrinacorlette.bsky.social said.

www.politico.com/news/2025/12...

Apropos of nothing except every other news article

It sure would have been nice to have AI to talk about identification strategies with in grad school. It is SO good at this!

@adrianna.bsky.social @michalhorny.bsky.social @coveredca.bsky.social @markmeiselbach.bsky.social @mattdeisenberg.bsky.social @steveparente.bsky.social @davidslusky.bsky.social @tradeoffs.org

Sorry if I missed you not sure who's on here these days!

Do you have a paper on health insurance policy in the Marketplace, MA, or group markets that you would like to present @ashecon.bsky.social in a panel with @dmaanderson.bsky.social @paulshafer.bsky.social sky.social and me? If so, please shoot me an email or DM!

Will Expanding Catastrophic Coverage Eligibility Increase Marketplace Premium Affordability in 2026? David M Anderson, PhD, Dylan Nagy, MS, Coleman Drake, PhD; Will Expanding Catastrophic Coverage Eligibility Increase Marketplace Premium Affordability in 2

❗NEW RAPID POLICY ANALYSIS RESEARCH ❗

With @colemandrake.bsky.social & Dylan Nagy we analyzed the affordability implications of the new 9/4/25 announcement that all individuals with incomes >250% FPL can purchase CATASTROPHIC plans in the ACA

academic.oup.com/healthaffair...

1/4

Tagging those who might be interested

@charlesgaba.com @louisenorris.bsky.social @xpostfactoid.bsky.social @dmaanderson.bsky.social @adrianna.bsky.social @dgorenstein.bsky.social @coveredca.bsky.social @cynthiaccox.bsky.social @kffhealthnews.org @kff.org @emily-gee.bsky.social

TLDR: Direct subsidies to <200% FPL enrollees where cost effectiveness is highest at increasing coverage. Returns diminish substantially above that point, and state budgetary constraints increase.

~10 states are now supplementing federal premium subsidies, yet no prior study has examined the best way to do this to maximize coverage. Using data from Maryland, we find that subsidies targeted to lower income enrollees are most cost effective.

Efficient Subsidy Targeting in the Health Insurance Marketplaces Enrollment in the Health Insurance Marketplaces created by the Affordable Care Act reached an all-time high of approximately 25 million Americans in 2025, roughly doubling since enhanced premium tax c...

🔥NEW WORKING PAPER ALERT🔥

Efficient Subsidy Targeting in the Health Insurance Marketplaces with @markmeiselbach.bsky.social & Dan Polsky, supported by @commonwealthfund.org & AHRQ.

We study how states can efficiently allocate supplemental marketplace premium subsidies

arxiv.org/abs/2510.13791

Balloon Juice - Zero use insurance policies The Paragon Institute insists that people who don’t generate an insurance claim is a phantom enrollment or a fraudulent enrollment. A staggering 40 percent of enrollees in 94 percent actuarial value s...

Decreasing the cost of purchasing coverage and reducing administrative burdens should lead to a substantial increase in zero claim enrollees

balloon-juice.com/2025/08/18/z...

#HealthPolicy
#ACA

😆

HPM researchers are focusing on burdens that keep people from insurance coverage and health care Created with the Heyzine flipbook maker

The latest Pitt HPM newsletter did a nice profile of the work that my colleague @colemandrake.bsky.social and I do on administrative burdens in health insurance, and why this is such an important area of health policy to understand. (No bias whatsoever.) heyzine.com/flip-book/77...

On the folly of relying too heavily (and overly narrowly) on OHIE — well-tread ground if you were on health policy Twitter in 2013

Glad @citizencohn.bsky.social posted this response letter when WSJ would not

www.thebulwark.com/p/one-big-de...

Tracking the Affordable Care Act Provisions in the 2025 Reconciliation Bill | KFF KFF is tracking the Affordable Care Act (ACA) provisions in the 2025 federal budget bill, including changes related to enrollment, verifying eligiblity, and filing and reconciliation.

Hard to overstate how useful this resource is.

A few more fiddly Marketplace policies didn't make it into the Senate bill (e.g., SEP verification requirements) — probably because of Byrd concerns — but most consequential policies (including ending automatic re-enrollment with subsidies) remain

It’s possible to just help people.

Medicare Advantage Part B Premium Givebacks and Enrollment This study evaluates trends and expenditures in Medicare Advantage Part B premium givebacks and their association with plan enrollment.

New paper out with Andrew Anderson, @laurasamuel.bsky.social, and Kali Thomas in
@jamahealthforum.bsky.social on "Medicare Advantage Part B Premium Givebacks and Enrollment"

jamanetwork.com/journals/jam...

@bsph-hpm.bsky.social @johnshopkinssph.bsky.social

More below.

Another day, another reviewer at a major medical journal rejecting my difference-in-difference study because of time-invariant differences between treated and control groups

Coverage Retention and Plan Switching Following Switches From a Zero- to a Positive-Premium Plan This cross-sectional study estimates how zero-premium silver plan turnover affected Marketplace coverage in 29 HealthCare.gov states after the implementation of the American Rescue Plan Act.

New RESEARCH with @colemandrake.bsky.social @dludwinski.com Sarah Avina and Dylan Nagy in @jama.com #HealthForum

Examining #ZeroPremium plan turnover leads to less re-enrollment and more active choices to plan switch

jamanetwork.com/journals/jam...

The editorial boards of seven leading health econ journals are taking a stand today against political influence and ideological attacks on peer review and academia. No matter what you study we want to see your scholarship and will NEVER collaborate with suppression. Please repost.

CBO Confirms GOP Budget Bill Triggers Medicare Cuts Republican Plan Adds to the Deficit, Will Trigger Automatic Cuts Under Federal Law

turns out the GOP budget bill adds so much to deficits that it will automatically trigger cuts to Medicare (not just Medicaid).
Older voters unlikely to be happy about this when word gets out
democrats-budget.house.gov/news/press-r...

Understanding Marketplace "Silver Loading" Christen Linke Young explains a new proposal regarding cost-sharing reductions and how it could impact families who get coverage through the ACA.

Latest House bill text includes another blow to the ACA, ending “silver loading.” That would increase premiums by $350 for a hypothetical family. Here’s why: www.brookings.edu/articles/und...

The Spotlight Is on Medicaid Cuts, But the ACA Marketplaces Could See a One-Third Cut in Enrollment In his latest column, President and CEO Drew Altman shows how proposals contained in the House reconciliation bill could result in a one-third reduction in ACA Marketplace enrollment. “While all eyes ...

Republicans have given up on repealing “Obamacare,” but apparently they are still interested in significantly cutting it. Buried in reconciliation, provisions producing at least a 1/3 reduction in marketplace enrollment:

Also if they weren't "pausing" a regulation that makes it easier for elderly and disabled people to dually enroll in Medicare and Medicaid.

This policy is projected to result in 1.3 million fewer such people getting extra financial assistance from Medicaid to help pay for their meds and care.

If there is one thing to know this week, it’s this: The combined impact of proposed #Medicaid changes, reduced premium tax credits, and the establishing of new enrollment barriers would erode ACA coverage gains to the tune of 13.7 million more Americans being uninsured by 2034.

Balloon Juice - Section 1332 Reinsurance Waivers and Silverloading We talked earlier this week that the Republican reconciliation bill may contain a direct payment appropriation for Cost-Sharing Reduction (CSR) subsidies in the ACA.  This would end the practice of “S...

#Section1332 #Reinsurance #ACA waivers would become much more expensive for states in a no #Silverload scenario

@colemandrake.bsky.social @egolberstein.bsky.social @dludwinski.com @adrianna.bsky.social
@standorn.bsky.social @charlesgaba.com

balloon-juice.com/2025/05/08/s...

New today @healthaffairs.bsky.social w/ @dmaanderson.bsky.social, Naomi Zewde, and Adam Biener on how states can implement #BasicHealthPlan to continue offering quality, affordable coverage to low income subsidized Marketplace enrollees. @commonwealthfund.org

www.healthaffairs.org/content/fore...

Well these are the most appropriate and reasonable award winners in the history of award winners. Congrats! @johnmullahy.bsky.social @edwardnorton.bsky.social