David Machledt

Her baby was in the NICU. She was in ICE detention. Nayra Guzmán was arrested 15 days after her daughter’s difficult birth. Before Trump took office, postpartum immigrants were rarely detained by ICE.

THEY DID THIS TO A MOTHER AND HER CHILD

At $65K/year, a 60 year old enrollee wlll go from paying around $460/month in most cases (just 8.5% of their gross income) to anywhere from $868/month at the *low* end in #NY17... to as much as a jaw-dropping $2,177/month in #AKAL.

That's an ADDITIONAL $4,900 - $19,000 per year in premiums alone.

Well done! A Massachusetts church displayed an “ICE was here” sign in its Nativity scene.

Premium Payments if Enhanced Premium Tax Credits Expire | KFF This data note examines how the expiration of the ACA's enhanced premium tax credits could affect the out-of-pocket portion of premiums for different households.

Maddie is right — this is a really important affordability protection at relatively modest incomes. See this KFF resource for details: www.kff.org/affordable-c...

For people over 400% FPL, premiums are capped at 8.5% of income under current policy. So someone making over $400,000 could only get subsidies if their monthly premium exceeds $2833, and only for the amount above that threshold. For someone at $62,600, monthly premium goes from $443 to full cost.

Medicaid Work Requirements: Mitigating Harm through Implementation This piece provides an overview of the structure of the new Medicaid work requirement and recommends how states can choose policies that lessen the negative effects of this new requirement. Recommendations include reducing administrative burden for states and individuals through streamlined compliance procedures, ensuring that health and functional status definitions capture the full range of people who should qualify for exemptions, and expanding state's ability to verify compliance through available data sources.

This piece breaks down the new Medicaid work requirement and outlines ways states can reduce harm—streamlining compliance, strengthening exemptions, and using data to verify eligibility. By D. Machledt: https://healthlaw.org/resource/medicaid-work-requirements-mitigating-harm-through-implementation/

According to the GAO, more full-time Walmart employees receive SNAP benefits than any other employer in the nation. Perhaps Walmart executives should spend more time puzzling over the ethics of that. www.gao.gov/assets/gao-2...

Medicare announces price cuts for 15 prescription drugs, including Ozempic The lower prices stem from the Medicare negotiation program created under the Biden administration's Inflation Reduction Act.

Medicare announces price cuts for 15 prescription drugs, including Ozempic
The lower prices stem from the Medicare negotiation program created under the Biden administration's Inflation Reduction Act.
www.nbcnews.com/health/healt...

When you only want boy-friendly spaces

An informational graphic from KFF displaying statistics on Medicare Advantage Enrollees. It shows that 17% had a diagnosis that increased federal payments to their Medicare Advantage Plan. 1% had a diagnosis removed in a chart review.

1 in 6 Medicare Advantage enrollees had a diagnosis added on a chart review that increased federal payments to their insurers.

Chart reviews, which aren't used in traditional Medicare, are among the largest contributors to higher payments to MA plans. https://on.kff.org/3XRl2Ec

After Series of Denials, His Insurer Approved Doctor-Recommended Cancer Care. It Was Too Late. - KFF Health News Eric Tennant’s doctors recommended histotripsy, which would target, and potentially destroy, a cancerous tumor in his liver. But by the time his insurer approved the treatment, Tennant was no longer c...

Eric Tennant’s doctors recommended histotripsy, which would target, and potentially destroy, a cancerous tumor in his liver. But by the time his insurer approved the treatment, Tennant was no longer considered a good candidate. He died in September. kffhealthnews.org/news/article...

Bar chart shows the number of people in 1000s on home care waiting or interest lists by whether or not states screens people on any waiting lists for eligibility prior to adding them to the list. The chart shows that a disproportionate number of people on waiting lists for home care live in states that don’t assess eligibility for people waiting.

Between 2024 and 2025, total enrollment in waiting and interest lists for home care through Medicaid increased by 14%, and is over 600,000 in 2025.

Federal cuts to Medicaid could change waiting list sizes again: https://on.kff.org/48fSeu7

Why We Are Stuck with Prior Authorization Review Prior authorization review frustrates patients and physicians, but we likely can’t just eliminate it. In his new column, President and CEO Dr. Drew Altman discusses why, and why the focus is now inste...

No one likes prior authorization review. But could we get rid of it? My new column: www.kff.org/from-drew-al...

An incredibly important issue. Read it

A cyclist on a sidewalk is usually a symptom of bad infrastructure.

As I often say, cyclist vs. pedestrian conflicts arise because both are fighting over the scraps of space not occupied by cars. But what if we took that space from cars to make biking, walking, and rolling safer?

We thank all of the members who are standing up for the people of DC! The reps that went to bat for DC help us to stay in the fight to protect our home and each other!

Democrats, VOTE NO on H.R. 5214 and 5107!!!

New Data Highlight Risks to Children and Parents if Enhanced Marketplace Subsidies Expire Marketplace subsidy enhancements which have been in place since 2021 are set to expire at the end of December 2025, and their fate is currently uncertain. Since 2014, when Affordable Care Act (ACA)…

While Medicaid is by far the biggest player for children's coverage, the Marketplace has become increasingly important.

New brief from @urbaninstitute.bsky.social finds that 453,000 children will become uninsured if subsidies expire.

ccf.georgetown.edu/2025/11/14/n...

My colleague @shelbytgonzales.bsky.social unpacks the new effort to rescind Biden Admin's #PublicCharge rule and how doing so will create fear and confusion among people who are immigrants and their families.

How might my tax deductions affect the size of my ACA premium subsidy? Learn how tax-deductible contributions to an IRA, HSA, or self-employed health insurance deduction might lower your MAGI and boost the amount of your ACA premium tax credits.

See here for details:

www.healthinsurance.org/faqs/how-mig...

KFF's estimate that out-of-pocket ACA premiums will increase if enhanced tax credits expire by an average of 114% has been widely reported. But, it varies a lot, especially by income. Here's what increases look like in dollar terms -- from $378 at $18,000 to $1,836 at $45,000.

Haha! As if you can really price shop when it’s so hard to know ahead how much a service will actually cost! Haven’t studies also found that savings generated from HDHP plans also dissipated in the out years?

As the ~discourse~ seems to bend interminably towards Republicans trying to figure out how they can (further) HDHP-ify ACA coverage, it's worth revisiting what is probably our best (most rigorous) study on the effect of deductibles in health insurance.

academic.oup.com/qje/article-...

Can we please see the last two months of jobs reports now?

He just admitted that tariffs are taxes.

Chart titled 'States Report a Variety of Challenges With Implementing New Medicaid Work Requirements'. The chart lists challenges by categories: System Changes, Implementation Timeline, Staff Capacity, Fiscal Impact, and Applicant and Enrollee Issues. Each category details specific implementation challenges faced by states according to a 2019-2020 KFF survey of state Medicaid officials. Examples include system upgrades, pressure to make system changes in a short timeline, training needs for staff, potential increased cost due to accelerated timelines and changes, and potential confusion among applicants and enrollees.

State Medicaid programs shared insights into the challenges they anticipate when implementing work requirements next year: https://on.kff.org/3LLhQHu

How a thrown sandwich became a symbol of D.C.’s resistance In an already surreal moment, Washingtonians have embraced bread puns, sandwich flags, and sub-themed street art as a form of protest.

Sean Charles Dunn’s moment of culinary resistance — he wouldn't be subservient, one could say — has become a symbol of D.C.’s refusal to accept the federal occupation quietly.

Earlier today, D.C.'s own "sandwich guy" was found not guilty of the charges against him.

The vast majority of poll-sniffing punditry just refuses to take on board this very basic feature of human psychology. People make vibes decisions based on factors they're probably not fully conscious of. And then they cast about for a respectable-sounding rationalization for that decision.