Rebecca Piazza

Republicans' new Medicaid red tape will push Missouri to the brink and block healthcare for millions • Missouri Independent The budget bill passed by the U.S. House will kick millions of people off of Medicaid by piling on new red tape.

Today in the @missouriindependent.com
I shared how new Medicaid red tape imposed by Republicans will kick over 10 million people off their healthcare, including more than 180,000 people in Missouri ‼️

missouriindependent.com/2025/06/06/r...

Interesting heuristic here: since the overwhelming majority of people are employed, almost by definition the majority of people who lose SNAP benefits to paperwork requirements will be people who have just lost their jobs. An odd group to target for an austerity campaign!

Agriculture text is out. Will go through it in this thread.

tl;dr: this'd be the largest SNAP (nutrition assistance, formerly food stamps) cuts in history. It would severely worsen food insecurity in America.

My daughter’s speech therapist went out of business because Medicaid reimbursement rates were too low. We do not have Medicaid. I’m going to keep posting this until people understand that when Medicaid gets cut *everyone* loses services.

When government capacity is intentionally reduced, anyone with needs out of the ordinary is the first feel the failure

Some news about RIFs within HHS's procurement staff. I oversaw HHS procurement policy as an assistant secretary for a year and know folks still there. Heavy sledding alert, but TLDR: Enormous cuts make contract bloat and fraud far likelier. 1/10

Today I lost an NIH grant training clinicians to do research about intimate partner violence with perinatal women.

More women are murdered in the perinatal period than die of obstetric complications.

I didn't just lose a grant. We lost an entire cohort of people building careers to prevent that.

I helped build a government AI system. DOGE fired me, rolled the AI out to the whole agency, and implied the AI can do my job and the jobs of the others they've fired.

It can't. But, what DOGE accidentally revealed about themselves in the process is fascinating. 🧵

Where Vincent Vega can’t get over the bargain of a five dollar shake

18F alum here. While I appreciate the well-deserved attention the 18F team is getting, let's address a fundamental misunderstanding of why 18F was so effective in working with other govt agencies to improve their digital services and why starting a consulting company is not a substitute. 1/

Every year, OPM runs the Federal Employee Viewpoint Survey to find out how feds feel about their jobs. It's a big deal for agencies, who all want to be top-ranked. (IIRC, NASA usually wins.) This year, OPM is skipping it. www.chcoc.gov/content/2025...

... and one of the reasons why you haven't heard of 18F is because 18F's successes are really down to the agencies, departments, and programs. Because they're responsible for the tech.

And you want them to be responsible, not a small authoritarian unaccountable cadre that works in secret.

18F, the federal government’s technology shop, was demolished by Musk’s team shortly after midnight. It was a cost-recoverable org, charging agencies for their expertise, using a consulting model. Its cost to government was negligible, its benefits huge. My team there once saved DoD $500 billion.

Mourning 18F’s elimination as a former employee but even more so as a former 18F agency customer. Unlike DOGE, 18F did the hard work of cultural transformation and sharing their methods with other Feds as they helped improve services. They weren’t just techies, they were teachers.

I want to read this piece!

Drug test failures fueling shortage of school crossing guards in D.C. More than two in five who apply to be crossing guards test positive, largely for marijuana, a drug D.C. legalized a decade ago.

I would much rather have a crossing guard by my neighborhood school who occasionally smokes pot on the weekend than no crossing guard, which is the current situation. This risk calculus seems wrong. www.washingtonpost.com/dc-md-va/202...

If you think a food is so unhealthy that it should be banned for food stamp recipients, you should support banning it for richer people too. Otherwise, you either support poisoning the middle class, or you're just trying to further control and complicate poor people's lives

Don’t make me tap the sign (cc RFK Jr)

Musk Allies Discuss Deploying A.I. to Find Budget Savings A top official at the General Services Administration said artificial intelligence could be used to identify waste and redundancies in federal contracts.

1/ I suspect we are days away from hearing Elon is "using AI" to “streamline” benefits programs.

You should know why fully automating decisions about who gets critical assistance is a terrible idea that will have disastrous consequences.

A 🧵 based on work I’ve done with the great @awhf.bsky.social

Hello week 2 of tax filing season! 💥

Direct File is live and you can now import your tax information directly from the IRS.

Visit DirectFile.irs.gov to check eligibility and learn more. 👏

Musk's Junta Establishes Him as Head of Government Imagining how we'd cover overseas what's happening to the U.S. right now

Having watched with growing alarm the developments of the last 24 and 36 hours in Washington, I thought I’d take a stab at how the US media would cover this story if it was happening in a foreign country. Here’s that story that should be written this weekend: www.doomsdayscenario.co/p/musk-s-jun...

There appear to be at least three separately operating heel factions breaking things within the government in wholly different ways right now. There's the Miller-headed immigration one, the DOGE/Elon one, and a Project 2025 OMB one. This dynamic hasn't showed up in mainstream reporting at all.

Wyden Demands Answers Following Report of Musk Personnel Seeking Access to Highly Sensitive U.S. Treasury Payments System | The United States Senate Committee on Finance Wyden Demands Answers Following Report of Musk Personnel Seeking Access to Highly Sensitive U.S. Treasury Payments System

Appreciate that @wyden.senate.gov is asking important questions about access to the payments system. Journalists, please raise these up. I hope more actions will be taken ASAP.
www.finance.senate.gov/chairmans-ne...

Elon’s Twitter Destruction Playbook Hits The US Government, And It’s Even More Dangerous Remember how Elon Musk destroyed Twitter by ripping apart its infrastructure without understanding it? Now imagine that same playbook applied to the federal government. It’s happening, and th…

“He’s applying the same destructive playbook to the federal government, where the stakes involve not just user experience or advertising dollars, but the basic functioning of American democracy.” www.techdirt.com/2025/01/31/e...

We can help feed each other and clothe each other. We can take each other in and provide shelter. We can raise money. We can know our rights when it comes to ICE, etc.

But I can’t fly a fucking plane.

“We’re all we have” has its limits. We need government regulations for a reason.

I’ve spent about 2-3 hours each day on calls or chats with my US gov friends. Here’s an anonymized recap of what’s going on.

First, I am so very sorry that they are living our last year at Twitter. I never wanted to think about that time again, and I hope my advice is helpful. 1/

What counts as modern versus traditional or novel versus revivalist is subjective, after all, and a good firm like SOM can design within constraints to deliver a decent project.

But this time the goal is to change the procurements process — who selects the firms and even who contractors can hire.