John A. Graves | Lightnews

John Graves @johngraves.bsky.social · 2d

Negotiating it as a straight subsidy would reduce the uncertainty around having to precisely predict your income--or else face potentially significant financial consequences at tax time.

The CBO projected that dynamic could depress enrollment in the marketplaces.

John Graves @johngraves.bsky.social · 2d

This proposal would directly deposit the subsidy into HSAs -- and it's not clear how they'd be structured. Would it be a tax credit still subject to overpayment clawbacks? or a straight subsidy?

John Graves @johngraves.bsky.social · 2d

H.R.1. eliminates these safe harbors--meaning that if you receive an advance credit that is $2,000 too high, your tax liability goes up by the full $2,000 overpayment.

John Graves @johngraves.bsky.social · 2d

The original ACA put in place these safe harbors in case someone's projected income (i.e., what they think their income will be next year) doesn't match their actual income.

For incomes under 200% of FPL, repayment caps were around $325 for an individual or $650 for a family.

John Graves @johngraves.bsky.social · 2d

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...

Republicans Pitch Alternative to ACA Extension to End Government Shutdown

GOP senators have proposed sending money directly to consumers’ health accounts rather than to insurance companies.

www.wsj.com

John Graves @johngraves.bsky.social · 14d

The supplemental materials have a ZIP-to-PESA (Pediatric Emergency Service Area) and ZIP-to-PERR (Pediatric Emergency Referral Region) crosswalk, for those who are interested in using the Atlas!

Adrianna McIntyre @adrianna.bsky.social · 14d

@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)

Development of an Atlas for US Pediatric Acute Care

This cross-sectional study offers a national US atlas of pediatric acute care centers in the US.

jamanetwork.com

Larry Levitt @larrylevitt.bsky.social · 22d

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.

John Graves @johngraves.bsky.social · 22d

ggplot + gganimate FTW.

and similar in 2015 -- but v different than 2010!

John Graves @johngraves.bsky.social · 22d

yay! congrats stacie!

John Graves @johngraves.bsky.social · 22d

As one might imagine given these age dynamics and the state's demographics, Florida is the top state where folks are most dependent on this coverage over their lifetimes.

So sharp changes in the affordability of plans due to expiring enhanced tax credits is going to be acutely felt there.

John Graves @johngraves.bsky.social · 22d

At any given time, less than 10% of the non-Medicare-eligible population is covered with private plans in the marketplaces.

But there is a minor surge in so-called "non-group" coverage in early adulthood.

And then, as folks approach Medicare, non-group coverage really takes off.

John Graves @johngraves.bsky.social · 22d

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.

Adrianna McIntyre @adrianna.bsky.social · Sep 24

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...

Adam Raymakers @araymakers.bsky.social · Sep 23

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...

Modeling the Budgetary Impacts of Sickle Cell Disease Gene Therapies on State Medicaid Programs - Journal of General Internal Medicine

Journal of General Internal Medicine -

link.springer.com

Michael L. Barnett @mlbarnett.bsky.social · Sep 8

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?

Louise Norris @louisenorris.bsky.social · Jul 30

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-...

Does the IRS change how much I'll have to pay for my health insurance each year?

Unless Congress extends the subsidy enhancements, the percentage of income that you have to pay for self-purchased (individual/family) health coverage is going to increase significantly in 2026. This ...

www.healthinsurance.org

John Graves @johngraves.bsky.social · Jul 29

Jan 26

John Graves @johngraves.bsky.social · Jul 29

alas it will have to live as “personal correspondence” for now …

John Graves @johngraves.bsky.social · Jul 29

When TN had it's "mini unwinding" back in 2016 (due to difficulties implementing the MAGI conversion, resulting in delays implementing eligibility system) the demographic group that saw the most rapid disenrollments were those 19-21.

John Graves @johngraves.bsky.social · Jul 29

in a way--the enhanced premiums were scheduled to expire and the OBBB codified a decision not to extend them past 2025

John Graves @johngraves.bsky.social · Jul 29

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.

George Pearkes @peark.es · Jul 29

Cost trends in general for patients on ACA exchange and Medicaid plans. Basically the premiums they set aren't high enough to cover the actual health care utilization of those to groups. Policy changes in Medicaid payouts are also playing a role.

Cas Piancey @cascoinfoundation.org · Jul 29

Any idea why payouts are suddenly skyrocketing?

John Graves @johngraves.bsky.social · Jul 29

www.maths.dur.ac.uk/users/jochen...

www.maths.dur.ac.uk

John Graves @johngraves.bsky.social · Jul 29

Reminds me of the classic Basu's Elephant paper I learned from Alan Zaslavsky in his survey design course.

We're doing a similar exercise you recommend for a new insurance simulation model: MLE w/ (unweighted) survey data, with later weighted aggregation & MCMC calibration for population ests

George Pearkes @peark.es · Jul 29

Cost trends in general for patients on ACA exchange and Medicaid plans. Basically the premiums they set aren't high enough to cover the actual health care utilization of those to groups. Policy changes in Medicaid payouts are also playing a role.

Cas Piancey @cascoinfoundation.org · Jul 29

Any idea why payouts are suddenly skyrocketing?

JAMA @jama.com · Dec 13

Viewpoint from John Graves and Gabrielle Lyons discusses enrollment in Medicare Advantage vs traditional Medicare among older adults and common reasons for plan disenrollment.

https://ja.ma/3VCyjA9

PDF preview image of "Incentivizing Network Adequacy in Medicare Advantage"

John Graves @johngraves.bsky.social · Jul 23

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

The Tennis Letter @thetennisletter.bsky.social · Jul 23

Venus Williams after becoming the oldest WTA match winner since 2004:

“I had to come back for the insurance, because they informed me this year that I’m on cobra. So it’s like, I got to get my benefits on” 😭😭😭😭

The Tennis Letter @thetennisletter.bsky.social · Jul 23

Venus Williams after becoming the oldest WTA match winner since 2004:

“I had to come back for the insurance, because they informed me this year that I’m on cobra. So it’s like, I got to get my benefits on” 😭😭😭😭

John Graves @johngraves.bsky.social · Jul 13

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.

Glen O'Hara @gsoh31.bsky.social · Jul 13

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.

Glen O'Hara @gsoh31.bsky.social · Jul 13

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.

Light upyour news

Sign in to Lightnews

Sign up to start reading

Connect Bluesky

Connect with Bluesky

Light up
your news