Adrianna McIntyre
@adrianna.bsky.social
Assistant Professor of Health Policy and Politics at @hsph.harvard.edu
I study how administrative burdens impede health insurance coverage, strategies to reduce these barriers, and the politics of health reform
she/her/Michigander
I study how administrative burdens impede health insurance coverage, strategies to reduce these barriers, and the politics of health reform
she/her/Michigander
Pinned
Adrianna McIntyre
@adrianna.bsky.social
· Nov 11
Hi, new friends.
I mostly research and write about health insurance coverage and access — specifically, how to improve take-up and retention in Medicaid and marketplace plans. I also study the politics of health reform.
Sidekick Nellie cares less about health policy and more about kibble policy.
I mostly research and write about health insurance coverage and access — specifically, how to improve take-up and retention in Medicaid and marketplace plans. I also study the politics of health reform.
Sidekick Nellie cares less about health policy and more about kibble policy.
area pup has decided she is now petrified of exactly one half of one flight of stairs
November 11, 2025 at 2:06 AM
area pup has decided she is now petrified of exactly one half of one flight of stairs
My dad, in trying to convey extremely elementary firearm safety education, imposed a version of this rule for Nerf guns — to the extent that it's become an essential part of family lore that my younger brother once asked, "okay, so can you pretend to be a deer?" (because Michigan)
I keep yelling this at my phone when I see these photos and I’m going to start yelling it here:
NEVER. POINT. YOUR FIREARM. AT ANYTHING. YOU DO NOT INTEND. TO DESTROY.
NEVER. POINT. YOUR FIREARM. AT ANYTHING. YOU DO NOT INTEND. TO DESTROY.
November 11, 2025 at 1:50 AM
My dad, in trying to convey extremely elementary firearm safety education, imposed a version of this rule for Nerf guns — to the extent that it's become an essential part of family lore that my younger brother once asked, "okay, so can you pretend to be a deer?" (because Michigan)
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-...
academic.oup.com/qje/article-...
November 10, 2025 at 9:51 PM
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-...
academic.oup.com/qje/article-...
Reposted by Adrianna McIntyre
This is neither here nor there, but the distinction between a FSA and a HSA is actually pretty monumental — FSAs are use-it-or-lose-it, HSAs are not — and I don't think we actually know which one Trump(/Rick Scott/Bill Cassidy) is talking about in his new concepts of a plan
November 10, 2025 at 9:14 PM
This is neither here nor there, but the distinction between a FSA and a HSA is actually pretty monumental — FSAs are use-it-or-lose-it, HSAs are not — and I don't think we actually know which one Trump(/Rick Scott/Bill Cassidy) is talking about in his new concepts of a plan
Reposted by Adrianna McIntyre
This is such a bizarre talking point; I've thankfully never had to use most of the types of insurance that I have for me and my family
This is a good excuse to share my WSJ letter to the editor explaining that "not filing a claim doesn’t mean you didn’t need insurance" www.wsj.com/opinion/the-...
This is a good excuse to share my WSJ letter to the editor explaining that "not filing a claim doesn’t mean you didn’t need insurance" www.wsj.com/opinion/the-...
November 10, 2025 at 5:57 PM
This is such a bizarre talking point; I've thankfully never had to use most of the types of insurance that I have for me and my family
This is a good excuse to share my WSJ letter to the editor explaining that "not filing a claim doesn’t mean you didn’t need insurance" www.wsj.com/opinion/the-...
This is a good excuse to share my WSJ letter to the editor explaining that "not filing a claim doesn’t mean you didn’t need insurance" www.wsj.com/opinion/the-...
Reposted by Adrianna McIntyre
I've come around to the idea that many alternative payment models are really limited in the traditional Medicare space because they can't stop people from using expensive care from non-model participants. ACOs and episode-based payment models can't control "leakage" enough to be very effective.
🚨New Publication🚨 Risk-based provider payment is more common in Medicare Advantage than any other segment of US health care financing. What happens to broad categories of health care utilization, and low-value service use, when provider groups adopt these contracts? jamanetwork.com/journals/jam...
Health Care Utilization and Low-Value Service Use After Risk-Based Contract Adoption
This cohort study examined whether health care organizations’ transition to risk-based payment contracts in Medicare Advantage was associated with changes in health care utilization or use of low-valu...
jamanetwork.com
November 10, 2025 at 6:06 PM
I've come around to the idea that many alternative payment models are really limited in the traditional Medicare space because they can't stop people from using expensive care from non-model participants. ACOs and episode-based payment models can't control "leakage" enough to be very effective.
Reposted by Adrianna McIntyre
Timely.
My paper on the consumer financial impacts of Missouri's 2005 Medicaid cut with @1armedeconomist.bsky.social and Slava Mikhed is finally out in the fall issue of AJHE: www.journals.uchicago.edu/doi/10.1086/...
Missouri’s Medicaid Contraction and Consumer Financial Outcomes | American Journal of Health Economics: Vol 11, No 4
Abstract In July 2005, the state of Missouri implemented a series of cuts to its Medicaid program. These cuts resulted in the elimination of the Medical Assistance for Workers with Disabilities progra...
www.journals.uchicago.edu
November 10, 2025 at 5:18 PM
Timely.
This work is so important, especially in the context of how modestly (if at all) outreach efforts improve retention.
Also important: the work requirements that need to be implemented by the end of next year may prove much harder to automate than standard eligibility redeterminations
Also important: the work requirements that need to be implemented by the end of next year may prove much harder to automate than standard eligibility redeterminations
New at Can We Still Govern? New Medicaid work requirements will see an estimated 5 million lose coverage.
Small investments in in-house tech capacity could allow states to start preparing now to expand automatic renewal of clients. Here is the evidence 🧵
donmoynihan.substack.com/p/how-a-van-...
Small investments in in-house tech capacity could allow states to start preparing now to expand automatic renewal of clients. Here is the evidence 🧵
donmoynihan.substack.com/p/how-a-van-...
Lessons from Pandemic Era Medicaid Automation for Work Requirements
Small tech capacity investments offer big returns
donmoynihan.substack.com
November 10, 2025 at 4:08 PM
This work is so important, especially in the context of how modestly (if at all) outreach efforts improve retention.
Also important: the work requirements that need to be implemented by the end of next year may prove much harder to automate than standard eligibility redeterminations
Also important: the work requirements that need to be implemented by the end of next year may prove much harder to automate than standard eligibility redeterminations
Reposted by Adrianna McIntyre
New at Can We Still Govern? New Medicaid work requirements will see an estimated 5 million lose coverage.
Small investments in in-house tech capacity could allow states to start preparing now to expand automatic renewal of clients. Here is the evidence 🧵
donmoynihan.substack.com/p/how-a-van-...
Small investments in in-house tech capacity could allow states to start preparing now to expand automatic renewal of clients. Here is the evidence 🧵
donmoynihan.substack.com/p/how-a-van-...
Lessons from Pandemic Era Medicaid Automation for Work Requirements
Small tech capacity investments offer big returns
donmoynihan.substack.com
November 10, 2025 at 2:22 PM
New at Can We Still Govern? New Medicaid work requirements will see an estimated 5 million lose coverage.
Small investments in in-house tech capacity could allow states to start preparing now to expand automatic renewal of clients. Here is the evidence 🧵
donmoynihan.substack.com/p/how-a-van-...
Small investments in in-house tech capacity could allow states to start preparing now to expand automatic renewal of clients. Here is the evidence 🧵
donmoynihan.substack.com/p/how-a-van-...
Reposted by Adrianna McIntyre
If he thinks that bad, wait til he sees how few people file claims for auto, fire, and flood insurance.
Tell me you don’t understand risk pools without telling me you don’t understand risk pools
November 10, 2025 at 3:24 PM
If he thinks that bad, wait til he sees how few people file claims for auto, fire, and flood insurance.
I don't think that Trump has any specific health care plan to point to — he never has — but Cassidy is a different story.
He was advocating for "Roth HSAs" back in 2017 and 2017, in the lead up to the ACA's near-repeal.
From Tim Jost in 2017:
He was advocating for "Roth HSAs" back in 2017 and 2017, in the lead up to the ACA's near-repeal.
From Tim Jost in 2017:
ACA Replacement Bill From Cassidy And Colleagues Offers State Options, Roth HSAs | Health Affairs Forefront
A new ACA replacement plan from Senators Cassidy, Collins, Isakson, and Capito gives states three choices. They can 1) keep the ACA (more or less); 2) adopt a different approach based on subsidized “R...
www.healthaffairs.org
November 9, 2025 at 6:22 PM
I don't think that Trump has any specific health care plan to point to — he never has — but Cassidy is a different story.
He was advocating for "Roth HSAs" back in 2017 and 2017, in the lead up to the ACA's near-repeal.
From Tim Jost in 2017:
He was advocating for "Roth HSAs" back in 2017 and 2017, in the lead up to the ACA's near-repeal.
From Tim Jost in 2017:
Reposted by Adrianna McIntyre
Seems like a good time to do a special issue of @jhppl.bsky.social on the Politics of Private Health Insurance. Call for papers will be out soon, so stay tuned. There’s seem to be, uh, a few politically relevant topics to discuss. @mirandayaver.bsky.social @adrianna.bsky.social
Republicans waged a relentless, decades-long campaign to privatize Medicare and Medicaid
They fought even mild efforts to expand public insurance
Now they are objecting to extending extra ACA subsidies, supposedly because money flows to private insurers
We are supposed to take this seriously?
They fought even mild efforts to expand public insurance
Now they are objecting to extending extra ACA subsidies, supposedly because money flows to private insurers
We are supposed to take this seriously?
November 8, 2025 at 10:10 PM
Seems like a good time to do a special issue of @jhppl.bsky.social on the Politics of Private Health Insurance. Call for papers will be out soon, so stay tuned. There’s seem to be, uh, a few politically relevant topics to discuss. @mirandayaver.bsky.social @adrianna.bsky.social
Ah yes, just what everyone has been clamoring for: HSAs with infinite deductible non-plans
Trump: "I am recommending to Senate Republicans that the Hundreds of Billions of Dollars currently being sent to money sucking Insurance Companies in order to save the bad Healthcare provided by ObamaCare, BE SENT DIRECTLY TO THE PEOPLE SO THAT THEY CAN PURCHASE THEIR OWN, MUCH BETTER, HEALTHCARE."
November 8, 2025 at 4:41 PM
Ah yes, just what everyone has been clamoring for: HSAs with infinite deductible non-plans
Reposted by Adrianna McIntyre
Our group at Illinois Gies College of Business is hiring! We are especially interested in public or environmental economists. Our group includes myself, @tderyugina.bsky.social, David Molitor, Nolan Miller, Jeff Brown, Riley League, and Mackenzie Alston.
www.aeaweb.org/joe/listing....
www.aeaweb.org/joe/listing....
American Economic Association: JOE Listings - August 1, 2025 - January 31, 2026
www.aeaweb.org
November 7, 2025 at 2:14 PM
Our group at Illinois Gies College of Business is hiring! We are especially interested in public or environmental economists. Our group includes myself, @tderyugina.bsky.social, David Molitor, Nolan Miller, Jeff Brown, Riley League, and Mackenzie Alston.
www.aeaweb.org/joe/listing....
www.aeaweb.org/joe/listing....
making a brioche dough for the first time and mildly horrified
did not realize a single recipe could call for so much butter
did not realize a single recipe could call for so much butter
November 7, 2025 at 1:18 AM
making a brioche dough for the first time and mildly horrified
did not realize a single recipe could call for so much butter
did not realize a single recipe could call for so much butter
Reposted by Adrianna McIntyre
There are a lot of very interesting design choices in this model. A brief thread. 1/4
November 6, 2025 at 10:34 PM
There are a lot of very interesting design choices in this model. A brief thread. 1/4
"what if MFN in Medicaid, but voluntary?"
November 6, 2025 at 10:18 PM
"what if MFN in Medicaid, but voluntary?"
Reposted by Adrianna McIntyre
Yeah, this place has the au jus.
November 6, 2025 at 7:36 PM
Yeah, this place has the au jus.
Reposted by Adrianna McIntyre
THAT'S A WRAP
🚨🚨🚨 The jury has reached a verdict. Sean Dunn, aka the DC Sandwich Guy, has been found NOT GUILTY of assault.
November 6, 2025 at 7:27 PM
THAT'S A WRAP
Reposted by Adrianna McIntyre
This study could be titled "what makes doctors quit"
The answers are saddening:
1) being a woman
2) practicing in a rural area
3) caring for sicker patients and dual-eligible patients
www.acpjournals.org/doi/10.7326/...
The answers are saddening:
1) being a woman
2) practicing in a rural area
3) caring for sicker patients and dual-eligible patients
www.acpjournals.org/doi/10.7326/...
Trends in and Predictors of Physician Attrition From Clinical Practice Across Specialties: A Nationwide, Longitudinal Analysis: Annals of Internal Medicine: Vol 0, No 0
Background: The United States faces a predicted shortage of 36 500 physicians by 2036, with an increasing proportion of physicians leaving clinical practice or expressing an intent to do so. Evidence ...
www.acpjournals.org
November 6, 2025 at 3:20 PM
This study could be titled "what makes doctors quit"
The answers are saddening:
1) being a woman
2) practicing in a rural area
3) caring for sicker patients and dual-eligible patients
www.acpjournals.org/doi/10.7326/...
The answers are saddening:
1) being a woman
2) practicing in a rural area
3) caring for sicker patients and dual-eligible patients
www.acpjournals.org/doi/10.7326/...
Reposted by Adrianna McIntyre
Drug pricing law/policy experts have many questions going into this announcement. For those watching, here are just a few important ones. 1. What's the form of the "deal"? Is it a model through CMMI (as suggested in @ddiamond.bsky.social's reporting)? How enforceable is the deal (and by whom)? 1/6
Trump has long been fixated on the "fat pill," the "fat drug," the "fat shot," the "fat killer" — you get the idea.
(He's also questioned if the drugs work.)
Today Trump will announce a deal with Eli Lilly and Novo Nordisk in the Oval Office to lower the price of some of their drugs. More to come.
(He's also questioned if the drugs work.)
Today Trump will announce a deal with Eli Lilly and Novo Nordisk in the Oval Office to lower the price of some of their drugs. More to come.
Trump, long fixated on ‘fat drug,’ to announce deal to lower its price
The president has cited the high cost of GLP-1 drugs, which help with weight loss, as his go-to example in his push to reduce U.S. drug prices.
www.washingtonpost.com
November 6, 2025 at 2:51 PM
Drug pricing law/policy experts have many questions going into this announcement. For those watching, here are just a few important ones. 1. What's the form of the "deal"? Is it a model through CMMI (as suggested in @ddiamond.bsky.social's reporting)? How enforceable is the deal (and by whom)? 1/6
In April, the administration declined to finalize a proposed rule that would’ve required both Medicare and Medicaid to cover AOMs (likely triggering price negotiation in Medicare)
Still waiting on details, but hard to believe a voluntary “President Deals” policy approach will expand access as much
Still waiting on details, but hard to believe a voluntary “President Deals” policy approach will expand access as much
Trump has long been fixated on the "fat pill," the "fat drug," the "fat shot," the "fat killer" — you get the idea.
(He's also questioned if the drugs work.)
Today Trump will announce a deal with Eli Lilly and Novo Nordisk in the Oval Office to lower the price of some of their drugs. More to come.
(He's also questioned if the drugs work.)
Today Trump will announce a deal with Eli Lilly and Novo Nordisk in the Oval Office to lower the price of some of their drugs. More to come.
Trump, long fixated on ‘fat drug,’ to announce deal to lower its price
The president has cited the high cost of GLP-1 drugs, which help with weight loss, as his go-to example in his push to reduce U.S. drug prices.
www.washingtonpost.com
November 6, 2025 at 2:29 PM
In April, the administration declined to finalize a proposed rule that would’ve required both Medicare and Medicaid to cover AOMs (likely triggering price negotiation in Medicare)
Still waiting on details, but hard to believe a voluntary “President Deals” policy approach will expand access as much
Still waiting on details, but hard to believe a voluntary “President Deals” policy approach will expand access as much
Reposted by Adrianna McIntyre
New study finds more generous state safety net policies w/ fewer administrative barriers are linked to better birth outcomes, esp for marginalized groups. Very relevant finding in current policy environment!
doi.org/10.1016/j.so... @gabeschwartz.bsky.social @npwf.bsky.social @donmoyn.bsky.social
doi.org/10.1016/j.so... @gabeschwartz.bsky.social @npwf.bsky.social @donmoyn.bsky.social
November 5, 2025 at 8:57 PM
New study finds more generous state safety net policies w/ fewer administrative barriers are linked to better birth outcomes, esp for marginalized groups. Very relevant finding in current policy environment!
doi.org/10.1016/j.so... @gabeschwartz.bsky.social @npwf.bsky.social @donmoyn.bsky.social
doi.org/10.1016/j.so... @gabeschwartz.bsky.social @npwf.bsky.social @donmoyn.bsky.social