Mandi Spishak-Thomas
@aspishakthomas.com
Research professor @ Rutgers studying Medicaid. Social worker and health policy wonk. Union organizer (AAUP-AFT) and member of Brooklyn CB6. Baseball #LFGM and WNBA🗽enthusiast. Free 🇵🇸. ACAB. Still 😷. she/her.
aspishakthomas.com
aspishakthomas.com
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Mandi Spishak-Thomas
@aspishakthomas.com
· Dec 15
@aspishakthomas.com @emmasandoe.bsky.social & @heatherhhoward.bsky.social examine Medicaid estate recovery. Some states recently initiated policy changes to address problems with Medicaid estate recovery, and the authors evaluate the impact of these policies. read.dukeupress.edu/jhppl/articl...
Lots of Pain for Little Gain: Three Decades of Medicaid Estate Recovery | Journal of Health Politics, Policy and Law | Duke University Press
read.dukeupress.edu
Our paper reflecting on 30 years of Medicaid estate recovery is fully out today! We shed light on policy mechanisms, state variation, and its potential to drive wealth disparities. Thank you to @jhppl.bsky.social for being the perfect home for our work on this understudied, but longstanding, policy.
Reposted by Mandi Spishak-Thomas
Police have never killed more people than they have in the last year despite all of the "talk" about RE-FORM.
January 15, 2026 at 2:35 AM
Police have never killed more people than they have in the last year despite all of the "talk" about RE-FORM.
Reposted by Mandi Spishak-Thomas
I've read most of the scholarship about US policing since the early 20th century. What you learn from this is that violence is inherent. You cannot "separate" out violence from policing. Police in the U.S. are violence workers.
January 15, 2026 at 2:33 AM
I've read most of the scholarship about US policing since the early 20th century. What you learn from this is that violence is inherent. You cannot "separate" out violence from policing. Police in the U.S. are violence workers.
Reposted by Mandi Spishak-Thomas
ACA signups are down by over a million with open enrollment ending and enhanced tax credits expired, but there are two things we still don't know:
How many will decline to "effectuate" their coverage with higher net premiums?
How many will switch to higher deductible plans?
How many will decline to "effectuate" their coverage with higher net premiums?
How many will switch to higher deductible plans?
January 14, 2026 at 3:56 PM
ACA signups are down by over a million with open enrollment ending and enhanced tax credits expired, but there are two things we still don't know:
How many will decline to "effectuate" their coverage with higher net premiums?
How many will switch to higher deductible plans?
How many will decline to "effectuate" their coverage with higher net premiums?
How many will switch to higher deductible plans?
Reposted by Mandi Spishak-Thomas
Y'all we love a timely study! New @jama.com
Authors looked at over 5,000 internal agency documents from 2011-2023, finding the FDA’s decisions about mife “has been shaped by scientific evidence and a cautious regulatory approach led by scientists at the agency”
jamanetwork.com/journals/jam...
Authors looked at over 5,000 internal agency documents from 2011-2023, finding the FDA’s decisions about mife “has been shaped by scientific evidence and a cautious regulatory approach led by scientists at the agency”
jamanetwork.com/journals/jam...
The US Food and Drug Administration’s Regulation of Mifepristone
This qualitative analysis uses information from US Food and Drug Administration (FDA) documents obtained through a Freedom of Information Act request to characterize the FDA’s decision-making with res...
jamanetwork.com
January 14, 2026 at 12:21 PM
Y'all we love a timely study! New @jama.com
Authors looked at over 5,000 internal agency documents from 2011-2023, finding the FDA’s decisions about mife “has been shaped by scientific evidence and a cautious regulatory approach led by scientists at the agency”
jamanetwork.com/journals/jam...
Authors looked at over 5,000 internal agency documents from 2011-2023, finding the FDA’s decisions about mife “has been shaped by scientific evidence and a cautious regulatory approach led by scientists at the agency”
jamanetwork.com/journals/jam...
Reposted by Mandi Spishak-Thomas
Attending #SSWR2026 as a social policy researcher (or friend)? Join us for our annual happy hour on Friday night at 6:30 at Calico! Be in touch if you need more info and looking forward to learning from your work throughout the conference!
January 13, 2026 at 6:27 PM
Attending #SSWR2026 as a social policy researcher (or friend)? Join us for our annual happy hour on Friday night at 6:30 at Calico! Be in touch if you need more info and looking forward to learning from your work throughout the conference!
Reposted by Mandi Spishak-Thomas
THREAD. This can be an important educational moment for progressive people who don't work in or study the punishment bureaucracy. Having spent 20 years in it--and just publishing a book on exactly this topic--I can say that reality works in the opposite way that Jamelle assumes.
maybe an unpopular position on this website but i think the moderate dem focus on ICE training can be, with political pressure, the pathway to more fundamental reforms. rhetorically it is not too hard to move from “more training” to “turns out they’re untrainable and we have to start all over.”
January 14, 2026 at 3:17 AM
THREAD. This can be an important educational moment for progressive people who don't work in or study the punishment bureaucracy. Having spent 20 years in it--and just publishing a book on exactly this topic--I can say that reality works in the opposite way that Jamelle assumes.
Reposted by Mandi Spishak-Thomas
since it's behind a paywall now, I wanted to share this graph from "How Trump 2.0 is slashing NIH-backed research — in charts" (Nature, April 2025). Say it with me: the anti-trans/LGBTQ+ movement is an anti-science movement:
[article sans figs can be read here: web.archive.org/web/20250501... ]
[article sans figs can be read here: web.archive.org/web/20250501... ]
January 12, 2026 at 6:45 PM
since it's behind a paywall now, I wanted to share this graph from "How Trump 2.0 is slashing NIH-backed research — in charts" (Nature, April 2025). Say it with me: the anti-trans/LGBTQ+ movement is an anti-science movement:
[article sans figs can be read here: web.archive.org/web/20250501... ]
[article sans figs can be read here: web.archive.org/web/20250501... ]
Long live our beautiful bike lane!! 🔥
NEWS: A Brooklyn Supreme Court judge tossed out a lawsuit against the Court Street protected bike lane on Monday, rejecting an attempt by a local business group to kill the street-safety project. buff.ly/HFykqWA
BREAKING: Brooklyn Judge Dismisses Court St. Bike Lane Lawsuit - Streetsblog New York City
Justice Inga O'Neale dismissed the lawsuit by the Court Street Merchants Association.
nyc.streetsblog.org
January 12, 2026 at 11:21 PM
Long live our beautiful bike lane!! 🔥
Reposted by Mandi Spishak-Thomas
I hope the players of the #WNBA hold this lock out until they get everything they want. I’m perfectly okay with having a delayed season if it means better pay and benefits for them.
January 10, 2026 at 3:59 PM
I hope the players of the #WNBA hold this lock out until they get everything they want. I’m perfectly okay with having a delayed season if it means better pay and benefits for them.
Reposted by Mandi Spishak-Thomas
Saturday, Trump invaded Venezuela, sacrificing lives for oil. Four days later, ICE forces invading Minneapolis murdered a legal observer recording their activity.
Trump wants to be emperor & tyrant. Socialists must fight back.
Join us 1/11, 1pm, E60th & 5th Ave: actionnetwork.org/events/no-wa...
Trump wants to be emperor & tyrant. Socialists must fight back.
Join us 1/11, 1pm, E60th & 5th Ave: actionnetwork.org/events/no-wa...
January 9, 2026 at 1:59 AM
Saturday, Trump invaded Venezuela, sacrificing lives for oil. Four days later, ICE forces invading Minneapolis murdered a legal observer recording their activity.
Trump wants to be emperor & tyrant. Socialists must fight back.
Join us 1/11, 1pm, E60th & 5th Ave: actionnetwork.org/events/no-wa...
Trump wants to be emperor & tyrant. Socialists must fight back.
Join us 1/11, 1pm, E60th & 5th Ave: actionnetwork.org/events/no-wa...
Reposted by Mandi Spishak-Thomas
The first #FindingsFriday insight of 2026 comes from a NEW study led by CSHP & @rutgersifh.bsky.social Assistant Research Professor @aspishakthomas.com.
It explores the origins and major features of #Medicaid estate recovery, as well as its impact on beneficiaries: go.rutgers.edu/j3ei8p0
It explores the origins and major features of #Medicaid estate recovery, as well as its impact on beneficiaries: go.rutgers.edu/j3ei8p0
January 9, 2026 at 3:46 PM
The first #FindingsFriday insight of 2026 comes from a NEW study led by CSHP & @rutgersifh.bsky.social Assistant Research Professor @aspishakthomas.com.
It explores the origins and major features of #Medicaid estate recovery, as well as its impact on beneficiaries: go.rutgers.edu/j3ei8p0
It explores the origins and major features of #Medicaid estate recovery, as well as its impact on beneficiaries: go.rutgers.edu/j3ei8p0
Reposted by Mandi Spishak-Thomas
+ approximately half of the weight loss while on GLP-1s is muscle and bone mass. The implications of muscle and bone mass loss for an aging population are considerable.
Many people who stop using weight loss drugs will return to their previous weight within two years, a new review of existing research has found. https://cnn.it/4jzMQHs
January 9, 2026 at 3:36 PM
+ approximately half of the weight loss while on GLP-1s is muscle and bone mass. The implications of muscle and bone mass loss for an aging population are considerable.
Reposted by Mandi Spishak-Thomas
The U.S. Is Funding Fewer Grants in Every Area of Science and Medicine: "...less research was funded in areas such as aging, diabetes, strokes, cancer and mental health."
The U.S. Is Funding Fewer Grants in Every Area of Science and Medicine
A quiet policy change means the government is making fewer bets on long-term science.
www.nytimes.com
December 8, 2025 at 9:24 PM
The U.S. Is Funding Fewer Grants in Every Area of Science and Medicine: "...less research was funded in areas such as aging, diabetes, strokes, cancer and mental health."
Reposted by Mandi Spishak-Thomas
Renee Nicole Good was not the first person to be murdered by ICE under Trump.
Keith Porter was a Black man killed by ICE on New Years Eve.
Silverio Gonzalez was an undocumented immigrant killed in Franklin Park.
Marimar Martinez was shot 5 times in Chicago & survived.
No one is safe.
Keith Porter was a Black man killed by ICE on New Years Eve.
Silverio Gonzalez was an undocumented immigrant killed in Franklin Park.
Marimar Martinez was shot 5 times in Chicago & survived.
No one is safe.
January 9, 2026 at 4:41 AM
Renee Nicole Good was not the first person to be murdered by ICE under Trump.
Keith Porter was a Black man killed by ICE on New Years Eve.
Silverio Gonzalez was an undocumented immigrant killed in Franklin Park.
Marimar Martinez was shot 5 times in Chicago & survived.
No one is safe.
Keith Porter was a Black man killed by ICE on New Years Eve.
Silverio Gonzalez was an undocumented immigrant killed in Franklin Park.
Marimar Martinez was shot 5 times in Chicago & survived.
No one is safe.
Reposted by Mandi Spishak-Thomas
Anyone who has read Copaganda knows that we are in the crucial early moments of virality after an extra-judicial police murder. It's extremely important for ICE that the media plays along with the idea that what happened is contested and there are multiple perspectives.
January 7, 2026 at 8:35 PM
Anyone who has read Copaganda knows that we are in the crucial early moments of virality after an extra-judicial police murder. It's extremely important for ICE that the media plays along with the idea that what happened is contested and there are multiple perspectives.
Reposted by Mandi Spishak-Thomas
ICE agent kills woman, DHS tells obvious, insane lies about it: defector.com/ice-agent-ki...
January 7, 2026 at 8:37 PM
ICE agent kills woman, DHS tells obvious, insane lies about it: defector.com/ice-agent-ki...
Reposted by Mandi Spishak-Thomas
Beginning 2022, I started having arguments with people who didn't experience the loss of a loved one to COVID & associate "lockdown" with sourdough starters & WFH rather than Zoom funerals.
I just had to accept that we did not have a shared reality, nor were they willing to remember.
I just had to accept that we did not have a shared reality, nor were they willing to remember.
there’s a thread on reddit right now called “was COVID really that bad?” and it is interesting to read people’s accounts five years out
there seems to be a collective trauma response where people (outside of healthcare workers) don’t remember how many people died
someone called it anticlimactic
there seems to be a collective trauma response where people (outside of healthcare workers) don’t remember how many people died
someone called it anticlimactic
January 6, 2026 at 7:55 PM
Beginning 2022, I started having arguments with people who didn't experience the loss of a loved one to COVID & associate "lockdown" with sourdough starters & WFH rather than Zoom funerals.
I just had to accept that we did not have a shared reality, nor were they willing to remember.
I just had to accept that we did not have a shared reality, nor were they willing to remember.
Reposted by Mandi Spishak-Thomas
Starting tomorrow, the Trump administration is set to send notices to 1,000 student loan borrowers (first round) noticing them of an intent to garnish their wages for student loan debt.
This is cruel and unnecessary.
If you receive a notice, send it to us and we'll try to help.
This is cruel and unnecessary.
If you receive a notice, send it to us and we'll try to help.
January 6, 2026 at 3:37 PM
Starting tomorrow, the Trump administration is set to send notices to 1,000 student loan borrowers (first round) noticing them of an intent to garnish their wages for student loan debt.
This is cruel and unnecessary.
If you receive a notice, send it to us and we'll try to help.
This is cruel and unnecessary.
If you receive a notice, send it to us and we'll try to help.
Reposted by Mandi Spishak-Thomas
Meanwhile about SARS-CoV-2...
"It's just a flu". "Don't worry, it's endemic like colds and flu". "We can simply manage it like other seasonal respiratory viruses".
"It's just a flu". "Don't worry, it's endemic like colds and flu". "We can simply manage it like other seasonal respiratory viruses".
“These viruses are serious, dangerous, and life-threatening. We are seeing children who are seriously ill, families grieving devastating losses, and hospitals under capacity strain.”
www.cnn.com/2026/01/05/h...
www.cnn.com/2026/01/05/h...
Flu reaches highest levels in the US in 25 years | CNN
Flu continues to visit misery across the US, with all but four states showing high or very high levels of activity as a new virus strain called subclade K continues to spread.
www.cnn.com
January 6, 2026 at 12:16 PM
Meanwhile about SARS-CoV-2...
"It's just a flu". "Don't worry, it's endemic like colds and flu". "We can simply manage it like other seasonal respiratory viruses".
"It's just a flu". "Don't worry, it's endemic like colds and flu". "We can simply manage it like other seasonal respiratory viruses".
Reposted by Mandi Spishak-Thomas
The NWSL announced the high impact player rule, and the NWSLPA is prepared to take legal action.
December 23, 2025 at 6:58 PM
The NWSL announced the high impact player rule, and the NWSLPA is prepared to take legal action.
Reposted by Mandi Spishak-Thomas
Folks ask what lower tenure density means and essentially it means shifting to hiring contingent faculty who get paid less and have less job security. Which is bad for students in a BUNCH of ways, incl it's harder to find someone a few years later for a letter of recommendation.
December 23, 2025 at 5:14 PM
Folks ask what lower tenure density means and essentially it means shifting to hiring contingent faculty who get paid less and have less job security. Which is bad for students in a BUNCH of ways, incl it's harder to find someone a few years later for a letter of recommendation.
Reposted by Mandi Spishak-Thomas
Gaps in contraceptive access persist across the U.S. — and federal funding cuts could make them worse.
Full report:
Full report:
An Overview of Federally Funded Contraceptive Programs
With sufficient funding, states can utilize Medicaid SPAs and Section 1115 waivers, MCO contracts, and Title X grants to expand access to contraceptives.
bit.ly
December 22, 2025 at 2:27 PM
Gaps in contraceptive access persist across the U.S. — and federal funding cuts could make them worse.
Full report:
Full report:
LFG, solidarity forever 🔥
#WNBA players have voted to empower the union to "call a strike when necessary ... The players’ vote is neither a call for an immediate strike nor an intention to pursue one," the statement reads.
Confirmed with the WNBPA that 93% of eligible players voted. The measure passed with 98% of the vote.
Confirmed with the WNBPA that 93% of eligible players voted. The measure passed with 98% of the vote.
December 18, 2025 at 9:10 PM
LFG, solidarity forever 🔥
A lot to say about NJ transit’s inability to operate trains on time, but one thing that is particularly grating as a weekly NE Corridor commuter is how you almost always arrive to NY Penn ~20 min later than they promise on the schedule, an unspoken, but consistent delay.
December 18, 2025 at 9:02 PM
A lot to say about NJ transit’s inability to operate trains on time, but one thing that is particularly grating as a weekly NE Corridor commuter is how you almost always arrive to NY Penn ~20 min later than they promise on the schedule, an unspoken, but consistent delay.