David Machledt
@machledtdc.bsky.social
Give me a bike, time to adventure, and family and friends to share it with. Also, a lot of health policy, but the views here are my own.
Reposted by David Machledt
THEY DID THIS TO A MOTHER AND HER CHILD
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.
azmirror.com
December 5, 2025 at 9:32 PM
THEY DID THIS TO A MOTHER AND HER CHILD
Reposted by David Machledt
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.
That's an ADDITIONAL $4,900 - $19,000 per year in premiums alone.
December 5, 2025 at 4:48 PM
Reposted by David Machledt
Well done! A Massachusetts church displayed an “ICE was here” sign in its Nativity scene.
December 4, 2025 at 8:23 PM
Well done! A Massachusetts church displayed an “ICE was here” sign in its Nativity scene.
Reposted by David Machledt
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/
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.
healthlaw.org
December 1, 2025 at 6:47 PM
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/
Reposted by David Machledt
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...
November 27, 2025 at 11:32 PM
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...
Reposted by David Machledt
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...
The lower prices stem from the Medicare negotiation program created under the Biden administration's Inflation Reduction Act.
www.nbcnews.com/health/healt...
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
November 26, 2025 at 1:59 PM
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...
The lower prices stem from the Medicare negotiation program created under the Biden administration's Inflation Reduction Act.
www.nbcnews.com/health/healt...
Reposted by David Machledt
When you only want boy-friendly spaces
November 25, 2025 at 2:42 PM
When you only want boy-friendly spaces
Reposted by David Machledt
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
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
November 24, 2025 at 6:08 PM
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
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
Reposted by David Machledt
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...
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...
kffhealthnews.org
November 21, 2025 at 7:30 PM
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...
Reposted by David Machledt
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
Federal cuts to Medicaid could change waiting list sizes again: https://on.kff.org/48fSeu7
November 21, 2025 at 5:04 PM
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
Federal cuts to Medicaid could change waiting list sizes again: https://on.kff.org/48fSeu7
Reposted by David Machledt
No one likes prior authorization review. But could we get rid of it? My new column: www.kff.org/from-drew-al...
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...
www.kff.org
November 20, 2025 at 3:10 PM
No one likes prior authorization review. But could we get rid of it? My new column: www.kff.org/from-drew-al...
Reposted by David Machledt
An incredibly important issue. Read it
Data on race and ethnicity has put us on the cusp of breakthroughs in treating kidney failure, which disproportionately affects Black Americans. But the Trump administration has halted that data collection as part of its war on supposed "DEI." Important new story from @laylaayanna.bsky.social
The Trump Admin’s War on Data Is Compromising Major Health Advancements for Black Americans
Thanks to a 2009 medical breakthrough, researchers could be on the precipice...
talkingpointsmemo.com
November 20, 2025 at 3:15 PM
An incredibly important issue. Read it
Reposted by David Machledt
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?
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?
my hot take as a full-time pedestrian and transit rider is that i want cities to do the absolute maximum amount to provide cyclists with safe and protected bike lanes everywhere so that i don't have to feel the least bit bad for kicking one off the sidewalk into the street
And before you say anything about Just Do More Public Transit, make your neighbors less fucking neurotic about funding and designing roads for public transit
Replace bike lane flex posts with bollards!
Replace bike lane flex posts with bollards!
November 20, 2025 at 3:46 PM
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?
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?
Reposted by David Machledt
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!!!
Democrats, VOTE NO on H.R. 5214 and 5107!!!
November 20, 2025 at 12:30 AM
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!!!
Democrats, VOTE NO on H.R. 5214 and 5107!!!
Reposted by David Machledt
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...
New brief from @urbaninstitute.bsky.social finds that 453,000 children will become uninsured if subsidies expire.
ccf.georgetown.edu/2025/11/14/n...
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)…
ccf.georgetown.edu
November 18, 2025 at 4:40 PM
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...
New brief from @urbaninstitute.bsky.social finds that 453,000 children will become uninsured if subsidies expire.
ccf.georgetown.edu/2025/11/14/n...
Reposted by David Machledt
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.
By moving to rescind the Biden Admin’s #PublicCharge rule, which largely restored long-standing policy after courts blocked a harmful rule put forward in the first Trump rule, the Administration is reigniting fear and confusion among people who are immigrants and their families.
November 18, 2025 at 3:51 PM
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.
Reposted by David Machledt
Reposted by David Machledt
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.
November 11, 2025 at 3:47 PM
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.
Reposted by David Machledt
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-...
Can we please see the last two months of jobs reports now?
November 10, 2025 at 9:36 PM
Can we please see the last two months of jobs reports now?
Reposted by David Machledt
State Medicaid programs shared insights into the challenges they anticipate when implementing work requirements next year: https://on.kff.org/3LLhQHu
November 10, 2025 at 7:01 PM
State Medicaid programs shared insights into the challenges they anticipate when implementing work requirements next year: https://on.kff.org/3LLhQHu
Reposted by David Machledt
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.
Earlier today, D.C.'s own "sandwich guy" was found not guilty of the charges against him.
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.
51st.news
November 7, 2025 at 12:11 AM
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.
Earlier today, D.C.'s own "sandwich guy" was found not guilty of the charges against him.