Matt Fiedler
@mattafiedler.bsky.social
Senior Fellow, Center on Health Policy, The Brookings Institution. Former Chief Economist for Council of Economic Advisers.
Will Medicare Advantage’s growth change the degree of favorable selection into the program? My new paper w/ Samantha Crow offers an answer: probably not much.
www.brookings.edu/articles/wil...
www.brookings.edu/articles/wil...
Will Medicare Advantage's rise strengthen or weaken favorable selection? | Brookings
Samantha Crow and Matthew Fiedler examine the effect of Medicare Advantage penetration on favorable selection.
www.brookings.edu
October 10, 2025 at 1:57 PM
Will Medicare Advantage’s growth change the degree of favorable selection into the program? My new paper w/ Samantha Crow offers an answer: probably not much.
www.brookings.edu/articles/wil...
www.brookings.edu/articles/wil...
What will the Senate bill mean for health coverage? We don’t yet have final CBO estimates, but it’s clear they’ll be pretty similar to the House bill. That puts the U.S. on track for an unprecedented increase in the uninsured rate that will wipe out ~3/4 of post-2013 declines.
July 1, 2025 at 5:10 PM
What will the Senate bill mean for health coverage? We don’t yet have final CBO estimates, but it’s clear they’ll be pretty similar to the House bill. That puts the U.S. on track for an unprecedented increase in the uninsured rate that will wipe out ~3/4 of post-2013 declines.
The Senate reconciliation bill, at least in its current form, appears likely to reduce coverage about as much as the House bill. If it becomes law, that would mean reversing most of recent years' insurance coverage gains:
bsky.app/profile/matt...
bsky.app/profile/matt...
My new piece @healthaffairs.bsky.social Forefront finds that if the House bill becomes law and enhanced premium tax credits expire on schedule, the US will see an unprecedented increase in the uninsured rate, wiping out about ~3/4 of the post-2013 decline.
June 28, 2025 at 9:22 PM
The Senate reconciliation bill, at least in its current form, appears likely to reduce coverage about as much as the House bill. If it becomes law, that would mean reversing most of recent years' insurance coverage gains:
bsky.app/profile/matt...
bsky.app/profile/matt...
Reposted by Matt Fiedler
New-to-me nugget on work requirements implementation in here:
Pinging Equifax's The Work Number — which states are likely to rely on to get recent-enough employment data — "sometimes costs over $20 per person per query"
Pinging Equifax's The Work Number — which states are likely to rely on to get recent-enough employment data — "sometimes costs over $20 per person per query"
How Medicaid Work Requirements Betray Work and Waste Money
I Oversaw Work Requirements in Michigan - Here is What I Told Congress
donmoynihan.substack.com
June 26, 2025 at 12:13 PM
New-to-me nugget on work requirements implementation in here:
Pinging Equifax's The Work Number — which states are likely to rely on to get recent-enough employment data — "sometimes costs over $20 per person per query"
Pinging Equifax's The Work Number — which states are likely to rely on to get recent-enough employment data — "sometimes costs over $20 per person per query"
Clever new piece from Kennah Watts and Jack Hoadley takes a first look at how decisions under the No Surprises Act arbitration process vary across arbitrators. Lots of interesting findings here, including that provider win rates vary a lot by arbitrator.
June 25, 2025 at 1:18 PM
Clever new piece from Kennah Watts and Jack Hoadley takes a first look at how decisions under the No Surprises Act arbitration process vary across arbitrators. Lots of interesting findings here, including that provider win rates vary a lot by arbitrator.
From a first look at the Senate drafts, the cuts to Medicaid & the Marketplaces are similar to the House’s, maybe even a bit deeper on net. Upshot: these drafts, like the House bill, would put the US on course for an unprecedented rise in the uninsured rate.
bsky.app/profile/matt...
bsky.app/profile/matt...
My new piece @healthaffairs.bsky.social Forefront finds that if the House bill becomes law and enhanced premium tax credits expire on schedule, the US will see an unprecedented increase in the uninsured rate, wiping out about ~3/4 of the post-2013 decline.
June 16, 2025 at 10:17 PM
From a first look at the Senate drafts, the cuts to Medicaid & the Marketplaces are similar to the House’s, maybe even a bit deeper on net. Upshot: these drafts, like the House bill, would put the US on course for an unprecedented rise in the uninsured rate.
bsky.app/profile/matt...
bsky.app/profile/matt...
Reposted by Matt Fiedler
My new piece @healthaffairs.bsky.social Forefront finds that if the House bill becomes law and enhanced premium tax credits expire on schedule, the US will see an unprecedented increase in the uninsured rate, wiping out about ~3/4 of the post-2013 decline.
June 10, 2025 at 4:57 PM
My new piece @healthaffairs.bsky.social Forefront finds that if the House bill becomes law and enhanced premium tax credits expire on schedule, the US will see an unprecedented increase in the uninsured rate, wiping out about ~3/4 of the post-2013 decline.
Reposted by Matt Fiedler
"...the US uninsured rate has never risen as far, as fast as it will if the House bill and other looming policy changes affecting insurance coverage take effect"
-- @mattafiedler.bsky.social www.healthaffairs.org/content/fore...
-- @mattafiedler.bsky.social www.healthaffairs.org/content/fore...
Taking Stock Of The Health Coverage Impacts Of The House Reconciliation Bill | Health Affairs Forefront
The US uninsured rate has never risen as far, as fast as it will if the House bill and other looming policy changes affecting insurance coverage take effect; the resulting increase would erase almost ...
www.healthaffairs.org
June 10, 2025 at 9:05 PM
"...the US uninsured rate has never risen as far, as fast as it will if the House bill and other looming policy changes affecting insurance coverage take effect"
-- @mattafiedler.bsky.social www.healthaffairs.org/content/fore...
-- @mattafiedler.bsky.social www.healthaffairs.org/content/fore...
My new piece @healthaffairs.bsky.social Forefront finds that if the House bill becomes law and enhanced premium tax credits expire on schedule, the US will see an unprecedented increase in the uninsured rate, wiping out about ~3/4 of the post-2013 decline.
June 10, 2025 at 4:57 PM
My new piece @healthaffairs.bsky.social Forefront finds that if the House bill becomes law and enhanced premium tax credits expire on schedule, the US will see an unprecedented increase in the uninsured rate, wiping out about ~3/4 of the post-2013 decline.
Reposted by Matt Fiedler
Ok folks, we know work requirements reduce benefits without increasing work (cc: @chloeneast.bsky.social)
But who loses benefits and what happens if work requirements are reversed?
New evidence from linked SNAP-Medicaid data and a natural experiment in CT tell a concerning story...
Thread below 👇
But who loses benefits and what happens if work requirements are reversed?
New evidence from linked SNAP-Medicaid data and a natural experiment in CT tell a concerning story...
Thread below 👇
SNAP work requirements have biggest effect on those least able to work
Most people pushed out of SNAP in Connecticut didn’t find their way back in, even when work requirements were later reversed.
tobin.yale.edu
June 2, 2025 at 2:07 PM
Ok folks, we know work requirements reduce benefits without increasing work (cc: @chloeneast.bsky.social)
But who loses benefits and what happens if work requirements are reversed?
New evidence from linked SNAP-Medicaid data and a natural experiment in CT tell a concerning story...
Thread below 👇
But who loses benefits and what happens if work requirements are reversed?
New evidence from linked SNAP-Medicaid data and a natural experiment in CT tell a concerning story...
Thread below 👇
Interesting new paper providing clear evidence that the flu vaccine is effective at reducing both office and emergency department visits for flu in kids.
May 27, 2025 at 3:22 PM
Interesting new paper providing clear evidence that the flu vaccine is effective at reducing both office and emergency department visits for flu in kids.
Important step from CMS to begin conducting risk adjustment data validation (RADV) audits for *all* MA contracts each year. If implemented well, this could, in effect, reduce MA risk scores by a few percentage points. But a few things to keep an eye on:
www.cms.gov/newsroom/pre...
www.cms.gov/newsroom/pre...
CMS Rolls Out Aggressive Strategy to Enhance and Accelerate Medicare Advantage Audits | CMS
Agency Will Begin Auditing All Eligible Medicare Advantage Contracts Each Payment Year and Add Resources to Expedite Completion of 2018 to 2024 Audits
www.cms.gov
May 23, 2025 at 3:30 PM
Important step from CMS to begin conducting risk adjustment data validation (RADV) audits for *all* MA contracts each year. If implemented well, this could, in effect, reduce MA risk scores by a few percentage points. But a few things to keep an eye on:
www.cms.gov/newsroom/pre...
www.cms.gov/newsroom/pre...
Reposted by Matt Fiedler
I want one, and I don’t want the US government undermining the development, distribution, and accessibility of COVID boosters.
FDA Commissioner Makary: "By the way, America doesn't want covid boosters."
May 22, 2025 at 6:28 PM
I want one, and I don’t want the US government undermining the development, distribution, and accessibility of COVID boosters.
Reposted by Matt Fiedler
Also unlike the ACA repeal debate, I am unsure how widely the projected loss of coverage for ~10 million people is known. The ACA debate was clearly healthcare focused. This time, I'm seeing lots of articles referencing the "budget bill," "policy bill," "tax bill," etc. The stakes are less clear.
The magnitude of cuts to health spending and loss of coverage resulting from Trump and Congressional Republican plans is reminiscent of the 2017 ACA repeal debate.
One big difference, which could matter politically: No explicit rollback of pre-existing condition protections.
One big difference, which could matter politically: No explicit rollback of pre-existing condition protections.
May 21, 2025 at 10:02 PM
Also unlike the ACA repeal debate, I am unsure how widely the projected loss of coverage for ~10 million people is known. The ACA debate was clearly healthcare focused. This time, I'm seeing lots of articles referencing the "budget bill," "policy bill," "tax bill," etc. The stakes are less clear.
Reposted by Matt Fiedler
Thread: Latest House GOP reconciliation bill language again makes the draconian #Medicaid cuts harsher. For example, mandatory work requirements now will take effect 12/31/26 instead of 1/1/29 and states have option to implement them earlier (1/x)
May 22, 2025 at 1:49 AM
Thread: Latest House GOP reconciliation bill language again makes the draconian #Medicaid cuts harsher. For example, mandatory work requirements now will take effect 12/31/26 instead of 1/1/29 and states have option to implement them earlier (1/x)
Reposted by Matt Fiedler
Latest House bill text includes another blow to the ACA, ending “silver loading.” That would increase premiums by $350 for a hypothetical family. Here’s why: www.brookings.edu/articles/und...
Understanding Marketplace "Silver Loading"
Christen Linke Young explains a new proposal regarding cost-sharing reductions and how it could impact families who get coverage through the ACA.
www.brookings.edu
May 22, 2025 at 1:14 AM
Latest House bill text includes another blow to the ACA, ending “silver loading.” That would increase premiums by $350 for a hypothetical family. Here’s why: www.brookings.edu/articles/und...
The updated reconciliation language doubles down on the bill’s Marketplace cuts by ending “silver loading” for the 2026 plan year. This would greatly increase many Marketplace enrollees’ premiums, compounding increases due to expiration of enhanced tax credits.
May 22, 2025 at 1:32 AM
The updated reconciliation language doubles down on the bill’s Marketplace cuts by ending “silver loading” for the 2026 plan year. This would greatly increase many Marketplace enrollees’ premiums, compounding increases due to expiration of enhanced tax credits.
Reposted by Matt Fiedler
"The plan saves money mainly by removing millions of people from coverage, while offering no alternative means to insure them." Always read @lorenadler.bsky.social and @mattafiedler.bsky.social.
A look at how the House Republican proposals would cut health coverage:
www.washingtonpost.com/opinions/202...
www.washingtonpost.com/opinions/202...
Opinion | How do Republicans plan to cut health coverage? Two basic ways.
The House reconciliation plan’s provisions add up to millions more going without insurance.
www.washingtonpost.com
May 22, 2025 at 1:13 AM
"The plan saves money mainly by removing millions of people from coverage, while offering no alternative means to insure them." Always read @lorenadler.bsky.social and @mattafiedler.bsky.social.
Reposted by Matt Fiedler
Congress is looking at major changes to the Medicaid expansion. New research finds it has saved 27,000 lives. www.nytimes.com/2025/05/16/h...
As Congress Debates Cutting Medicaid, a Major Study Shows It Saves Lives
www.nytimes.com
May 17, 2025 at 11:27 AM
Congress is looking at major changes to the Medicaid expansion. New research finds it has saved 27,000 lives. www.nytimes.com/2025/05/16/h...
Reposted by Matt Fiedler
Eric Roberts and @joefigs.bsky.social led a groundbreaking new study on Medicaid and Medicare, out today in NEJM. I’m lucky to have been a part of it.
Medicare saves lives. But is it enough to save lives of the most vulnerable Americans? The study suggests no; Medicaid still matters. (1/11)
Medicare saves lives. But is it enough to save lives of the most vulnerable Americans? The study suggests no; Medicaid still matters. (1/11)
Loss of Subsidized Drug Coverage and Mortality among Medicare Beneficiaries | NEJM
A total of 14 million Medicare beneficiaries receive the Low-Income Subsidy (LIS),
which reduces cost sharing in Medicare Part D. Losing the LIS may impede medication
access and affect mortality. U...
www.nejm.org
May 14, 2025 at 9:32 PM
Eric Roberts and @joefigs.bsky.social led a groundbreaking new study on Medicaid and Medicare, out today in NEJM. I’m lucky to have been a part of it.
Medicare saves lives. But is it enough to save lives of the most vulnerable Americans? The study suggests no; Medicaid still matters. (1/11)
Medicare saves lives. But is it enough to save lives of the most vulnerable Americans? The study suggests no; Medicaid still matters. (1/11)
Reposted by Matt Fiedler
"The plan saves money mainly by removing millions of people from coverage, while offering no alternative means to insure them."
Must-read @mattafiedler.bsky.social @lorenadler.bsky.social on House Republican cuts to Medicaid and the ACA www.washingtonpost.com/opinions/202...
Must-read @mattafiedler.bsky.social @lorenadler.bsky.social on House Republican cuts to Medicaid and the ACA www.washingtonpost.com/opinions/202...
Opinion | How do Republicans plan to cut health coverage? Two basic ways.
The House reconciliation plan’s provisions add up to millions more going without insurance.
www.washingtonpost.com
May 15, 2025 at 3:12 PM
"The plan saves money mainly by removing millions of people from coverage, while offering no alternative means to insure them."
Must-read @mattafiedler.bsky.social @lorenadler.bsky.social on House Republican cuts to Medicaid and the ACA www.washingtonpost.com/opinions/202...
Must-read @mattafiedler.bsky.social @lorenadler.bsky.social on House Republican cuts to Medicaid and the ACA www.washingtonpost.com/opinions/202...
How would a federal Medicaid work requirement affect enrollment?
My new paper looks back at an Arkansas requirement very similar to one the House passed in 2023.
I estimate an Arkansas-like policy would reduce Medicaid enrollment for ppl subject to it by 34% in the long run:
My new paper looks back at an Arkansas requirement very similar to one the House passed in 2023.
I estimate an Arkansas-like policy would reduce Medicaid enrollment for ppl subject to it by 34% in the long run:
April 30, 2025 at 6:47 PM
How would a federal Medicaid work requirement affect enrollment?
My new paper looks back at an Arkansas requirement very similar to one the House passed in 2023.
I estimate an Arkansas-like policy would reduce Medicaid enrollment for ppl subject to it by 34% in the long run:
My new paper looks back at an Arkansas requirement very similar to one the House passed in 2023.
I estimate an Arkansas-like policy would reduce Medicaid enrollment for ppl subject to it by 34% in the long run:
Reposted by Matt Fiedler
GOP leaders are now saying they want to protect Medicaid for "the truly vulnerable"
That's actually code for a big cut -- and taking out a piece of the ACA with it
My latest at @thebulwark.bsky.social
www.thebulwark.com/p/health-ins...
That's actually code for a big cut -- and taking out a piece of the ACA with it
My latest at @thebulwark.bsky.social
www.thebulwark.com/p/health-ins...
Health Insurance for Millions Is Now on the Chopping Block
Republicans’ very quiet, very serious effort to go after Obamacare’s Medicaid expansion.
www.thebulwark.com
April 20, 2025 at 11:56 AM
GOP leaders are now saying they want to protect Medicaid for "the truly vulnerable"
That's actually code for a big cut -- and taking out a piece of the ACA with it
My latest at @thebulwark.bsky.social
www.thebulwark.com/p/health-ins...
That's actually code for a big cut -- and taking out a piece of the ACA with it
My latest at @thebulwark.bsky.social
www.thebulwark.com/p/health-ins...
Reposted by Matt Fiedler
Aside from the bigger picture, I’m not sure where Cassidy gets the idea that “states are supposed to pay 40%.”
FMAP is calculated according to a formula in statute, which enforces a floor of 50% and a ceiling of 83% match.
Louisiana is only paying 32 cents on the dollar.
FMAP is calculated according to a formula in statute, which enforces a floor of 50% and a ceiling of 83% match.
Louisiana is only paying 32 cents on the dollar.
Senator Cassidy comes out for enormous cuts to Medicaid.
Not surprising given that he helped write the Graham-Cassidy Medicaid destruction plan in 2017.
Expect to see more of this from Rs - but don’t be fooled: cutting money to states to run Medicaid means people lose coverage and benefits.
Not surprising given that he helped write the Graham-Cassidy Medicaid destruction plan in 2017.
Expect to see more of this from Rs - but don’t be fooled: cutting money to states to run Medicaid means people lose coverage and benefits.
April 16, 2025 at 9:55 PM
Aside from the bigger picture, I’m not sure where Cassidy gets the idea that “states are supposed to pay 40%.”
FMAP is calculated according to a formula in statute, which enforces a floor of 50% and a ceiling of 83% match.
Louisiana is only paying 32 cents on the dollar.
FMAP is calculated according to a formula in statute, which enforces a floor of 50% and a ceiling of 83% match.
Louisiana is only paying 32 cents on the dollar.
Reposted by Matt Fiedler
Speaker Johnson here is trying to frame Medicaid coverage of working people -- who are eligible based on the ACA Medicaid expansion in 40 states plus DC -- as "fraud, waste, and abuse."
bsky.app/profile/atru...
bsky.app/profile/atru...
Mike Johnson: "We have to eliminate people on Medicaid who are not actually eligible to be there. Able-bodied workers for example, young men who should never be on the program at all."
April 14, 2025 at 1:35 PM
Speaker Johnson here is trying to frame Medicaid coverage of working people -- who are eligible based on the ACA Medicaid expansion in 40 states plus DC -- as "fraud, waste, and abuse."
bsky.app/profile/atru...
bsky.app/profile/atru...