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
awww. gave Nellie some extra bedtime pats in honor of George
November 11, 2025 at 4:45 AM
awww. gave Nellie some extra bedtime pats in honor of George
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
The authors also find that "a meaningful portion of all spending reductions came from well-off consumers who were predictably sick" — again, despite (1) HSAs being pre-funded to a level sufficient to cover the deductible in the first year and (2) most employees still being under the deductible level
November 10, 2025 at 10:16 PM
The authors also find that "a meaningful portion of all spending reductions came from well-off consumers who were predictably sick" — again, despite (1) HSAs being pre-funded to a level sufficient to cover the deductible in the first year and (2) most employees still being under the deductible level
The authors find that the entirety of reduced spending — because HDHPs *do* reduce spending — came entirely from people seeking less care.
They weren't adept at distinguishing "high" and "low" value care; they scaled back all forms of care.
They weren't adept at distinguishing "high" and "low" value care; they scaled back all forms of care.
November 10, 2025 at 10:11 PM
The authors find that the entirety of reduced spending — because HDHPs *do* reduce spending — came entirely from people seeking less care.
They weren't adept at distinguishing "high" and "low" value care; they scaled back all forms of care.
They weren't adept at distinguishing "high" and "low" value care; they scaled back all forms of care.
Before getting to the findings, two key facts about the study context:
1. Employees were high-income; fewer than 10% had incomes under $100K and more than a quarter had incomes over $150K (this is employee income, not household)
2. HSAs were *pre-funded* to the deductible level
1. Employees were high-income; fewer than 10% had incomes under $100K and more than a quarter had incomes over $150K (this is employee income, not household)
2. HSAs were *pre-funded* to the deductible level
November 10, 2025 at 9:57 PM
Before getting to the findings, two key facts about the study context:
1. Employees were high-income; fewer than 10% had incomes under $100K and more than a quarter had incomes over $150K (this is employee income, not household)
2. HSAs were *pre-funded* to the deductible level
1. Employees were high-income; fewer than 10% had incomes under $100K and more than a quarter had incomes over $150K (this is employee income, not household)
2. HSAs were *pre-funded* to the deductible level
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-...
"what if MFN in Medicaid, but voluntary?"
November 6, 2025 at 10:18 PM
"what if MFN in Medicaid, but voluntary?"
Cool new study from @pamherd.bsky.social, @giannella.bsky.social, @jbarofsky.bsky.social, @lukef.bsky.social, & @donmoyn.bsky.social finds technical assistance & capacity improvements from USDS significantly improved Medicaid renewal outcomes during unwinding
www.healthaffairs.org/doi/10.1377/...
www.healthaffairs.org/doi/10.1377/...
November 4, 2025 at 1:48 PM
Cool new study from @pamherd.bsky.social, @giannella.bsky.social, @jbarofsky.bsky.social, @lukef.bsky.social, & @donmoyn.bsky.social finds technical assistance & capacity improvements from USDS significantly improved Medicaid renewal outcomes during unwinding
www.healthaffairs.org/doi/10.1377/...
www.healthaffairs.org/doi/10.1377/...
I am trying and struggling to remember a previous time when multiple state officials publicly rebuked a CMS administrator for spreading misinformation
kffhealthnews.org/news/article...
kffhealthnews.org/news/article...
November 3, 2025 at 8:19 PM
I am trying and struggling to remember a previous time when multiple state officials publicly rebuked a CMS administrator for spreading misinformation
kffhealthnews.org/news/article...
kffhealthnews.org/news/article...
And while I'm glad there are startups trying to compete with Equifax, I struggle with the idea that we're going to effectively confront the issues with work reporting requirements in Medicaid by getting people to instead report their work somewhere else.
November 3, 2025 at 4:27 PM
And while I'm glad there are startups trying to compete with Equifax, I struggle with the idea that we're going to effectively confront the issues with work reporting requirements in Medicaid by getting people to instead report their work somewhere else.
Wow, really appreciate this deep reporting on how Equifax stands to reap considerable gains under Medicaid work requirements — including some new visibility into "prices per ping"
www.nytimes.com/2025/11/03/h...
www.nytimes.com/2025/11/03/h...
November 3, 2025 at 4:11 PM
Wow, really appreciate this deep reporting on how Equifax stands to reap considerable gains under Medicaid work requirements — including some new visibility into "prices per ping"
www.nytimes.com/2025/11/03/h...
www.nytimes.com/2025/11/03/h...
Timely (grim) new NBER working paper: Households screened out of SNAP "suffer tangible downstream economic consequences. Specifically, we find that process-related denials increase debt and delinquencies, and decrease credit scores."
www.nber.org/papers/w34434
www.nber.org/papers/w34434
November 3, 2025 at 1:49 PM
Timely (grim) new NBER working paper: Households screened out of SNAP "suffer tangible downstream economic consequences. Specifically, we find that process-related denials increase debt and delinquencies, and decrease credit scores."
www.nber.org/papers/w34434
www.nber.org/papers/w34434
stuffed star pulls important double duty as a snoozing pillow
October 31, 2025 at 1:58 AM
stuffed star pulls important double duty as a snoozing pillow
Guess I have to finish this new syllabus
October 30, 2025 at 4:49 PM
Guess I have to finish this new syllabus
This June white paper from Wakely remains useful: www.wakely.com/wp-content/u...
October 29, 2025 at 3:28 PM
This June white paper from Wakely remains useful: www.wakely.com/wp-content/u...
Assume, for a moment, that this is the logical comparison to make. Why would 2026 premiums be lower than 2019/2020 premiums?
(A: Because, by making insurance even lower cost, the enhanced subsidies brought in younger, healthier enrollees from 2021-2025, lowering overall risk and average premiums)
(A: Because, by making insurance even lower cost, the enhanced subsidies brought in younger, healthier enrollees from 2021-2025, lowering overall risk and average premiums)
October 29, 2025 at 3:20 PM
Assume, for a moment, that this is the logical comparison to make. Why would 2026 premiums be lower than 2019/2020 premiums?
(A: Because, by making insurance even lower cost, the enhanced subsidies brought in younger, healthier enrollees from 2021-2025, lowering overall risk and average premiums)
(A: Because, by making insurance even lower cost, the enhanced subsidies brought in younger, healthier enrollees from 2021-2025, lowering overall risk and average premiums)
*taps 2017 sign*
October 28, 2025 at 5:44 PM
*taps 2017 sign*
Nellie’s newest nemesis
October 27, 2025 at 8:16 PM
Nellie’s newest nemesis
I don't think this is quite right? The pre-enrollment verification policy, which was ultimately included in OBBBA, effectively ends automatic renewals, but that policy won't take effect until the end of 2027 (for people who would otherwise renew into 2028 coverage)
www.politico.com/live-updates...
www.politico.com/live-updates...
October 24, 2025 at 3:20 PM
I don't think this is quite right? The pre-enrollment verification policy, which was ultimately included in OBBBA, effectively ends automatic renewals, but that policy won't take effect until the end of 2027 (for people who would otherwise renew into 2028 coverage)
www.politico.com/live-updates...
www.politico.com/live-updates...
ICYMI: The information session for Harvard’s PhD in Health Policy will be held next Tuesday, October 28.
Register here: harvard.zoom.us/meeting/regi...
Register here: harvard.zoom.us/meeting/regi...
October 23, 2025 at 3:58 PM
ICYMI: The information session for Harvard’s PhD in Health Policy will be held next Tuesday, October 28.
Register here: harvard.zoom.us/meeting/regi...
Register here: harvard.zoom.us/meeting/regi...
Huh. CMS is using the fees that external researchers pay to access Medicare and Medicaid data to bring back furloughed employees.
www.politico.com/newsletters/...
www.politico.com/newsletters/...
October 23, 2025 at 2:04 PM
Huh. CMS is using the fees that external researchers pay to access Medicare and Medicaid data to bring back furloughed employees.
www.politico.com/newsletters/...
www.politico.com/newsletters/...