Joshua Cohen
@joshuapcohen.bsky.social
Health economist, writer, political junkie but allergic to extremes, sports fanatic and music enthusiast
As we've entered open enrollment season, there's sticker shock in both the ACA/Obamacare and commercial health insurance markets.
www.forbes.com/sites/joshua...
www.forbes.com/sites/joshua...
Sticker Shock As Insurance Costs Rise In ACA And Commercial Markets
Premium increases of 9% are expected in the employer-sponsored health insurance market in 2026. Millions more in the individual market will see an even higher spike.
www.forbes.com
November 10, 2025 at 6:06 PM
As we've entered open enrollment season, there's sticker shock in both the ACA/Obamacare and commercial health insurance markets.
www.forbes.com/sites/joshua...
www.forbes.com/sites/joshua...
The price deals cut on obesity drugs will have a negligible effect on Medicare beneficiary access. Same holds for other patients. And the agreement raises a series of unanswered questions which we won't find answers to, given the confidential terms of the negotiations.
www.forbes.com/sites/joshua...
www.forbes.com/sites/joshua...
Trump's Price Cuts For Obesity Drugs Raise More Questions Than Answers
How much impact the obesity drug price cuts will have on patients remains to be seen. What's been publicly released raises more questions than answers.
www.forbes.com
November 10, 2025 at 2:13 PM
The price deals cut on obesity drugs will have a negligible effect on Medicare beneficiary access. Same holds for other patients. And the agreement raises a series of unanswered questions which we won't find answers to, given the confidential terms of the negotiations.
www.forbes.com/sites/joshua...
www.forbes.com/sites/joshua...
Republicans appear to have more than just "concepts of a plan" on healthcare. A GOP plan taking shape to redirect Obamacare subsidies to individuals who can use them for health savings accounts could erode the foundation of the Affordable Care Act.
www.forbes.com/sites/joshua...
www.forbes.com/sites/joshua...
Republicans’ Plan To Redirect Obamacare Subsidies Takes Shape
If implemented, a Republican plan to redirect Affordable Care Act subsidies to individuals who can use them for health savings accounts could erode the law's foundation.
www.forbes.com
November 9, 2025 at 9:39 PM
Republicans appear to have more than just "concepts of a plan" on healthcare. A GOP plan taking shape to redirect Obamacare subsidies to individuals who can use them for health savings accounts could erode the foundation of the Affordable Care Act.
www.forbes.com/sites/joshua...
www.forbes.com/sites/joshua...
The Trump administration's announced price cuts for weight loss drugs are certainly interesting. But what's been released to the public raises more questions than answers.
www.forbes.com/sites/joshua...
www.forbes.com/sites/joshua...
Trump's Price Cuts For Obesity Drugs Raise More Questions Than Answers
How much impact the obesity drug price cuts will have on patients remains to be seen. What's been publicly released raises more questions than answers.
www.forbes.com
November 6, 2025 at 11:03 PM
The Trump administration's announced price cuts for weight loss drugs are certainly interesting. But what's been released to the public raises more questions than answers.
www.forbes.com/sites/joshua...
www.forbes.com/sites/joshua...
As states form coalitions to counter what they view as detrimental public health policy emanating from the Trump administration, I'm reminded of one of our nation's founding principles: Federalism. This piece is about that, using the state alliances as an illustration.
www.forbes.com/sites/joshua...
www.forbes.com/sites/joshua...
States’ Pursuit Of Own Public Health Policy Reflects Federalism
Now that national public health authority appears to be eroding, there's a revival of state autonomy, in the form of coalitions of states establishing their own policy.
www.forbes.com
November 5, 2025 at 10:18 PM
As states form coalitions to counter what they view as detrimental public health policy emanating from the Trump administration, I'm reminded of one of our nation's founding principles: Federalism. This piece is about that, using the state alliances as an illustration.
www.forbes.com/sites/joshua...
www.forbes.com/sites/joshua...
The British government is considering raising the level of a cost-effectiveness threshold used as a benchmark to determine whether a healthcare intervention provides value for money for the National Health Service.
www.forbes.com/sites/joshua...
www.forbes.com/sites/joshua...
U.S.-U.K. Negotiations Could Lead To Higher Drug Spending In Britain
Whatever cost-effectiveness threshold level NICE adopts in future, it will reflect a policy choice that appropriately balances societal “health, fairness and innovation.”
www.forbes.com
November 4, 2025 at 10:33 PM
The British government is considering raising the level of a cost-effectiveness threshold used as a benchmark to determine whether a healthcare intervention provides value for money for the National Health Service.
www.forbes.com/sites/joshua...
www.forbes.com/sites/joshua...
Democrats introduced a bill that would repeal the orphan-only drugs exemption included in the One Big Beautiful Bill. As is almost invariably the case with legislation, this repeal effort as well as the orphan-only drugs exemption itself entail tradeoffs.
www.forbes.com/sites/joshua...
www.forbes.com/sites/joshua...
Dems Seek Repeal Of Orphan-Only Drugs Exemption From Price Negotiation
The Democratic Senators say their goal is to preserve incentives for “genuine rare-disease innovation” while ensuring that “blockbuster drugs can still be negotiated.”
www.forbes.com
November 4, 2025 at 7:49 PM
Democrats introduced a bill that would repeal the orphan-only drugs exemption included in the One Big Beautiful Bill. As is almost invariably the case with legislation, this repeal effort as well as the orphan-only drugs exemption itself entail tradeoffs.
www.forbes.com/sites/joshua...
www.forbes.com/sites/joshua...
Biosimilar access in the U.S. is improving. But barriers have prevented these lower-priced versions of originator biologics from truly flourishing. FDA is addressing approvals, but two often bigger hurdles - patent disputes and payer reimbursement - remain.
www.forbes.com/sites/joshua...
www.forbes.com/sites/joshua...
FDA Simplifies Biosimilar Approvals; Patents And Payment Issues Remain
FDA Commissioner Makary wants to expedite biosimilar approvals. But in the U.S., the greater impediments to access have been patent disputes and payment hurdles.
www.forbes.com
November 3, 2025 at 1:10 PM
Biosimilar access in the U.S. is improving. But barriers have prevented these lower-priced versions of originator biologics from truly flourishing. FDA is addressing approvals, but two often bigger hurdles - patent disputes and payer reimbursement - remain.
www.forbes.com/sites/joshua...
www.forbes.com/sites/joshua...
I sense some skepticism in the commentary around the health insurer Cigna's policy announcement this week. While I'm not sold on the idea that this heralds the end of rebates that don't get passed through to patients, it's a step in the right direction.
www.forbes.com/sites/joshua...
www.forbes.com/sites/joshua...
Cigna’s Rebate-Free Pharmacy Model Holds Promise For Some Patients
Cigna says it will “transition toward a new model where discounts negotiated with drug companies are available upfront to Americans buying their medications.”
www.forbes.com
November 2, 2025 at 7:32 PM
I sense some skepticism in the commentary around the health insurer Cigna's policy announcement this week. While I'm not sold on the idea that this heralds the end of rebates that don't get passed through to patients, it's a step in the right direction.
www.forbes.com/sites/joshua...
www.forbes.com/sites/joshua...
On health insurance, the media and politicians in Washington DC tend to focus on federal government spending in programs such as Medicaid and Obamacare. This ignores, however, the much larger subsidies given in the commercial sector.
www.forbes.com/sites/joshua...
www.forbes.com/sites/joshua...
Private And Public Health Insurers Depend On Government Subsidies
The most prevalent form of health insurance in America, employer-sponsored coverage, is subsidized in absolute dollars to a substantially greater extent than Obamacare.
www.forbes.com
November 2, 2025 at 1:29 PM
On health insurance, the media and politicians in Washington DC tend to focus on federal government spending in programs such as Medicaid and Obamacare. This ignores, however, the much larger subsidies given in the commercial sector.
www.forbes.com/sites/joshua...
www.forbes.com/sites/joshua...
Like many Americans, I found out this morning how large the spike in health insurance premiums will be in 2026. In my case, 16% (over $100 per month more than in 2025). Americans are paying much more in premiums each year for worsening coverage. It's absurd.
www.forbes.com/sites/joshua...
www.forbes.com/sites/joshua...
Sticker Shock As Insurance Costs Rise In ACA And Commercial Markets
Premium increases of 9% are expected in the employer-sponsored health insurance market in 2026. Millions more in the individual market will see an even higher spike.
www.forbes.com
November 1, 2025 at 2:45 PM
Like many Americans, I found out this morning how large the spike in health insurance premiums will be in 2026. In my case, 16% (over $100 per month more than in 2025). Americans are paying much more in premiums each year for worsening coverage. It's absurd.
www.forbes.com/sites/joshua...
www.forbes.com/sites/joshua...
It's that time of year again: Open enrollment, when many Americans select health plans for the upcoming year. Across the Obamacare exchanges, monthly premiums are rising by as much as 30% on average. And this doesn't account for the expiring subsidies.
www.forbes.com/sites/joshua...
www.forbes.com/sites/joshua...
As Open Enrollment Begins, Data Show Obamacare Premiums Increasing 30%
What may exacerbate the 30% increase in premiums is if ACA subsidies expire, as they’re due to Dec. 31. The rise in monthly premiums could then be much greater than 30%.
www.forbes.com
November 1, 2025 at 1:34 PM
It's that time of year again: Open enrollment, when many Americans select health plans for the upcoming year. Across the Obamacare exchanges, monthly premiums are rising by as much as 30% on average. And this doesn't account for the expiring subsidies.
www.forbes.com/sites/joshua...
www.forbes.com/sites/joshua...
Direct-to-consumer advertising of prescription medications is ubiquitous. The Trump administration is addressing what it sees as a "public health crisis." But will things change with respect to these commercials?
undark.org/2025/10/27/d...
undark.org/2025/10/27/d...
What Will the Trump-Era Crackdown on Drug Ads Accomplish?
The federal government announced a new approach to regulating pharmaceutical ads. Consumers may not see a difference.
undark.org
October 30, 2025 at 3:03 PM
Direct-to-consumer advertising of prescription medications is ubiquitous. The Trump administration is addressing what it sees as a "public health crisis." But will things change with respect to these commercials?
undark.org/2025/10/27/d...
undark.org/2025/10/27/d...
On this rainy day in Boston, my piece on the sun (its benefits), sunscreen (its protective properties), and the anti-sunscreen movement, is out.
undark.org/2025/10/13/a...
undark.org/2025/10/13/a...
What the Anti-Sunscreen Movement Misses
New research suggests sunlight has unexpected benefits, but this doesn't mean everyone should ditch their sunscreen.
undark.org
October 13, 2025 at 5:25 PM
On this rainy day in Boston, my piece on the sun (its benefits), sunscreen (its protective properties), and the anti-sunscreen movement, is out.
undark.org/2025/10/13/a...
undark.org/2025/10/13/a...
Kennedy’s repeating refuted (or at least disputed) links isn’t a one-off. He has often done this regarding exposure to substances such as acetaminophen, thimerosal and aluminum salts that he thinks are tied to autism.
www.forbes.com/sites/joshua...
www.forbes.com/sites/joshua...
RFK Jr. Is Doubling Down On Multiple Unproven Links To Autism
Kennedy’s doubling down on disputed links isn't a one-off. He has often done this regarding exposure to substances like acetaminophen that he thinks are linked to autism.
www.forbes.com
October 12, 2025 at 6:11 PM
Kennedy’s repeating refuted (or at least disputed) links isn’t a one-off. He has often done this regarding exposure to substances such as acetaminophen, thimerosal and aluminum salts that he thinks are tied to autism.
www.forbes.com/sites/joshua...
www.forbes.com/sites/joshua...
Reposted by Joshua Cohen
Without critical details, it's hard to evaluate the impact of Trump's most favored nation initiative on drug pricing for patients and Medicaid.
www.forbes.com/sites/joshua...
www.forbes.com/sites/joshua...
Missing Details On Trump’s Drug Price Plan Make It Hard To Evaluate
Trump has called its initiative an “historic” step in drug pricing policy. But the lack of critical details makes it hard to assess the impact on patients and Medicaid.
www.forbes.com
October 7, 2025 at 12:28 PM
Without critical details, it's hard to evaluate the impact of Trump's most favored nation initiative on drug pricing for patients and Medicaid.
www.forbes.com/sites/joshua...
www.forbes.com/sites/joshua...
Is Trump's most favored nation initiative consequential? Well, not for the vast majority (>90%) of U.S. patients. It could be meaningful for Medicaid payers, but even that remains to be seen. For now, the impact on Medicaid is shrouded in opacity.
www.forbes.com/sites/joshua...
www.forbes.com/sites/joshua...
Trump’s Drug Price Initiative Has No Impact On Most US Patients’ Costs
Trump touted a deal with Pfizer in which the firm will sell drugs at discounts on a website called TrumpRx. But for most patients their out-of-pocket costs won’t change.
www.forbes.com
October 5, 2025 at 8:10 PM
Is Trump's most favored nation initiative consequential? Well, not for the vast majority (>90%) of U.S. patients. It could be meaningful for Medicaid payers, but even that remains to be seen. For now, the impact on Medicaid is shrouded in opacity.
www.forbes.com/sites/joshua...
www.forbes.com/sites/joshua...
Florida Surgeon General Joseph Ladapo's stance opposing vaccine mandates stands in stark contrast to longstanding (current and past) U.S. immigration policy.
www.forbes.com/sites/joshua...
www.forbes.com/sites/joshua...
Ladapo’s Stance On Vaccine Mandates Contradicts U.S. Immigration Law
Florida's Surgeon General Joseph Ladapo has likened vaccine mandates to slavery.
Nevertheless, vaccine mandates are integral to current and past U.S. immigration policy.
www.forbes.com
October 3, 2025 at 3:56 PM
Florida Surgeon General Joseph Ladapo's stance opposing vaccine mandates stands in stark contrast to longstanding (current and past) U.S. immigration policy.
www.forbes.com/sites/joshua...
www.forbes.com/sites/joshua...
While many MAHA ideas are problematic, improving diet and exercise is laudable. Our diet in the US is really quite poor. I've lived overseas for decades. Generally, diet is much better outside the US. Perhaps one way to address the problem is adding nutrient warnings.
www.forbes.com/sites/joshua...
www.forbes.com/sites/joshua...
U.S. Could Follow Other Countries’ Lead And Add Nutrient Warnings
Perhaps nutrient warnings could also apply to food and non-alcoholic beverages. Evidence from countries that implemented warning policies supports their effectiveness.
www.forbes.com
October 3, 2025 at 3:17 PM
While many MAHA ideas are problematic, improving diet and exercise is laudable. Our diet in the US is really quite poor. I've lived overseas for decades. Generally, diet is much better outside the US. Perhaps one way to address the problem is adding nutrient warnings.
www.forbes.com/sites/joshua...
www.forbes.com/sites/joshua...
Why canceling a federal government survey on hunger and food insecurity matters.
www.forbes.com/sites/joshua...
www.forbes.com/sites/joshua...
What Canceling The U.S. Federal Government’s Hunger Survey Means
The survey data on hunger and food insecurity help shape policy at the local, state and federal government levels, specifically to guide food assistance programs.
www.forbes.com
October 3, 2025 at 1:34 PM
Why canceling a federal government survey on hunger and food insecurity matters.
www.forbes.com/sites/joshua...
www.forbes.com/sites/joshua...
There are many problematic ideas in the MAHA movement. But paying closer attention to diet (and exercise) is a welcome feature. Americans' dietary habits can be poor. Perhaps MAHA could push for adding nutrient warning labels as is done in other nations.
www.forbes.com/sites/joshua...
www.forbes.com/sites/joshua...
U.S. Could Follow Other Countries’ Lead And Add Nutrient Warnings
Perhaps nutrient warnings could also apply to food and non-alcoholic beverages. Evidence from countries that implemented warning policies supports their effectiveness.
www.forbes.com
October 2, 2025 at 1:40 PM
There are many problematic ideas in the MAHA movement. But paying closer attention to diet (and exercise) is a welcome feature. Americans' dietary habits can be poor. Perhaps MAHA could push for adding nutrient warning labels as is done in other nations.
www.forbes.com/sites/joshua...
www.forbes.com/sites/joshua...
Many rural hospitals and nursing homes have been operating in the red or close to it for years. The One Big Beautiful Bill will greatly exacerbate this longstanding problem. In anticipation of cuts in 2026, some hospitals and clinics are already closing their doors.
www.forbes.com/sites/joshua...
www.forbes.com/sites/joshua...
Medicaid Cuts May Already Be Impacting Hospitals
The One Big Beautiful Bill may lead to 16 million Medicaid/ACA enrollees losing coverage. Hospitals in turn will have reduced revenue and higher uncompensated care costs.
www.forbes.com
October 2, 2025 at 11:27 AM
Many rural hospitals and nursing homes have been operating in the red or close to it for years. The One Big Beautiful Bill will greatly exacerbate this longstanding problem. In anticipation of cuts in 2026, some hospitals and clinics are already closing their doors.
www.forbes.com/sites/joshua...
www.forbes.com/sites/joshua...
Leucovorin is being touted by FDA Commissioner Makary as a treatment for individuals with autism who have cerebral folate deficiency. It may have modest promise, but the science is far from being settled.
www.forbes.com/sites/joshua...
www.forbes.com/sites/joshua...
Leucovorin May Have Promise In Autism, But Science Is Far From Settled
Regarding autism, the mix of genetic and environmental factors thought to cause it can complicate seemingly simple solutions like leucovorin.
www.forbes.com
October 1, 2025 at 8:51 PM
Leucovorin is being touted by FDA Commissioner Makary as a treatment for individuals with autism who have cerebral folate deficiency. It may have modest promise, but the science is far from being settled.
www.forbes.com/sites/joshua...
www.forbes.com/sites/joshua...
Ever since moving back to the US on a more or less permanent basis in 1995, I've never understood the farce of federal government shutdowns. What's particularly troubling is the real fallout. Here I describe the role of Obamacare subsidies in the current standoff. www.forbes.com/sites/joshua...
Government Shutdown Imperils Obamacare Subsidies, Affordability
Federal government shutdown imperils the extension of Obamacare subsidies for more than 22 million Americans, which could make their healthcare much less affordable.
www.forbes.com
October 1, 2025 at 12:19 PM
Ever since moving back to the US on a more or less permanent basis in 1995, I've never understood the farce of federal government shutdowns. What's particularly troubling is the real fallout. Here I describe the role of Obamacare subsidies in the current standoff. www.forbes.com/sites/joshua...