xpostfactoid
@xpostfactoid.bsky.social
Blogging mostly healthcare policy at http://xpostfactoid.substack.com. ACA implementation watcher. CSR czar. AKA Andrew Sprung.
About the garbage ACA "reform" Bill Cassidy is peddling now -- replacing regulated, comprehensive insurance with lump-sum payments to buy unregulated plans, with HSAs to replace good out-of-pocket cost protection:
He's been peddling that snake oil since 2015, and probably earlier
He's been peddling that snake oil since 2015, and probably earlier
Cassidy Introduces Obamacare Replacement Plan: The Patient Freedom Act is a Conservative Response to King v. Burwell | U.S. Senator Bill Cassidy
Today, U.S. Senator Bill Cassidy, M.D. (R-LA) introduced the Patient Freedom Act, a conservative response to protect millions of Americans who are at risk of losing their health care coverage followin...
www.cassidy.senate.gov
November 10, 2025 at 12:33 AM
About the garbage ACA "reform" Bill Cassidy is peddling now -- replacing regulated, comprehensive insurance with lump-sum payments to buy unregulated plans, with HSAs to replace good out-of-pocket cost protection:
He's been peddling that snake oil since 2015, and probably earlier
He's been peddling that snake oil since 2015, and probably earlier
Reposted by xpostfactoid
This is apparently a 7 week or so CR. I'll remind everyone that the first-ever extended shutdown, the Newt one, was a two-parter; a short-ish fall shutdown, followed by a CR, followed by a longer winter shutdown. Will this be a two-parter? We don't know yet. *They* may not know yet.
November 9, 2025 at 10:08 PM
This is apparently a 7 week or so CR. I'll remind everyone that the first-ever extended shutdown, the Newt one, was a two-parter; a short-ish fall shutdown, followed by a CR, followed by a longer winter shutdown. Will this be a two-parter? We don't know yet. *They* may not know yet.
No, Trump does not have "ideas" to redirect health insurance money. He has deluded incoherent fantasies that Republicans will convert into unworkable, access-destroying plans.
Or turn it around: Trump is babbling his own misunderstanding of depraved right-wing plans for health insurance "reform."
Or turn it around: Trump is babbling his own misunderstanding of depraved right-wing plans for health insurance "reform."
Trump demands ACA subsidy changes as Senate remains divided over shutdown
Republicans say any vote on Obamacare subsidies would come after Democrats agree to reopen the government. The president has his own ideas to redirect health insurance money
wapo.st/4nEammV
Republicans say any vote on Obamacare subsidies would come after Democrats agree to reopen the government. The president has his own ideas to redirect health insurance money
wapo.st/4nEammV
Trump demands ACA subsidy changes as Senate remains divided over shutdown
Republicans say any vote on Obamacare subsidies would come after Democrats agree to reopen the government. The president has his own ideas to redirect health insurance money.
wapo.st
November 9, 2025 at 1:55 PM
No, Trump does not have "ideas" to redirect health insurance money. He has deluded incoherent fantasies that Republicans will convert into unworkable, access-destroying plans.
Or turn it around: Trump is babbling his own misunderstanding of depraved right-wing plans for health insurance "reform."
Or turn it around: Trump is babbling his own misunderstanding of depraved right-wing plans for health insurance "reform."
Reposted by xpostfactoid
Update: Welp. It looks like the Senate GOP is already running with Trumps “HSAs for All!” rant.
It’s 2017 all over again, but even meaner and dumber.
youtu.be/ZBAsIq9UUsg?...
It’s 2017 all over again, but even meaner and dumber.
youtu.be/ZBAsIq9UUsg?...
'A Novel Idea': Marshall Proposes Giving ACA Subsidies Directly To People Instead Of Health Insurers
YouTube video by Forbes Breaking News
youtu.be
November 9, 2025 at 2:48 AM
Update: Welp. It looks like the Senate GOP is already running with Trumps “HSAs for All!” rant.
It’s 2017 all over again, but even meaner and dumber.
youtu.be/ZBAsIq9UUsg?...
It’s 2017 all over again, but even meaner and dumber.
youtu.be/ZBAsIq9UUsg?...
Reposted by xpostfactoid
40 men Trump sent to CECOT tell the NYT they were beaten, tortured, and sexually assaulted. The details are worse than you can imagine.
We can’t let them get away with this. Miller and the other architects of this sadism need to go to prison.
www.nytimes.com/2025/11/08/w...
We can’t let them get away with this. Miller and the other architects of this sadism need to go to prison.
www.nytimes.com/2025/11/08/w...
‘You Are All Terrorists’: Four Months in a Salvadoran Prison
www.nytimes.com
November 9, 2025 at 2:20 AM
40 men Trump sent to CECOT tell the NYT they were beaten, tortured, and sexually assaulted. The details are worse than you can imagine.
We can’t let them get away with this. Miller and the other architects of this sadism need to go to prison.
www.nytimes.com/2025/11/08/w...
We can’t let them get away with this. Miller and the other architects of this sadism need to go to prison.
www.nytimes.com/2025/11/08/w...
Don't dignify the bullshit ACA alternatives that frauds like Cassidy are peddling now by treating them as anything other than snake oil, worse than the crap Republicans couldn't even bring themselves to pass in 2017.
Senate Dems, do not cave. Ensuring healthcare premiums don’t surge is an 80-20 issue. They want to gut the ACA because their disdain for Obama far outweighs their concern for anyone’s health.
November 8, 2025 at 9:02 PM
Don't dignify the bullshit ACA alternatives that frauds like Cassidy are peddling now by treating them as anything other than snake oil, worse than the crap Republicans couldn't even bring themselves to pass in 2017.
Why not just give everyone vitamins, such as those sold by the late great Trump Network, and call it a day?
No deductibles, but everyone has to pay $140 for a urine test and $70/month for vitamins that will keep them from needing "healthcare."
www.dailykos.com/story/2016/0...
No deductibles, but everyone has to pay $140 for a urine test and $70/month for vitamins that will keep them from needing "healthcare."
www.dailykos.com/story/2016/0...
You have to read between the lines here to imagine what President Trump is proposing. But, it sounds like it may be a plan for health accounts that could be used for insurance that doesn’t cover pre-existing conditions, which could create a death spiral in ACA plans that do.
November 8, 2025 at 7:02 PM
Why not just give everyone vitamins, such as those sold by the late great Trump Network, and call it a day?
No deductibles, but everyone has to pay $140 for a urine test and $70/month for vitamins that will keep them from needing "healthcare."
www.dailykos.com/story/2016/0...
No deductibles, but everyone has to pay $140 for a urine test and $70/month for vitamins that will keep them from needing "healthcare."
www.dailykos.com/story/2016/0...
I have been running in the early morning for 18 months, and I have developed a conviction that the air is more conducive to running before full daylight.
When I have to run later, I suffer from what I call daylightitus.
Is there anything to this?
When I have to run later, I suffer from what I call daylightitus.
Is there anything to this?
November 8, 2025 at 1:11 AM
I have been running in the early morning for 18 months, and I have developed a conviction that the air is more conducive to running before full daylight.
When I have to run later, I suffer from what I call daylightitus.
Is there anything to this?
When I have to run later, I suffer from what I call daylightitus.
Is there anything to this?
Today in Trump and his minions love and support Russian agents
In a plea deal in Dec 2024, Smirnov admitted to completely fabricating the conspiracy that became central to a GOP effort to impeach then-President Joe Biden. Days later, the Russian asset pleaded guilty to four felony charges, including one count of obstruction, and was sentenced to six years.
Alexander Smirnov, the ex–FBI informant who admitted to lying about the Biden-Burisma connection, has been released from prison just months into his six-year prison sentence. trib.al/W2wJSVD
November 7, 2025 at 10:58 PM
Today in Trump and his minions love and support Russian agents
Reposted by xpostfactoid
He has no problem giving hundreds of billions in overpayments to some of the same insurance carriers for Medicare Advantage, though.
Translation: “We will let your health care premiums skyrocket and have no plan to help alleviate the pain”
November 7, 2025 at 10:55 PM
He has no problem giving hundreds of billions in overpayments to some of the same insurance carriers for Medicare Advantage, though.
Premium Alignment, or how a dozen states are quietly providing ACA enrollees w/better options even in the face of expiring tax credits -- Gaba's overview open.substack.com/pub/charlesg...
Premium Alignment, or how a dozen states are quietly providing ACA enrollees w/better options even in the face of expiring tax credits
A special heads up to ACA enrollees in ARKANSAS, ILLINOIS & WASHINGTON.
open.substack.com
November 7, 2025 at 7:32 PM
Premium Alignment, or how a dozen states are quietly providing ACA enrollees w/better options even in the face of expiring tax credits -- Gaba's overview open.substack.com/pub/charlesg...
Like that goddamned ballroom, Trumpcare 2.0 is gilded with gold xpostfactoid.substack.com/p/aca-market...
ACA marketplace 2026: The silver loading mitigation
Gold plans priced below benchmark are available to about half of enrollees nationally
xpostfactoid.substack.com
November 7, 2025 at 4:10 PM
Like that goddamned ballroom, Trumpcare 2.0 is gilded with gold xpostfactoid.substack.com/p/aca-market...
Really key column from Jamelle Bouie that brings the core political dynamic of the Trump years into sharp focus.
This election was clarifying.
This election was clarifying.
Opinion | Make No Mistake: Trump Is an Albatross
www.nytimes.com
November 6, 2025 at 9:15 PM
Really key column from Jamelle Bouie that brings the core political dynamic of the Trump years into sharp focus.
This election was clarifying.
This election was clarifying.
The ACA's ARPA subsidies: Good enough for me and @emily-gee.bsky.social
www.americanprogress.org/article/bett...
www.americanprogress.org/article/bett...
Better Late Than Never: Restoring Enhanced Premium Tax Credits Would Lower Health Care Costs for Millions
While Congress has stalled on re-upping enhanced subsidies for Affordable Care Act marketplace plans, a clean extension would still offer Americans relief on premium costs for 2026.
www.americanprogress.org
November 5, 2025 at 8:47 PM
The ACA's ARPA subsidies: Good enough for me and @emily-gee.bsky.social
www.americanprogress.org/article/bett...
www.americanprogress.org/article/bett...
Aw, that award is just a political football
November 5, 2025 at 8:45 PM
Aw, that award is just a political football
the economic carnage [Trump has]unleashed is inseparable from his consolidation of autocratic power.
An absurd media narrative in runup to the election said Dems must choose between being "anti-Trump" and running on substance.
The lesson from this election is that anti-Trump politics *is* affordability politics, and affordability politics *is* anti-Trump politics:
newrepublic.com/article/2027...
The lesson from this election is that anti-Trump politics *is* affordability politics, and affordability politics *is* anti-Trump politics:
newrepublic.com/article/2027...
November 5, 2025 at 7:34 PM
the economic carnage [Trump has]unleashed is inseparable from his consolidation of autocratic power.
Reposted by xpostfactoid
Nationwide, 1 in 5 child care workers are immigrants, most of them Latinas. In Chicago, it’s 1 in 4.
@chabeli.bsky.social reports.
@chabeli.bsky.social reports.
‘I have papers’: Child care worker detained by ICE officers inside a Chicago day care
Raids inside day cares had been off limits until this year, when, on his first day in office, President Donald Trump removed that protection.
19thnews.org
November 5, 2025 at 5:28 PM
Nationwide, 1 in 5 child care workers are immigrants, most of them Latinas. In Chicago, it’s 1 in 4.
@chabeli.bsky.social reports.
@chabeli.bsky.social reports.
Reposted by xpostfactoid
I’m a Primary Care Doctor. My Patients Are Scared to Show Up Due to ICE. truthout.org/articles/im-...
(I wrote a thing in @truthout.org about what it's like to be a primary care doctor when ICE is attacking my patients. )
(I wrote a thing in @truthout.org about what it's like to be a primary care doctor when ICE is attacking my patients. )
I’m a Primary Care Doctor. My Patients Are Scared to Show Up Due to ICE.
How am I supposed to adequately care for patients who are being constantly terrorized by immigration police?
truthout.org
September 19, 2025 at 4:54 PM
I’m a Primary Care Doctor. My Patients Are Scared to Show Up Due to ICE. truthout.org/articles/im-...
(I wrote a thing in @truthout.org about what it's like to be a primary care doctor when ICE is attacking my patients. )
(I wrote a thing in @truthout.org about what it's like to be a primary care doctor when ICE is attacking my patients. )
Reposted by xpostfactoid
That’s an extraordinary vote of confidence for a third term www.fox29.com/news/electio...
November 5, 2025 at 12:43 PM
That’s an extraordinary vote of confidence for a third term www.fox29.com/news/electio...
Jeff Spurgeon
@wqxr.bsky.social
picked a nice morning to play Leonard Cohen's Hallelujah (instrumental version).
I cried...
@wqxr.bsky.social
picked a nice morning to play Leonard Cohen's Hallelujah (instrumental version).
I cried...
November 5, 2025 at 12:45 PM
Jeff Spurgeon
@wqxr.bsky.social
picked a nice morning to play Leonard Cohen's Hallelujah (instrumental version).
I cried...
@wqxr.bsky.social
picked a nice morning to play Leonard Cohen's Hallelujah (instrumental version).
I cried...
Reposted by xpostfactoid
AOC: I think what this night is starting and shaping up to represent is that Americans everywhere are not going to be scared. We will not be intimidated by an administration that is violating the rights and making life hard and unaffordable for every single American in this country.
November 5, 2025 at 3:16 AM
AOC: I think what this night is starting and shaping up to represent is that Americans everywhere are not going to be scared. We will not be intimidated by an administration that is violating the rights and making life hard and unaffordable for every single American in this country.
Reposted by xpostfactoid
AOC: We know that Donald Trump has not only been convicted of committing crimes, but that the supreme court has given him a blank check to continue to commit crimes while in office. So we cannot underestimate the threat and the danger of this moment. But we cannot respond to that with cowardice.
November 5, 2025 at 3:21 AM
AOC: We know that Donald Trump has not only been convicted of committing crimes, but that the supreme court has given him a blank check to continue to commit crimes while in office. So we cannot underestimate the threat and the danger of this moment. But we cannot respond to that with cowardice.
Reposted by xpostfactoid
Every single county in Virginia shifted Blue.
November 5, 2025 at 1:35 AM
Every single county in Virginia shifted Blue.
Reposted by xpostfactoid
These big wins will embolden Dems to take on Trump's lawbreaking and show there's a price for GOP enabling of him. Folks hate to hear this, but normal patterns are asserting themselves: Liberalism isn't dead, Rs are likely to lose in 2026, and Trump is really unpopular, not a magical exception.
November 5, 2025 at 1:30 AM
These big wins will embolden Dems to take on Trump's lawbreaking and show there's a price for GOP enabling of him. Folks hate to hear this, but normal patterns are asserting themselves: Liberalism isn't dead, Rs are likely to lose in 2026, and Trump is really unpopular, not a magical exception.
Reposted by xpostfactoid
BREAKING: After ICE refuses to allow detained migrants to receive the Eucharist, Pope Leo calls on Trump and Vance to respect migrants‘ dignity and religious liberty.
“They must allow ministers to assist with their needs. They've been separated from their families and no one knows what happens.”
“They must allow ministers to assist with their needs. They've been separated from their families and no one knows what happens.”
November 4, 2025 at 8:14 PM
BREAKING: After ICE refuses to allow detained migrants to receive the Eucharist, Pope Leo calls on Trump and Vance to respect migrants‘ dignity and religious liberty.
“They must allow ministers to assist with their needs. They've been separated from their families and no one knows what happens.”
“They must allow ministers to assist with their needs. They've been separated from their families and no one knows what happens.”