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
Pinned
Adrianna McIntyre
@adrianna.bsky.social
· Nov 11
Hi, new friends.
I mostly research and write about health insurance coverage and access — specifically, how to improve take-up and retention in Medicaid and marketplace plans. I also study the politics of health reform.
Sidekick Nellie cares less about health policy and more about kibble policy.
I mostly research and write about health insurance coverage and access — specifically, how to improve take-up and retention in Medicaid and marketplace plans. I also study the politics of health reform.
Sidekick Nellie cares less about health policy and more about kibble policy.
part of me loves having a pile of manuscripts to review over a holiday break because it feels like the one part of my job, outside teaching, that I can explain to relatives and they at least sort of get it
November 24, 2025 at 10:48 PM
part of me loves having a pile of manuscripts to review over a holiday break because it feels like the one part of my job, outside teaching, that I can explain to relatives and they at least sort of get it
Reposted by Adrianna McIntyre
People have to sign up for ACA marketplace coverage by December 15 to have health insurance January 1. Even if Congress passed an extension with tweaks to the premium tax credits, computer systems could not be reprogrammed immediately.
November 24, 2025 at 6:45 PM
People have to sign up for ACA marketplace coverage by December 15 to have health insurance January 1. Even if Congress passed an extension with tweaks to the premium tax credits, computer systems could not be reprogrammed immediately.
New reporting on the other site that actually Trump's health care plans is coming in two weeks
November 24, 2025 at 6:26 PM
New reporting on the other site that actually Trump's health care plans is coming in two weeks
I don't often know if a court opinion is going to be completely withering based on its first sentence but "a former White House aide with no prior prosecutorial experience" does a thing
November 24, 2025 at 5:55 PM
I don't often know if a court opinion is going to be completely withering based on its first sentence but "a former White House aide with no prior prosecutorial experience" does a thing
Comparing the reported details of the "White House plan" on extending enhanced subsidies to the Suozzi et al bipartisan bill reminds me of students complaining about group work where one person waits for everyone else to share their work, then runs the draft through ChatGPT to fill in their parts.
November 24, 2025 at 5:28 PM
Comparing the reported details of the "White House plan" on extending enhanced subsidies to the Suozzi et al bipartisan bill reminds me of students complaining about group work where one person waits for everyone else to share their work, then runs the draft through ChatGPT to fill in their parts.
Friends don't let friends who can't explain silver-loading write about appropriating funds for cost-sharing reductions
I think @proptermalone.bsky.social can declare victory on his prediction that the GOP was eager to find a way to extend ACA subsidies (even if they've gone about it in a VERY dumb way). Two year extension + following details in the White House plan.
www.politico.com/news/2025/11...
www.politico.com/news/2025/11...
November 24, 2025 at 3:52 PM
Friends don't let friends who can't explain silver-loading write about appropriating funds for cost-sharing reductions
Reposted by Adrianna McIntyre
Charging minimum premiums would in itself like cut enrollment by about a million 1/
www.brookings.edu/articles/how...
www.brookings.edu/articles/how...
November 24, 2025 at 2:36 PM
Charging minimum premiums would in itself like cut enrollment by about a million 1/
www.brookings.edu/articles/how...
www.brookings.edu/articles/how...
Reposted by Adrianna McIntyre
See @adrianna.bsky.social et al. on the effect when low-income enrollees paying $0 for Massachusetts ConnectorCare were charged premiums under $10 come January. About 14% dropped coverage. 2/
Small Marketplace Premiums Pose Financial And Administrative Burdens: Evidence From Massachusetts, 2016–17 | Health Affairs Journal
Health insurance premiums are primarily understood to pose financial barriers to coverage. However, the need to remit monthly premium payments may also create administrative burdens that negatively af...
www.healthaffairs.org
November 24, 2025 at 2:39 PM
See @adrianna.bsky.social et al. on the effect when low-income enrollees paying $0 for Massachusetts ConnectorCare were charged premiums under $10 come January. About 14% dropped coverage. 2/
The Scott proposal hews most closely to Trump’s various remarks.
“While ACA plans would still be required to cover people with pre-existing conditions under the Scott proposal, it is likely that the ACA Marketplace would collapse in states that seek a waiver under his approach.”
“While ACA plans would still be required to cover people with pre-existing conditions under the Scott proposal, it is likely that the ACA Marketplace would collapse in states that seek a waiver under his approach.”
Proposals from Senators Scott and Cassidy to convert ACA premium tax credits into health accounts present trade-offs that benefit healthy people at the expense of sick people. Senator Scott's proposal, in particular, would destabilize the insurance market in some states.
www.kff.org/affordable-c...
www.kff.org/affordable-c...
November 21, 2025 at 10:48 PM
The Scott proposal hews most closely to Trump’s various remarks.
“While ACA plans would still be required to cover people with pre-existing conditions under the Scott proposal, it is likely that the ACA Marketplace would collapse in states that seek a waiver under his approach.”
“While ACA plans would still be required to cover people with pre-existing conditions under the Scott proposal, it is likely that the ACA Marketplace would collapse in states that seek a waiver under his approach.”
Heck of a legacy that Bill Cassidy has secured for himself.
HOT OFF THE PRESSES: RFK Jr. told me he personally instructed CDC to abandon its longstanding position that vaccines don't cause autism. He acknowledged that large-scale studies of MMR vaccine and thimerosal show no link. But he cited gaps in vaccine safety science.
www.nytimes.com/2025/11/21/u...
www.nytimes.com/2025/11/21/u...
Kennedy Says He Told C.D.C. to Change Website’s Language on Autism and Vaccines
www.nytimes.com
November 21, 2025 at 7:20 PM
Heck of a legacy that Bill Cassidy has secured for himself.
Using pooled data from 2021 and 2023, @chiamass.bsky.social finds that about in in eight (13%) Massachusetts residents has medical debt — and that share grows to one in six (17%) when subsetting to people with high deductible plans.
www.chiamass.gov/assets/docs/...
www.chiamass.gov/assets/docs/...
November 20, 2025 at 3:55 PM
Using pooled data from 2021 and 2023, @chiamass.bsky.social finds that about in in eight (13%) Massachusetts residents has medical debt — and that share grows to one in six (17%) when subsetting to people with high deductible plans.
www.chiamass.gov/assets/docs/...
www.chiamass.gov/assets/docs/...
Hear me out, people responsible for sourcing conference swag, particularly for women-dominated fields: travel-sized dry shampoo
November 19, 2025 at 7:20 PM
Hear me out, people responsible for sourcing conference swag, particularly for women-dominated fields: travel-sized dry shampoo
Sorry, is today, more than two weeks into open enrollment for 2026, the *first* time the Senate Finance Committee is hosting a hearing related to the expiring enhanced tax credits? When we've known their expiration date for literal years?
November 19, 2025 at 4:30 PM
Sorry, is today, more than two weeks into open enrollment for 2026, the *first* time the Senate Finance Committee is hosting a hearing related to the expiring enhanced tax credits? When we've known their expiration date for literal years?
We also need to know *which* subsidies are in play. As I understand it:
Paragon has proposed converting CSRs to HSA contributions
Cassidy has proposed converting ePTCs to HSA contributions
Trump has proposed (I think? this is least clear) converting *all* subsidies to HSA contributions.
Paragon has proposed converting CSRs to HSA contributions
Cassidy has proposed converting ePTCs to HSA contributions
Trump has proposed (I think? this is least clear) converting *all* subsidies to HSA contributions.
Wonky but important question for understanding the effects of proposals to convert ACA premium tax credits to health savings accounts: How big would the contributions be? Would they vary by income, age, and geography in the same way as the premium tax credits?
November 19, 2025 at 3:50 PM
We also need to know *which* subsidies are in play. As I understand it:
Paragon has proposed converting CSRs to HSA contributions
Cassidy has proposed converting ePTCs to HSA contributions
Trump has proposed (I think? this is least clear) converting *all* subsidies to HSA contributions.
Paragon has proposed converting CSRs to HSA contributions
Cassidy has proposed converting ePTCs to HSA contributions
Trump has proposed (I think? this is least clear) converting *all* subsidies to HSA contributions.
Reposted by Adrianna McIntyre
What's this mean for NIH-funded scientists?
It means the next time that Trump/RFK/JB want to terminate grants on topics they don't like, they'll have less trouble in court defending their actions.
It also means less certainty for scientists, less research, and more harm to US scientific leadership
It means the next time that Trump/RFK/JB want to terminate grants on topics they don't like, they'll have less trouble in court defending their actions.
It also means less certainty for scientists, less research, and more harm to US scientific leadership
November 19, 2025 at 1:35 PM
What's this mean for NIH-funded scientists?
It means the next time that Trump/RFK/JB want to terminate grants on topics they don't like, they'll have less trouble in court defending their actions.
It also means less certainty for scientists, less research, and more harm to US scientific leadership
It means the next time that Trump/RFK/JB want to terminate grants on topics they don't like, they'll have less trouble in court defending their actions.
It also means less certainty for scientists, less research, and more harm to US scientific leadership
Reposted by Adrianna McIntyre
We knew this regulation was going into effect, but we didn't yet know whether and how NIH might seek to use it.
Yesterday, we found out. NIH will indeed add specific language to new grant terms and, in doing so, it'll preserve the option to use this new power.
grants.nih.gov/grants/guide...
2/
Yesterday, we found out. NIH will indeed add specific language to new grant terms and, in doing so, it'll preserve the option to use this new power.
grants.nih.gov/grants/guide...
2/
November 19, 2025 at 1:35 PM
We knew this regulation was going into effect, but we didn't yet know whether and how NIH might seek to use it.
Yesterday, we found out. NIH will indeed add specific language to new grant terms and, in doing so, it'll preserve the option to use this new power.
grants.nih.gov/grants/guide...
2/
Yesterday, we found out. NIH will indeed add specific language to new grant terms and, in doing so, it'll preserve the option to use this new power.
grants.nih.gov/grants/guide...
2/
Reposted by Adrianna McIntyre
Trying to assess GOP health plans right now is like “trying to read tea leaves, only the cup is full of mud”
— @adrianna.bsky.social
www.thebulwark.com/p/not-so-imp...
— @adrianna.bsky.social
www.thebulwark.com/p/not-so-imp...
The Not-So-Impressive “New” Health Care Ideas Republicans Want to Rush Out
What GOP leaders are missing in their mad scramble to remake health care policy.
www.thebulwark.com
November 19, 2025 at 12:53 PM
Trying to assess GOP health plans right now is like “trying to read tea leaves, only the cup is full of mud”
— @adrianna.bsky.social
www.thebulwark.com/p/not-so-imp...
— @adrianna.bsky.social
www.thebulwark.com/p/not-so-imp...
Reposted by Adrianna McIntyre
Reposted by Adrianna McIntyre
Put librarians in charge. They would very quietly and quickly just figure it out and then take no credit.
November 18, 2025 at 9:08 PM
Put librarians in charge. They would very quietly and quickly just figure it out and then take no credit.
Thinking about this ten-year-old Peter Suderman joint for no reason at all
www.politico.com/magazine/sto...
www.politico.com/magazine/sto...
November 18, 2025 at 8:13 PM
Thinking about this ten-year-old Peter Suderman joint for no reason at all
www.politico.com/magazine/sto...
www.politico.com/magazine/sto...
Reposted by Adrianna McIntyre
💡The Healthcare Quality and Outcomes (HQO) Lab has been working with The Upshot team (via @nytimes.com) to assess which hospitals may be most at risk to Medicaid cuts under the One Big Beautiful Bill Act (#OBBBA). Read about their findings below ⬇️ via @hsph.harvard.edu
Medicaid Cuts Likely to Affect Urban Safety-Net Hospitals | Harvard T.H. Chan School of Public Health
The HQO Lab team collaborated with the New York Times The Upshot to understand which hospitals will be most at risk for the Medicaid cuts. This data blog was
hsph.harvard.edu
November 18, 2025 at 4:52 PM
💡The Healthcare Quality and Outcomes (HQO) Lab has been working with The Upshot team (via @nytimes.com) to assess which hospitals may be most at risk to Medicaid cuts under the One Big Beautiful Bill Act (#OBBBA). Read about their findings below ⬇️ via @hsph.harvard.edu
President Deals wants you to negotiate directly with health insurers over your monthly premium. Or to haggle with your doctor over the cost of your appointment. Or both, it's not really clear.
(Nobody has ever asked for this)
(Nobody has ever asked for this)
November 18, 2025 at 4:28 PM
President Deals wants you to negotiate directly with health insurers over your monthly premium. Or to haggle with your doctor over the cost of your appointment. Or both, it's not really clear.
(Nobody has ever asked for this)
(Nobody has ever asked for this)
Reposted by Adrianna McIntyre
Some numbers from our new KFF/NYT Survey of immigrants:
- 22% know someone who was detained or deported
- 49% feel less safe since President Trump took office
- 47% struggled to pay for food, housing, or health care
- Still, 70% would come to the U.S. again if given a choice
- 22% know someone who was detained or deported
- 49% feel less safe since President Trump took office
- 47% struggled to pay for food, housing, or health care
- Still, 70% would come to the U.S. again if given a choice
November 18, 2025 at 3:59 PM
Some numbers from our new KFF/NYT Survey of immigrants:
- 22% know someone who was detained or deported
- 49% feel less safe since President Trump took office
- 47% struggled to pay for food, housing, or health care
- Still, 70% would come to the U.S. again if given a choice
- 22% know someone who was detained or deported
- 49% feel less safe since President Trump took office
- 47% struggled to pay for food, housing, or health care
- Still, 70% would come to the U.S. again if given a choice
Reposted by Adrianna McIntyre
I'd also note that one lesson from 2025 vs. 2017 is that the politics of a narrower (in this case, health-focused) reconciliation bill are potentially trickier than a big (beautiful or otherwise) one. There's just one hill on which you win or lose, not a bunch of different hills you can choose from.
To quote Jeff Young, "just in time!"
There is no evidence that a consensus on health reform exists within the Republican caucus — we still don't have a clear picture of what the HSA-based alternative to extending the enhanced subsidies is. (A Bill Cassidy bill? A Rick Scott bill? No one knows!)
There is no evidence that a consensus on health reform exists within the Republican caucus — we still don't have a clear picture of what the HSA-based alternative to extending the enhanced subsidies is. (A Bill Cassidy bill? A Rick Scott bill? No one knows!)
White House plans to release health bill and backs reconciliation
Deputy chief of staff James Blair pointed to the fast-track process for health and tariff legislation.
www.politico.com
November 18, 2025 at 3:47 PM
I'd also note that one lesson from 2025 vs. 2017 is that the politics of a narrower (in this case, health-focused) reconciliation bill are potentially trickier than a big (beautiful or otherwise) one. There's just one hill on which you win or lose, not a bunch of different hills you can choose from.
To quote Jeff Young, "just in time!"
There is no evidence that a consensus on health reform exists within the Republican caucus — we still don't have a clear picture of what the HSA-based alternative to extending the enhanced subsidies is. (A Bill Cassidy bill? A Rick Scott bill? No one knows!)
There is no evidence that a consensus on health reform exists within the Republican caucus — we still don't have a clear picture of what the HSA-based alternative to extending the enhanced subsidies is. (A Bill Cassidy bill? A Rick Scott bill? No one knows!)
White House plans to release health bill and backs reconciliation
Deputy chief of staff James Blair pointed to the fast-track process for health and tariff legislation.
www.politico.com
November 18, 2025 at 3:25 PM
To quote Jeff Young, "just in time!"
There is no evidence that a consensus on health reform exists within the Republican caucus — we still don't have a clear picture of what the HSA-based alternative to extending the enhanced subsidies is. (A Bill Cassidy bill? A Rick Scott bill? No one knows!)
There is no evidence that a consensus on health reform exists within the Republican caucus — we still don't have a clear picture of what the HSA-based alternative to extending the enhanced subsidies is. (A Bill Cassidy bill? A Rick Scott bill? No one knows!)