Thanks so much Joan!

You can read the full letter from @warren.senate.gov @wyden.senate.gov @sanders.senate.gov here:

www.warren.senate.gov/imo/media/do...

Glad to be quoted in the letter.

We'll see if/how Equifax complies with the requests like the one "for each state contract, please provide estimated per-query costs for 2026" which would be a big deal for state governments.

I’m glad there is broad political consensus that this is a problem. I have some ideas on how we can actually fix it through antitrust enforcement, growing state capacity to build, and simplifying programs to protect them from capture. 👇

lpeproject.org/blog/the-mea...

I was at USDS, which became DOGE, and during the transition I urged them to focus on the vast majority of waste fraud and abuse which occurs in gov contracting.

They nodded excitedly and then invaded up the US Institute for Peace instead.

I hate to be the bearer of bad news, but love to dunk on bad contractors (also we are about to see this same thing play out in the other 55 states in territories this year because of new federal work requirements)

In the piece I argue that we can Enforce, Build, and Simplify our way out of this Means-Testing Industrial Complex and stop sacrificing our public programs to poorly performing contractors.

The story is the same for Deloitte's domination of eligibility systems that determine who gets Medicaid coverage and who does not.

With over $6B in contracts across 25 states, new work requirements included in OBBBA are an enormous opportunity to prey on bureaucratic complexity and profit.

This Means-Testing Industrial Complex is epitomized by Equifax's domination of income verification where the government has backed itself into a corner.

OBBBA requires more complex and frequent verifications which will rely on one dominate private company that is mercilessly hiking prices.

I’m glad you liked it! Thanks for sharing and happy to chat about the proposals I lay out any time :)

Eternally grateful for my USDS colleagues that drove around the country in a van with me for the most exhausting and fulfilling year of my life ❤️

Huge thanks to the great team at Better Government Labs for coauthoring the research out in Health Affairs @donmoyn.bsky.social @pamherd.bsky.social @giannella.bsky.social @jbarofsky.bsky.social and for allowing me to moonlight as blogger.

Open Access Paper: www.healthaffairs.org/doi/full/10....

The CBO estimates that 5M people will lose their Medicaid as work requirements take effect.

States must build in-house tech capacity now to protect their enrollees through the coming crisis and beyond.

The challenge ahead is enormous and states need the capacity to meet the moment.

Our bet paid off - across red and blue states representing over 40% of the nation's Medicaid population, we doubled automatic renewal rates and halved the number of people losing coverage for procedural and paperwork reasons.

Quietly across the country, millions of people kept their health care.

We set out to tackle this problem head on by showing up in communities across the country and automating Medicaid renewals wherever we could.

We made a big bet that directly providing technical capacity to state governments in a crisis could move the needle.

After the pandemic emergency ended in 2023, millions were at risk of losing their healthcare not because they were ineligible, but because of infuriating paperwork and broken systems.

Today, work requirements threaten to make the situation even worse for millions of Americans.