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Adrianna McIntyre

@adrianna.bsky.social

11K followers 460 following 1.2K posts

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

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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.

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Dmitry Grozoubinski @explaintrade.com · 3h

This is an exact encapsulation of why I moved to Bluesky.

No amount of handwringing in the Atlantic about how I owe some eternal Promethean suffering to the discourse is going to make me stay on a site I hate, that stopped doing anything for me professionally years ago.

Well – no. Bluesky may or may not be, as one centre-right friend who felt unwelcome put it, “self-righteous island”. But the idea that’s why we went is nonsense. That I’ve largely stopped posting on a site that’s done more to shape my career and social circle than the rest of the internet combined is less about avoiding rival opinions (I love arguing with people who are wrong!) than with the fact the site simply became unusable. It stopped generating the things (good jokes, interesting debate, clicks) I wanted; it became extremely good at generating the things (racists, pornbots, racist pornbots) I did not.

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JAMA Health Forum @jamahealthforum.com · 23h

Following Medicaid unwinding, coverage losses varied widely by state and group, yet many individuals regained insurance, resulting in modest overall increases in uninsurance. ja.ma/48pvidw

Line graph showing quarterly Medicaid enrollment from 2019-2023. Administrative and survey data are compared for adults and children. Enrollment percentages are on the y-axis; quarters of the year are on the x-axis.

Adrianna McIntyre @adrianna.bsky.social · 1d

some zooms detected

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Cynthia Cox @cynthiaccox.bsky.social · 1d

I’m getting a lot of questions about notices insurers are sending out to ACA/Obamacare enrollees about premiums for next year.

I’m curious to see a notice letter if you have one and want to share. My DMs are open.

@louisenorris.bsky.social @kgmom219.bsky.social

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Adrianna McIntyre @adrianna.bsky.social · 1d

"And fundamentally, the premise of the document is inconsistent with our core belief that scientific funding should be based on scientific merit alone."

Todd Wolfson @proftwolf.bsky.social · 1d

I am proud to say that MIT has rejected Trump's poison compact. MIT President Sally Kornbluth: "Therefore, with respect, we cannot support the proposed approach to addressing the issues facing higher education."
@aaup.org @aft.org @higheredlabor.bsky.social @uaw.org
links.mit.edu/nl3/N5Jy2cKq...

Regarding the Compact

links.mit.edu

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Adrianna McIntyre @adrianna.bsky.social · 2d

As people get sticker shock from letters about their new marketplace premiums and have to figure out what to do, it sure seems like it would be useful if there was a well-funded program to help people... navigate their options

Adrianna McIntyre @adrianna.bsky.social · 2d

anyway I'm slowly emerging from having been on vacation slow couple news weeks huh

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Adrianna McIntyre @adrianna.bsky.social · 2d

Fundamentally the same dynamic as the ESI tax exclusion, which is famously politically untouchable — and which, as a tax expenditure, "costs" taxpayers about 10x the amount that extending enhanced subsidies is projected to cost

Larry Levitt @larrylevitt.bsky.social · 2d

One political challenge for Republicans right now is that there is no constituency that directly benefits from allowing the ACA enhanced tax credits to expire. Yet, there are 22 million people who will see their out-of-pocket premiums go up.

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Adrianna McIntyre @adrianna.bsky.social · 2d

I saw that! It unfortunately is a little narrower than I was hoping for, though I just found this other Brookings blog post that might serve my purposes well enough www.brookings.edu/articles/the...

The true size of government is nearing a record high | Brookings

As the federal government has hovered close to two million employees for decades, the size of its grant and contract workforce has grown.

www.brookings.edu

Adrianna McIntyre @adrianna.bsky.social · 2d

Does anyone have a favorite short, recent-ish, and US-centric reading on "shadow bureaucracy" or "shadow government" (the increasing role that consultancies and other private organizations play in public administration)?

Something like this paper, but more bite-sized

www.augustinepotter.com

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Dan Diamond @ddiamond.bsky.social · 3d

KFF finds partisan split on Tylenol

Most Republicans (56%) say they think it’s definitely or probably true that taking Tylenol during pregnancy increases the risk of kids with autism.

Most Dems (86%) say it’s definitely or probably false.

Multiple medical associations have said there’s no link.

KFF
Donate
Many Are Uncertain if Taking Tylenol During Pregnancy Increases Risk of Children
Developing Autism, Most Republicans Say it is Probably or Definitely True
Do you think that it is definitely true, probably true, probably false, or definitely false that taking Tylenol during pregnancy increases the risk of the child developing autism?
I Definitely true Probably true Probably false
Definitely false
Total
30%
30%
35%
Party ID
Democrats
27%
Independents
29%
59%
33%
Republicans
50%
34%
31%

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Ashley Kirzinger @ashleykirzinger.bsky.social · 2d

This is why I think there is widespread support for continuing the enhanced premium tax credits. It is less about the connection to the ACA and more about people's overwhelming concerns about the cost of health care.

Want to see health care rank as a top voting issue again? Ask about cost.

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Adrianna McIntyre @adrianna.bsky.social · 2d

Useful new analysis from @mattafiedler.bsky.social: A specific — and arguably particularly consequential — effect of allowing enhanced ACA subsidies to lapse is that net-$0 plans would become far less available.

Matt estimates this change, alone, would cause over 400,000 people to lose coverage.

How would eliminating $0 Marketplace premiums affect insurance coverage? | Brookings

www.brookings.edu

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Ryan Enos @ryanenos.bsky.social · 3d

Nothing shows the dangerous tendency to normalize authoritarianism like the New York Times coverage of the extortion of Harvard. One could read this article and think it is about a free agent inking a contract with the Yankees. www.nytimes.com/2025/10/09/u...

Harvard Seeks Assurances as Talks Restart in Washington

www.nytimes.com

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Alexander Tsai, MD @drdrtsai.bsky.social · 3d

From @ryanenos.bsky.social & Levitsky: “Predictably, the extortionist has returned for more. The reward for capitulation was more extortion.”
www.thecrimson.com/article/2025...

Harvard Must Take a Stand Against Trump’s Compact | Opinion | The Harvard Crimson

Harvard, rather than quietly pursuing its own appeasement strategy, should lead the way to preserve academic freedom and democracy.

www.thecrimson.com

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Rachel Sachs @rachelsachs.bsky.social · 3d

Now up at Health Affairs Forefront, Kristi Martin and I analyze CMS's final guidance for the 2028 cycle of the Medicare drug price negotiation program, including key provisions that CMS both did and did not change from the draft guidance. www.healthaffairs.org/content/fore...

Administration Releases Medicare Drug Price Negotiation Program Final Guidance For 2028 | Health Affairs Forefront

The final guidance for the 2028 cycle of the Medicare drug price negotiation reflects CMS’s continued effort to balance statutory requirements with transparency, responsiveness to stakeholder input, a...

www.healthaffairs.org

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Julie Rovner @julierovner.bsky.social · 4d

Sir, you signed the law guaranteeing back pay for furloughed workers in 2018...

Aaron Rupar @atrupar.com · 4d

Q: Is it the White House's position that furloughed workers should get backpay?

TRUMP: I would say it depends on who we're talking about

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Adrianna McIntyre @adrianna.bsky.social · 5d

Alternative is that he’s shooting from the hip based on knowing the marketplace integrity rule (1) proposed a number of policies purportedly targeting fraudulent enrollment and (2) asserted that the rule on balance ~could~ improve the risk pool, but (2) was all hand-waving and contrary to research

Adrianna McIntyre @adrianna.bsky.social · 5d

The most charitable interpretation, I think, is that he was confusing individual premiums and net federal spending on APTCs, but the question pretty clearly seems to be about the former!

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Adrianna McIntyre @adrianna.bsky.social · 5d

Zero-claim enrollees would be risk-pool-improving and premium-reducing.

Reasonable people can debate whether/to what extent the increase in zero-claim enrollees might reflect increased broker-driven fraudulent enrollment, but not whether that enrollment increases (individual) premiums.

Sarah Karlin-Smith @sarahkarlin-smith.bsky.social · 5d

Oz seems to suggest there are very large number of people who have ACA plans who don't file claims in any year - suggesting fraud going on and this is why premiums are going up.

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Aatish Bhatia @aatishb.bsky.social · 5d

The number of international students arriving in the U.S. in August fell by 19 percent this year compared with last year — the largest decline on record outside of the pandemic.

Nearly 20 Percent Fewer International Students Traveled to the U.S. in August (Gift Article)

The data shows the steepest decline in August international student arrivals since the pandemic.

www.nytimes.com

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Sam Bagenstos @sbagen.bsky.social · 7d

This is a really outstanding post. "That’s the point of the compact. .... It is about control. Specifically it is about turning existing federal law, over which the administration has limited control, into terms of a 'deal' that offers the government much more control."

Joey Fishkin @fishkin.bsky.social · 7d

I thought I'd put the administration's proposed "compact" with universities in context, so I wrote the blog post below.

It's especially for journalists covering this story!

Many details about how the compact itself works and why the administration has retreated to this strategy.

Balkinization: The Art of Replacing the Law with the Deal

A group blog on constitutional law, theory, and politics

balkin.blogspot.com

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Adrianna McIntyre @adrianna.bsky.social · 6d

This Data for Progress survey gets at this more directly.

www.dataforprogress.org/insights/202...

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Adrianna McIntyre @adrianna.bsky.social · 6d

Key (big!) caveat is that we didn’t directly evaluate whether people understood that MassHealth (or whatever it is in their state) = Medicaid. The motivation for the survey when we conducted it — untethered from *gestures* all this — was about measuring program support, not policy literacy.

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Phil Rocco @philiprocco.bsky.social · 7d

Happily @adrianna.bsky.social and colleagues have this covered in @jhppl.bsky.social : read.dukeupress.edu/jhppl/articl...

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