I'm a research associate at Duke University Margolis Center. I used to be Richard Mayhew, a mid-level bureaucrat at UPMC Health Plan. I started writing here and have not found a reason to stop.
Bloomberg recently ran a great story on a family that is facing hard times affording health insurance because they don’t qualify for ACA subsidies and they don’t get coverage through work. The key take-away for me is that this population is one of the few insured groups that receives very little direct assistance. David and […]
Healthcare cost control is tough politics. Every dollar saved is a dollar out of someone’s wallet. The benefits are far more diffused in either incrementally lower premiums or slightly lower taxes than the counterfactual projection. Our political system is optimized to emphasized the loud screams of concentrated minorities who are losing something while the vast […]
First the big news from Arizona: BREAKING: Democrat Kyrsten Sinema wins election to U.S. Senate from Arizona. #APracecall at 5:41 p.m. MST. @AP election coverage: https://t.co/miEWlbTVZW #Election2018 #AZelection — AP Politics (@AP_Politics) November 13, 2018 And now the important news from Arizona: Congrats to @kyrstensinema. I wish her success. I’m grateful to all those who […]
Dominated plans are bad choices. A dominated plan is tied or beaten on all relevant criteria. This means a buyer is either limited in choice or is paying more than they should for a given level of accepted risk. Decision support tools are supposed to help make good choices easier. Good tools should encourage good choices […]
Alexander-Murray was a bipartisan attempt to fund Cost Sharing Reduction (CSR), add reinsurance, change 1332 waiver regulations, mandate outreach funding to be distributed via the states from HHS central control and doing something funkily unproductive with rebranding Catastrophic plans as Copper plans. It failed to advance despite having 60 Senators sponsor or support it. There […]
Two quick notes on Medicaid expansion: In Maine, Governor-elect Mills (D-ME) will expand Medicaid on her first day in office. Mills said she will implement Medicaid expansion immediately after she takes office on Jan. 2 using existing state funds. Due to organizational prep time, people may or may not be enrolling into expanded Medicaid in Maine […]
Florida voted. Florida counted. And now Florida recounts So Florida recounts likely in all three statewide races — senator, gov, ag commissioner, yikes. https://t.co/JPTYcV8DVv — Harris Meyer (@MHHmeyer) November 8, 2018 Lots of things are happening. Normal sources of vote count changes include: Transcription and reporting errors that are caught on a recanvass Late absentee […]