Adrianna McIntyre
@adrianna
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 adriannamcintyre.com
Maybe less jaw-dropping, but similar flavor: if you unpacked the scoring criteria for Rural Health Transformation Program funding — largely left to the discretion of CMS to define — they sure did seem to favor red states... academic.oup.com/healthaffair...
Married a Yooper, so when we get bored during summer visits to his parents we drive ten minutes to walk along Lake Michigan
New white paper from myself + colleagues: Implementation of Medicaid Work Requirements: Key Design Considerations and Strategies to Minimize Avoidable Coverage Loss hsph.me/Medicaid-Wor... We synthesize evidence in the peer-reviewed and gray literature to identify key lessons + recommendations
If you tried to mad libs a paper title to get me to click you couldn't do much better than this: The role of nonfinancial factors in the Congressional Budget Office’s health insurance coverage projections www.pnas.org/doi/abs/10.1...
A favorite teaching example of mine comes from a 2017 KFF poll that found support for M4A could be pulled from above 50% to below 50% if you stipulated that it would eliminate or replace the ACA (even though that's the whole point of M4A)
Great story from @bobjherman.bsky.social on the quiet erosion of employer-sponsored insurance, especially among small businesses www.statnews.com/2026/07/07/s...
absolute champ of a good girl (unbothered by the fireworks, mildly bothered by me wanting a photo when she’s ready for bed)
26 states are suing CMS over Medicaid work requirements interim final rule — specifically the surprise narrowing of the medical frailty exemption www.mass.gov/doc/medicaid...
A different account holds that it was actually Thompson's choice, because he favored three-letter agency acronyms, but I prefer Scully's version theincidentaleconomist.com/wordpress/he...
One of my favorite bits of health policy apocrypha is why we call it CMS instead of CMMS theincidentaleconomist.com/wordpress/wh...
MACPAC's June report includes a chapter on implementation of Medicaid work requirements, including a framework for metrics that could be useful in monitoring outcomes www.macpac.gov/wp-content/u...
absolutely wild to me that MGB, one of the highest-revenue health care systems in the country apparently fundraises from patients? (I started getting these after an annual checkup)
Do read @citizencohn.bsky.social on that ASPE report, quoting three former top appointees of the office. "If you read the report itself... you can detect the whiff of serious, longtime HHS analysts trying their best to produce a truthful document." www.thebulwark.com/p/donald-tru...
One last comment on medical frailty, and it's a big one: CMS is saying states "may not consider information older than 12 months when verifying medical frailty or other special medical needs" (p. 186) This is hugely consequential because claims adjudication can take 6 months or more.
The regulation does stipulate that states will need to report eligibility redetermination outcome data. (p. 249) However, as best I can tell — and I might be missing something — it is silent on whether those data will be made publicly available or strictly used for internal agency monitoring.
States are permitted (but are not obligated) to accept documentation about medical frailty from a range of clinician types. (p. 188) Safety net providers should be anticipating a massive expansion of administrative burdens in 2027.
After January 1, 2028, states face more stringest documentation requirements. Medical frailty has some leniency, but it's still the case that an attestation can only be used once during an enrollment spell (p. 364) This will be a problem if people can't get appointments between enrollment + renewal