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xpostfactoid.bsky.social
Blogging mostly healthcare policy at http://xpostfactoid.substack.com. ACA implementation watcher. CSR czar. AKA Andrew Sprung.
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The correct way to connect the authoritarian presence in LA and the Big Beautiful Bill is that the bill gives the government the resources to do this in dozens of cities at once. So if you don't like what's happening in LA, it's coming to your town if the bill passes.

Well, Mr. Chief Justice, just see how many norms and laws you've empowered this criminal president to shred.

When Senator Bill Cassidy announced he would vote to confirm RFK Jr, he included this in his statement: “If confirmed, he will maintain the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices without changes.” WITHOUT CHANGES.

My God how are we going to get these lunatics out of power before they destroy us

What if the president throws a crackdown and nobody comes?

So far

"Even if you think Garcia and Salazar let themselves buy into the bigotry, for the moment, who cares? You’ve got powerful Republicans calling out Trump’s lies.." It *is* kind of galling -- it was so obvious Trump's purge would be lawless. But take the allies you can get.

A spectacular indictment of Medicaid work requirements by 2 lawyers who saw the impact up close and won a lawsuit to kill them in Arkansas. Every single member of Congress should read it. And everyone else should read it and call their member of Congress. Gift link 🎁 www.nytimes.com/2025/06/08/o...

[gift link] The Legal Issues Surrounding Trump’s Plan to Use Troops to Suppress Protests President Trump has long mused about using troops to crush violent protests or riots in blue-state cities. He is now moving to do so in Los Angeles. www.nytimes.com/2025/06/08/u...

I loathe Musk as much as anyone else but for a sitting president to openly threaten a private citizen over what political donations he or she chooses to make is a reminder of how authoritarian this country is becoming by the day - by the hour even!

THREAD: An ex-DOGE engineer with no government or medical experience used AI to identify which Veterans Affairs contracts to kill, labeling them as “MUNCHABLE.” @vernalcoleman.bsky.social @ericumansky.bsky.social and I got the code. Here’s what it tells us 1/

Wait, is that Kyiv?

Wonder if a plane carrying Musk will go down

Justice Jackson: "the Court grants 'emergency' relief that allows Social Security to hand DOGE the highly sensitive data of millions of Americans...[giving] DOGE unfettered access to this personal, non-anonymized info right now—before the courts have time to assess whether DOGE’s access is lawful."

One under-noticed assault on ACA in House bill is usurpation of authority from state-based marketplaces - e.g., in enrollment period length and verification RQs. Since 2020 the #of SBMs has gone from 13 to 20 as states try various innovations. Republican support for states' rights: always bullshit

Buried?

2017 for 2018 revisited

Excellent summary of the many "technical" changes that all make enrollment harder.

Republicans aim to halve their ACA cake and eat it xpostfactoid.substack.com/p/halving-th...

Hmm, who do we want -- the young sane fascist or the old insane one?

Both sides made a solemn oath not to speak the Deplorable Word.

I didn't tremendously enjoy Percival Everett's Dr. No, but it's looking more and more acute. Billionaire would-be "Bond villain" wants to steal "nothing" from Fort Knox to gain power to destroy world order. www.nytimes.com/2022/11/01/b...

Yes we can grow them here! We're a banana republic!

The guy goes to a psychiatrist and says, "Doc, my brother's crazy. He thinks he's a chicken." and the doctor says, "well, why don't you turn him in?" and the guy says, "I would, but I need the eggs." www.youtube.com/watch?v=ced-...

Fun fact: Under House bill, Texas could preserve free gold ACA coverage for ~2 million low-income enrollees and affordable gold for ~400k enrollees in 200-400% FPL range by....mandating abortion coverage. (See 6/5 update, halfway down) xpostfactoid.substack.com/p/halving-th...

CBO forecasts that changes to the ACA marketplace will increase the uninsured population by 8.2 million. Not everyone who loses coverage becomes uninsured. The forecast suggests that marketplace enrollment will be cut by more than half. Updated post.

Post haste... xpostfactoid.substack.com/p/halving-th...

Yikes! -- that's "uninsured," not "unemployed."

Sad symmetry: In March 2010, CBO estimated that the ACA's changes to Medicaid and indiv. market insurance would each reduce the unemployed population by 16 million (-32 mil total). CBO now estimates House bill will increase uninsured by 16 mil -- split almost dead even between Medicaid/Marketplace

TIL that the House bill's stripping of eligibility for marketplace subsidies from lawfully present noncitizens subject to 5-yr waiting period for Medicaid only extends to 100% FPL, not to 100-138% FPL in expansion states. A relief. CBO estimates that 300k w/ income < 100% FPL will lose coverage. 1/

Weapons grade stupidity, including for selfish reasons: all the US measles outbreaks this year are related to IMPORTED cases—so we SHOULD fund a global network to protect the rest of the world AND OURSELVES The MAHA men—RFK Jr/Trump/Makary/Musk/Vought/Bhattacharya—are DESTROYING US & global health

Cost estimate of the House-passed "Big Beautiful Bill" is out It'd be the largest cut to Medicaid+CHIP and SNAP in history while still increasing deficits by $2.4 trillion due to $3.8 trillion in tax cuts This'd be the largest transfer of wealth from the poor to the rich in a single law in history

I’ve heard that tacked on the end for years now. I already think talking about states having “rights to exist” is an unhealthy category error, but even more so if that entails a particular ethnic or theological character.

CRA gone wild prospect.org/politics/202...

JUST IN: Newark Mayor Ras Baraka sues interim US Attorney Alina Habba for "false arrest and malicious prosecution." storage.courtlistener.com/recap/gov.us...