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lorenadler.bsky.social
Fellow and Associate Director, Brookings Institution Center on Health Policy | mostly health econ, occasionally budgets or Knicks
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Finance Committee text is out - this has the Medicaid cuts and the tax cuts. Will go through it in this thread. But what we can say for certain is that, like the House version, this would be BY FAR the largest Medicaid cuts in history, kicking many millions of people off their health insurance.

An important point that the Big Beautiful Bill, as currently constructed, would barely dent federal spending when you factor in the added interest costs on the increased federal debt. Lots of damage for such a minimal net spending reduction. www.nytimes.com/2025/06/09/o...

More bureaucracy, more paperwork, and a less efficient government. No more coverage lifeline for people between jobs. That's what prior attempts with Medicaid work requirements have delivered, all without even increasing employment.

New JCT analysis of the House-passed budget reconciliation bill is out. Under the GOP plan, more tax cuts go to millionaires than the entire half of America combined. This graph shows just the tax side. Include the Medicaid & SNAP cuts (which we'll get from CBO soon), & it's a cut for the poorest.

This is VERY bad and chilling news. As far back as I can think of the federal government has allowed researchers access to restricted government data while upholding the highest standards of data security and confidentiality. These data belong to us all, they should be accessible to researchers.

A helpful rundown of the House-passed reconciliation bill's effects on Medicaid & the ACA, including how its scale compares to the 2017 repeal & replace efforts www.brookings.edu/articles/new...

From CBO: • 11.8 million lose coverage due to One Big Beautiful Bill provisions • 16M fewer w/ coverage in 2034 when incorporating the 4.2M expected coverage loss from expiration of enhanced ACA subsidies That's a 57% ↑ in # of uninsured compared to June 2024 current policy projection

In the search for spending savings, House Republicans could've gone after overpayments to insurers & hospitals in Medicare. Instead, they singled out people w/ the lowest incomes for the lion's share of cuts. Then re-directed that $$ mainly for more high-income tax cuts.

Quick summary of the "big, beautiful bill": >10 million more uninsured >1 million low-income seniors see higher Medicare premiums & cost-sharing Large ACA premium ↑ ~ 30% cuts to SNAP ~ $3 trillion in new debt Makes low-income households worse off & high-income households better off.

A look at how the House Republican proposals would cut health coverage: www.washingtonpost.com/opinions/202...

Thread. 33 of 40 #Medicaid expansion states (+DC) will now face a 10 point cut in their expansion match rate under House GOP reconciliation bill. Latest language penalizes not only states using own funds to cover undocumented kids but also states covering legal immigrant kids/pregnant women (1/x)

This is Gary Cohn trying to reassure investors about the U.S. economy. He’s not very good at it: www.politico.com/news/2025/05...

Amid all the other news, it's easy to become inured to the basic facts here. Öztürk: -Is not accused of committing any crime -Is nonviolent -Was in this country legally -Merely engaged in speech that the administration objects to -Has been locked up for six weeks

Despite legal resident status and having been charged with no crime, our Georgetown colleague Badar Khan Suri has been designated a 'high risk' prisoner and for that reason gets only two hours of outdoor time PER WEEK. His traumatized son "cries all the time" and has ceased speaking.

Republicans argued that allowing Medicare to negotiate drug prices (as passed in the 2022 IRA) would destroy pharmaceutical innovation in the US. Will CBO score the innovation impact of a nearly 40% cut to NIH funding - and if so, how?

www.nytimes.com/2025/04/29/u...

President Trump has proposed taking over Canada and Greenland, imprisoning U.S. citizens overseas and serving an unconstitutional third term. Most Americans — including many Republicans — oppose each one, according to a Post-ABC News-Ipsos poll.

NEW from @nytimes.com: A bone-chilling account. A Venezuelan man detained alongside the 238 sent to El Salvador on March 15 seems to have disappeared off the face of the earth. His name isn't among the names of those sent to CECOT that day and no one spotted him among those men. He's just... gone.

Sen Van Hollen met with El Salvador's Vice President Félix Ulloa, who told him that the reason they are holding Kilmar Abrego Garcia at CECOT is because the Trump admin is paying them to do so. They also provided no evidence that Abrego Garcia is part of MS-13 or committed any crimes.

Trump to Bukele: "Home-growns are next. The home-growns. You gotta build about five more places. It's not big enough."

I had been doubtful that we were going to have a "this is the crisis moment" with Trump, as opposed to "everything about this is a destructive catastrophe." But the Abrego Garcia case is the crisis moment. 1/

NEW 🧵 The number of people travelling from Europe to the US in recent weeks has plummeted by as much as 35%, as travellers have cancelled plans in response to Trump’s policies and rhetoric, and horror stories from the border. Story: www.ft.com/content/6dc1...

We're tracking the number of international students whose visas have been revoked by the State Department. We've confirmed over 300 so far and there are likely many more. Get in touch if you've got information you'd like to share with us www.insidehighered.com/news/global/...

The Fourth Circuit is famously succinct. storage.courtlistener.com/recap/gov.us...

Under this theory, there is also nothing that prevents them from shipping *American citizens* to a gulag in El Salvador and saying "nothing we can do."

The government’s statement is a flex, not a confession of error. The important elements of the flex are these: 1. We send enemies to brutal foreign labor camps. 2. We decide who enemies are. 3. We may decide you are an enemy based on a secret informant, or our view of your tattoos. /1

The Department of Government Efficiency, for example

Trump administration starts gutting HHS. Biggest hits come within FDA, CDC, and NIH. And then there's this within CMS. www.statnews.com/2025/04/01/h...

NEW: In a court filing this evening, the Trump administration said that it had mistakenly deported a Maryland father to a notorious Salvadoran prison due to an "administrative error." www.theatlantic.com/politics/arc...

in happier news: @zachlowenba.bsky.social is joining The Ringer and launching a podcast, Bill Simmons announced tonight extremely good development for NBA fans

This guy is in one of the worst prisons in the world with no way out and may spend the rest of his life there because, it appears, he has an autism awareness tattoo in honor of his little brother. www.motherjones.com/politics/202...

I think of this whenever some conservative finds some supposedly wacky research topic that government grants pay for

Just heard that Trump is putting an end to atmospheric monitoring site NY67 that is run out of my lab. This is one of the oldest NADP sites in the US, continually measuring acid rain and other pollutants since 1977. Closing it down is tragic.

DOGE/SSA marked this person dead and *removed his savings from his bank account,* cancelled his social security and Medicare. #seattle https://www.seattletimes.com/seattle-news/politics/heres-a-dead-person-on-social-security-in-seattle-with-plenty-to-say/

NEW: State health department announces new measles case in Maryland State agency alerts: "Anyone who visited the following location.. may have been exposed: Washington Dulles International Airport: The international arrivals area March 5th, 4pm-9pm"

Incredible stuff in here: They ID'ed him, in part, by going to court hearings and watching him post

HHS will announce a new anti-trans campaign today, per three people familiar with pending announcement. The health department will tout Trump’s executive orders on transgender issues, assert that sex is binary and focus on participation in women’s sports. More TK with @fenitn.bsky.social

Sen. Patty Murray: "If you receive a directive to violate appropriations laws and withhold funding for workers, what will you do?" Labor secretary nominee Lori Chavez-DeRemer: "I do not believe the president is going to ask me to break the law." Murray: He's... been doing it.

If this reporting stands up (and it appears confirmed by multiple sources): devastating. The EIS is the front-line SWAT team of disease detection in the US and globally, and also the training ground for new generations of public health workers. No EIS, no boots on the ground for outbreaks. ->

Judge Coughenour has enjoyed the anti-constitutional birthright citizenship EO. He does not mince words, and they are richly deserved. www.seattletimes.com/seattle-news...

“In children who acquired H.I.V. at birth, the infection can progress very quickly to illness, with death occurring as early as eight to 12 weeks after birth — shorter than the 90-day pause on foreign aid.”

Meanwhile, the biggest measles risk to America is awaiting Senate confirmation to be HHS Secretary.