Research

Papers, reports, and testimony from my work at the Hoover Institution, mostly with the Healthcare Policy Working Group and the Fiscal Policy Initiative.

Health care

• Refocusing Medicare Reform on Its Cost to Taxpayers with Lanhee J. Chen, JAMA Health Forum, 2026
• Expanding Access to HSAs: A Path to More Healthcare Choices for ACA Enrollees with Daniel L. Heil and Lanhee J. Chen, Hoover Institution, 2025 (PDF)
  Many high-deductible ACA plans lose HSA eligibility because their out-of-pocket limits grow with premiums. A fix would open HSAs to about 945,000 more people for roughly $1.7 billion over ten years.
• The Choices for All Project: Healthcare Reforms for the Future with Lanhee J. Chen and Daniel L. Heil, Hoover Institution, 2023 (PDF)
  Five reforms that put prices and choices in front of patients, with chapter summaries and downloads.
• The Fiscal Costs of Medicare at 60 with Lanhee J. Chen and Daniel L. Heil, Hoover Institution, 2021

The public option

• Promises Unmet: The Early Experiences of State Public Option Plans with Lanhee J. Chen and Daniel L. Heil, Partnership for America’s Health Care Future, 2024
  Washington, Colorado, Nevada, and Minnesota have enacted public options. In Washington and Colorado, the promised premium savings would require hospital and provider payment cuts far deeper than either state has been willing to make.
• An Update to the Budget and Tax Effects of a Public Option with Lanhee J. Chen and Daniel L. Heil, Partnership for America’s Health Care Future, 2023
  After pandemic spending and inflation, a politically realistic public option would add $1.23 trillion to deficits in its first ten years and eventually pass Medicaid as the second-largest federal health program.
• Economic Shocks and Probable Expansions to a Public Option with Lanhee J. Chen and Daniel L. Heil, Hoover Institution working paper, 2021 (PDF)
  How a budget-neutral public option would likely grow into a costly entitlement during recessions or when health costs rise faster than expected.
• The Budget and Tax Effects of a Federal Public Option After COVID-19 with Lanhee J. Chen and Daniel L. Heil, Hoover Institution, 2020 (PDF)
  A public option that follows historical trends would add almost $800 billion to deficits over ten years. We estimate the tax increases it would take to pay for it.
• The Fiscal Effects of the Public Option with Lanhee J. Chen and Daniel L. Heil, Hoover Institution, 2020 (PDF)
  Projected savings from a public option assume low provider payments and premiums that cover costs. If Congress behaves as it has before, the plan would add over $700 billion to the ten-year deficit.

Data

• A Technical Overview of the Collection of Health Expenditures and Insurance (CHEI) Data with Daniel L. Heil, Hoover Economics Working Paper 19115, 2019 (PDF)
  Documentation for CHEI, our yearly person-level datasets of health coverage, medical spending, federal health subsidy eligibility, and the tax value of employer coverage.