Writing

Everything I've published on Substack, newest first. Podcast episodes are on the podcast page.

2026

• Oct 15Medicare for All Fixes Coverage for the Few by Breaking It for Everyone Else
  Medicare for All designs health care around an exception, instead of allowing it to function for most people and then making exceptions for those who need help.
• Aug 24For Medicare, Trust Fund Solvency Is the Wrong Number to Focus On
  The more important budget issue is that almost half of Medicare’s spending is subsidized by taxpayers
• Jun 8A Waiver for the Jones Act Demonstrates Why You Shouldn't Artificially Restrict Markets
  When there’s a policy problem, look for the government rule that says you’re not allowed to fix it.
• Jun 5Social Security (now) helps drive federal deficits
  A Plot Point article looking at Social Security's future cumulative effect on the federal debt
• Feb 19The Many Parts Needed to Answer the Question: "How Do You Fix Health Care?"
  Which part do you mean?
• Feb 10Did you pay for your Medicare benefits?
  Unless you're a lifelong top earner, you're getting more in benefits than you paid in.
• Feb 2A Medicaid State Waiver Idea to Provide Better Primary Care Without Spending More
  Looking for possible state partners for an eventual Section 1115 waiver

2025

• Nov 20The ACA+HSA Reform the GOP Should Consider While Negotiating the COVID-Era Temporary ACA Subsidies
  The GOP has the opportunity to begin unwinding price distortions caused by the ACA while helping enrollees better afford out-of-pocket payments.
• Nov 14HSA Eligibility on the ACA is About to Skyrocket
  A little appreciated change from the OBBBA is about to make 1/3rd of ACA enrollees eligible for health savings accounts.
• Nov 3Why Does Health Insurance Cost So Much?
  And how many healthy people need to buy insurance to keep costs low?
• Oct 30Is Health Insurance Even Worth It Anymore?
  Open enrollment season demonstrates some shocking annual costs of premiums and out-of-pocket maximums.
• Oct 15Principles, Not People or Parties
  Each time political control swaps, it exposes the people who maintain their principles and the people who just follow their party or politician.
• Sep 30The Existence of a Possible Negative Consequence is Not a Sufficient Reason to Oppose a Policy
  Every reform leads to someone being made worse off. But leaving bad policy in place often has a larger negative effect than replacing it with something better.
• Sep 18OBBBA’s Medicaid “Cuts” Still Lead to an Increase in Medicaid Spending
  A trillion dollar cut is more like a tap on the brakes plus a course correction
• Sep 5Trade-offs Abound: How To Think About Medicare Reform Options
  There are no free lunches when it comes to reducing Medicare spending
• Aug 5Getting to a Trillion (or Two) in Medicare Savings
  Federal spending doesn't fall without changes to Medicare
• Jul 8Two Key HSA Provisions Make It In The Final Budget Bill
  We've been pushing for these low-cost provisions that improve incentives for healthcare consumers
• Jun 18The Senate Shouldn’t Give Up on Expanding HSAs
  There are affordable reforms that can improve access
• May 14Notable Health Care Policies in the Ways and Means Tax Bill
  Two reforms from our Healthcare Policy Working Group make it in to the Ways and Means bill.
• Apr 24Poll Results: What Americans Know (and Don't Know) About the TCJA and the Federal Budget
  Only 17% of Americans know that Social Security is the largest federal spending program
• Apr 11Do the Thing That Works
  Applying Occam's Razor to well-intentioned policies that aren't succeeding
• Feb 25A Low Cost Way to Make More ACA Enrollees Eligible for Health Savings Accounts
  A small, low-cost reform could make 11 million ACA enrollees eligible for HSAs

2024

• Nov 5Which Parts of the TCJA Expire Next Year and How Much Do They Cost?
  A preview of the tax code discussion (fight?) we'll be having next summer.
• Oct 17The Status of Possible Legislative Changes to Direct Primary Care (DPC) Arrangements
  DPCs are the rare bipartisan health care reform that everyone loves, once they hear about them.
• Oct 1Make Progress By Letting People Do Things
  MPBLPDT: Not the best initialism. But a great way to make the world better.
• Jul 3Why Can Some States Announce Results on Election Night, But Others Can't?
  Ben Ginsberg takes me through key swing state vote-counting policies
• Jun 13What do American voters know about the federal budget?
  The answer is about what you'd expect. Michael Boskin discusses survey results.
• Mar 25Hope for Direct Primary Care (DPC) Access for Medicaid Enrollees
  The Medicaid Primary Care Improvement Act (H.R. 3836) passed the House on a voice vote. Here's what it could mean for enrollees and state Medicaid programs.

2022

• May 23Homelessness, Drug Policy, and the Housing Shortage in California
  Policy ideas from the SIEPR 2022 Spring Policy Forum

2021

• Oct 29What Does It Mean to Say Climate Change Will Cost 4 Percent of GDP?
  Misguided interpretations may be leading people to overestimate the relative costs of climate change
• Oct 25Initial Impressions of Direct Primary Care
  A neat real-world example of how prices can work in American healthcare.