Lisa Dubay

@ldubay.bsky.social

Senior Fellow by day for Urban Institute's Health Policy Center. Opinions my own!

Important work from my @urbaninstitute.bsky.social colleagues on the impact of HR1's Medicaid six month redetermination and work requirements on Medicaid enrollment. States have options to mitigate the potential loss of coverage which could range from 4.9 to 10.1 million people losing Medicaid.

Urban Institute@urbaninstitute.bsky.social · 4mo ago

According to a new Urban Institute analysis, #Medicaid expansion enrollment will decline by 4.9 to 10.1 million people in 2028 under new #work requirements and more frequent eligibility checks outlined in the One Big Beautiful Bill Act. Learn more about the impacts. https://urbn.is/4bRPTr6

Figure one shows a bar graph that compares projected average monthly Medicaid expansion enrollment in 2028 across different scenarios: without OBBBA work requirements and six-month redeterminations at 18.4 million, with OBBBA work requirements and high mitigation at 13.5 million, medium mitigation at 10.8 million, and low mitigation at 8.3 million. Data is sourced from the Urban Institute, Health Insurance Policy Simulation Model, 2025.

"researchers have estimated that the end of enhanced tax credits will lead to 7.3 mill people losing their ACA coverage in 2026, of whom 4.8 mill would become uninsured. The loss of the additional subsidies are projected to increase how much...enrollees must pay...from an avg of $888 to $1,904/year"

Expiring ACA Premium Tax Credits Could Lead to Nearly 340,000 Jobs Lost Across the U.S. in 2026

Unless Congress acts quickly to extend the enhanced ACA marketplace premium tax credits, nearly 5 million people could lose health insurance coverage in 2026.

commonwealthfund.org

Despite claims to the contrary, premium tax credits are well targeted to people with low & moderate incomes who need the most help with health costs. Three-quarters of people getting the credits have incomes below 300% FPL (~$47K for an individual). >90% have incomes below 400% FPL (~$63K)

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One more thread on a new provision in Senate reconciliation bill that Senate GOP will misleadingly tout as expanding access to home- and community-based services for seniors and people with disabilities (section 71123) but in context of the bill, it won't be meaningful (1/x)

New CBO estimates of reconciliation bill reported by Budget Committee Sunday: gross #Medicaid cuts of $792B before interactions with ACA changes. Total of $803B in net health care cuts. Estimates don't account for Rules Committee changes with even harsher Medicaid cuts. www.cbo.gov/publication/...?

Estimated Budgetary Effects of a Bill to Provide for Reconciliation Pursuant to Title II of H. Con. Res. 14, the One Big Beautiful Bill Act

As ordered reported by the House Committee on the Budget on May 18, 2025

cbo.gov

What are the effects of dismantling the Department of #Education on students with #disabilities? An Urban Wire post examines the potential impacts of disrupting the Department of Education’s key functions of enforcing critical civil rights laws and distributing IDEA #funding to the states.

How Dismantling the Education Department Could Affect Disabled Students across the US

Though states and local governments are primarily responsible for K–12 education, the US Department of Education is critical to ensuring disabled children in every community have access to a free, app...

urban.org

Interested in promoting upward mobility? Come hear about how to shape policy making and create change in your community with my @urbaninstitute.bsky.social colleagues.

Urban Institute@urbaninstitute.bsky.social · last yr.

Join Urban on 3/26 @ 1 p.m. ET for a virtual #event that will explore the Upward Mobility Framework. Participants will hear from speakers who are applying the Upward Mobility Framework to shape programming & policymaking and gain insights on how to create change in their #communities. #LiveatUrban

Important new research on the impact of federal work requirements for Medicaid beneficiares on coverage from my @urbaninstitute.bsky.social colleagues @jh4.bsky.social, Genevieve Kenney, and Michael Karpman.

Urban Institute@urbaninstitute.bsky.social · last yr.

According to #research, about 5 million expansion adults could lose #Medicaid in 2026 under a federal work requirement similar to the Limit, Save, Grow Act. Urban experts assessed the potential coverage losses under #federal Medicaid work requirements drawing on lessons from two states.

Dont' miss this timely virtual event ! Featuring @edwincpark.bsky.social, Genevieve Kenney, Sara Rosenbaum @milkeninstitute.org , and @greggbloche.bsky.social

Urban Institute@urbaninstitute.bsky.social · last yr.

Proposed cuts to #Medicaid could endanger #health insurance for low-income Americans. Join Urban on 3/10 @ 2:00 p.m. ET for a virtual event that will explore these cuts’ potential effects on the program and its more than 70 million beneficiaries. #LiveatUrban

The US DOT says it's planning to prioritize areas with high marriage & high birth rates for funding. Our new analysis @urbaninstitute.bsky.social shows this would disproportionately fund: —Communities with a higher white resident share —Low-density areas —High-income areas —Car-dependent areas

DOT’s Plan to Distribute Funding by Birth and Marriage Rates Would Leave Communities Most In Need Behind

If enacted, the new US Department of Transportation memo would prioritize funding to whiter, higher-income, more car-dependent areas over communities of color and people who walk, bike, or take public...

urban.org

What the new administration could mean for health related lawsuits including preventive services, MTALA, medication abortion, family planning and more...https://www.kff.org/medicare/issue-brief/how-pending-health-related-lawsuits-could-be-impacted-by-the-incoming-trump-administration/

How Pending Health-Related Lawsuits Could be Impacted by the Incoming Trump Administration | KFF

This brief provides an overview of current lawsuits in health policy including preventive services, abortion care, gender affirming care, Medicare drug price negotiations, nursing home staffing rules,...

kff.org

Advocates and experts are working to rally support for Medicaid, citing its coverage for kids, rural Americans and the disabled. “Medicaid is the backbone of many aspects of our health system,” @joanalker1.bsky.social told me, noting that about 1 in 4 Americans are covered through the program.

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SSI provides cash payments to over a million families who have children w disabilities. Do these substantial payments—which make up ~half of total income for recipients—improve kids’ outcomes? We use a cutoff in SSI eligibility for infants based on birthweight to investigate.

Abstract of the long-term effects of income for at risk infants:evidence from SSI