Jonathan Cohn Profile picture
@HuffPost policy/politics reporter. Proud husband & dad. Author of... THE TEN YEAR WAR Obamacare & the Unfinished Crusade for Universal Coverage
dr roth ⓀⒸ Profile picture Ricky Kalia, DO Profile picture 2 added to My Authors
25 Jul
ACA improvements?
Medicaid for holdout states?
Dental coverage for seniors?

There’s a case for all of the items on the Democratic health agenda. But probably not enough money — or votes.

A look at the tough choices ahead:…
Two key questions will help define boundaries of what’s possible:

1. To what extent are Dems determined to finance new health care spending w/savings they find elsewhere in health care?

2. How willing are Dems to find those savings from Rx reform?…
The importance of those Rx savings to other initiatives is one reason I continue to think — and continue to hear from some veteran operatives and staff — that ambitious reforms could actually pass despite all of the familiar obstacles…
Read 6 tweets
16 Jul
Via multiple sources, Dem budget negotiators may scale back funding increase for home and community-based care. Like, by more than half -- from $400B, which was what Biden proposed, to below $200B.

Very much in flux, nothing decided. (1)
This is the initiative to boost funding of home care aides and other services that let the elderly, people w/disabilities live at home, stay in labor force, etc. (2)…
Medicaid funds these services, but with limited allotments. That creates long waiting lists, plus the care workers are famously underpaid.… (3) Image
Read 8 tweets
22 Jun
In case you thought conservatives were done with the "death panel" smear, here's the Wall Street Journal editorial page this morning. (1)…
The subject of the editorial is the outrage over a new Alzheimer's drug that will cost $56,000 with scant evidence of benefit.

Editorial sneers about "experts" making that case. Also takes a swipe at Sen. Ron Wyden, who has spoken out against the drug. (2)
Wyden has spent his career as an advocate for seniors & their health care, going back to 1970s when he was with Oregon's chapter of the Gray Panthers.

Also his mother had Alzheimer's, a fact he's cited repeatedly when making the case to help patients & their families. (3)
Read 8 tweets
27 Apr
@JHWeissmann ...although I really think it depends on the issue. With a lot of these, you can dial it down, one way or another, and still get serious benefits.
@JHWeissmann And then you build on later. Make paid leave longer, expand child care to more kids or make it more generous, add dental now and visual later, etc.
Read 4 tweets
24 Apr
Lots of chatter about what Biden will say on health care, and lots of anxiety too. I tried to sort out what it means, what's happening etc.

As always, hard to be sure. Depends a bit on who you ask. Etc.…
On the policy side, I think there's a lot of common ground among Democrats -- more than it might seem. And I'm including the White House in that.

At the same time, some of these ideas are difficult political lifts.
For more background reading, start with the latest @JStein_WaPo article that I reference in mine:…
Read 12 tweets
11 Apr
Why are Michigan's COVID numbers so scary?

What is Gov. Whitmer doing and what is she *not* doing? And why?

Here’s an article on that -- and a thread (1)…
It’s not just the caseload numbers that are spiking. It’s also the hospitalizations.

Facilities are filling up, delaying elective procedures, etc.

Via @KristenShamus @HealthBridgeMI (2)……
You may have seen this desperate tweet from @umich surgery chairman @jdimick1 (3)

Read 17 tweets
18 Mar
Via @danpfeiffer newsletter, a reminder about politics of 2009 and role conservative Democrats played in setting political boundaries (1)…
It's such a huge difference.

Per this chart I made this week, of Senate seats that changed parties 2009 to 2021, Dems had more than a dozen in R-states. Survival strategy for most was to create distance from party & liberal-sounding policies. (2)…
Here's what Phil Schiliro, who was director of legislative strategy at the White House under Obama, told me for @HuffPost article on this. (Similar quotes in my book on the ACA.)…

Read 5 tweets
18 Mar
Latest from @adamcancryn on the internal Biden administration debate over an FDA commissioner, and concerns that Janet Woodcock is too close/sympathetic to pharmaceutical industry.

This passage, about Rep. Eshoo, caught my eye (1)…
In 2009, when E&C Committee was writing its version of what became the the Affordable Care Act, Eshoo pushed to give biologics a longer "exclusivity" period.

Chairman Henry Waxman, who thought it was a giveaway to industry, opposed that strongly. Eshoo prevailed. (2)
As legislation moved through Congress, Waxman kept fighting to reduce that period. So did Obama, who agreed w/Waxman and was really worked up about it.

But industry was too powerful, ultimately got its way. I cover this in my book. (3)…

Read 5 tweets
16 Mar
Agree with this. The political environment was in 2009 was very different.

Nobody was talking about ending the filibuster, a bunch of conservative Ds were firm no's on using reconciliation.

It was a 60-vote world and that was a huge constraint on both the stimulus & ACA.
And yes, that's a very big theme of my new book…
Read 4 tweets
1 Feb
Now @ASlavitt explaining why such a big difference between vaccines distributed and vaccines administered....
1. Initial delay created a backlog of 2nd doses, waiting at states. Three weeks for Prizer, four weeks for Moderna.
2. As people come back for second shots, @ASlavitt says efficiency should continue to improve.
Read 5 tweets
30 Jan
According to the article, the situation on the ground is a "mess."

Some expectation setting here, I'm sure. But every problem the article mentions is consistent w/what reporters (including me) have been hearing.

E.g., lots of doses tied up in chain pharmacy LTC program.
To see the impact of the LTC program on the data, let's look at Michigan, a state I've followed closely. (Thread to follow)

Total doses distributed = 1.48 Million
Total doses administered = 909K

So that's 65%. But...
Note asterisk on the distribution number. 430K are set aside for the federal LTC program. Of those, just 100K have been administered.

State isn't directly controlling that supply, at least according to Michigan officials. It's in the hands of CVS/Walgreens, they say.
Read 7 tweets
29 Jan
At White House COVID briefing, Fauci calls results from Janssen/J&J "very encouraging"

Says the most important finding is the efficacy against severe disease and death. "We have now a value-added additional vaccine candidate."
But Fauci also warning that we're seeing some vaccines less effective against some variants.

"This is a wake up call to all of us," he says -- we need to vaccinate quickly, and be prepared to modify existing vaccines to adapt.
Now @ASlavitt talking, gives a shout-out to seven states that have already vaccinated more than 10% of population:

Alaska, West Virginia, New Mexico, Connecticut, North Dakota, Oklahoma, South Dakota
Read 9 tweets
27 Jan
If you want to know more about how the administration is approaching the pandemic, I highly recommend the new @ezraklein podcast (now at @nytimes). First guest: @vivek_murthy…
This exchange in particular deserves emphasis -- i.e., how the difficulty isn't any one thing.

So it's not supply or distribution. It's supply *and* distribution. With a different situation in every community. And conditions that will change with time. Image
Biden's strategy reflects this. It's got many small parts, no single one of which is a game-changer. But together they add up.

Or, at least, we hope they add up. The test will be execution.

One thing to put these ideas on a piece of paper. Another to put them into action.
Read 4 tweets
27 Jan
With two-dose regimen, @ASlavitt says, it will take 500M+ doses to vaccinate everybody 16 and older.

(J&J, which is single dose, would reduce number)

"We are not counting on things that aren't in existence today."
It will be months before vaccines will be available to everybody, @ASlavitt warns. Supply will increase, distribution will improve, but not overnight.
"We're going to make sure we get six doses out of every Pfizer vial" says @ASlavitt

(He's talking about acquiring the syringes to get the extra dose consistently.)
Read 12 tweets
26 Jan
Biden administration says it is "working to purchase" 200M more shots from Pfizer/Moderna.

If that happens, it would be enough supply to reach nearly the whole population by end of summer.…

-- "Working to purchase" is not the same as "purchased." Unclear how far conversations have gone, whether companies can supply.

-- Does not count J&J, which if it comes online soon would dramatically increase supply on its own.
Biden speaking now:

"We believe we will soon be able to confirm" purchase of 100M more from Pfizer and Moderna each, for 200M.

Extra supply would start beginning summer, he says.
Read 5 tweets
17 Jan

There's a lot going on this week, I know, but want to draw your attention to a pair of new books that are quite relevant to what's been happening in U.S. politics -- and where we could go in the next few years. (1)
One is Kill Switch, by @AJentleson…

It's a history of the filibuster and how it has contributed to gridlock and widespread disillusionment with politics. (2)
I especially liked the focus on John Calhoun, who promoted the idea of a "minority veto" to protect Southern slave states.

I'm a bit of a Calhoun obsessive and -- like @jbouie -- think it's a straight line from his arguments to the dynamics of today. (3)…
Read 10 tweets
15 Jan
Few quick thoughts on the Biden rescue plan and vaccines.

The basic approach tracks with what experts have been outlining -- more money and support for states, training new workers, etc. (1)…
The campaign has promised more details, to go with another speech, on Friday. Hoping for more details then.

There's a call for mass clinics, for example, and that's great. Does that mean backstopping states? Running them directly? If so, how? (2)… Image
Likewise, the campaign goal of 100 million doses over 100 days would represent an improvement over the current pace. But it doesn't appear to be nearly enough to get to herd immunity by summer.

What's the long-term plan? (3)… Image
Read 5 tweets
18 Dec 20
**Some Personal News**

THE TEN YEAR WAR, my new book, is available for pre-order.

It’s an effort to tell the story of Obamacare and, more broadly, the story of American politics over the last decade. (1)…
My goal was to write a definitive history of the ACA, befitting such a consequential & controversial piece of legislation.

What went right? What went wrong? Why? And how can we do better next time?

THE TEN YEAR WAR tries to answer those questions. (2)…
THE TEN YEAR WAR draws on my past reporting, from Washington and around the country, plus new interviews with dozens of key players -- from relatively anonymous activists and congressional staffers to officials at the highest levels of power. (3)…
Read 6 tweets
12 Dec 20
General Gus Perna, giving Warp Speed briefing right now:

First shipments leaving Pfizer within 24 hours, will arrive at providers starting on Monday.
Describes this as "D-Day," but notes that it doesn't mean "distribution" as some as thought. It's the military designation for the beginning of an operation.
First distributions, via Perna/Warp Speed:

Monday 145 sites
Tuesday 425 sites
Wednesday 66 sites
Read 5 tweets
5 Apr 20
Just read this thorough and thoroughly devastating @washingtonpost report on how the administration squandered precious time in the COVID response.

Two things in particular jumped out at me.

Public health officials were raising alarms in January and by the middle of the month some were discussing using the Defense Production Act to speed manufacturing of supplies...

By early February, officials were warning that the U.S. would have dangerous supply shortages, including if the all-important N95 masks.

But administration has focused on this only recently, still doesn’t seem to have a handle on it.

Read 5 tweets
2 Apr 20
This is news: Trump using DPA on 3M.

Background here, via @theintercept…
Officials, health care systems all over the country have said 3M wasn't doing enough to make sure N95s get to places of need.

Here's director of emergency management in Florida
Read 7 tweets