Health and social policy analyst. Visiting Fellow @Paragon_Inst. Former @WaysandMeansGOP, @SenateAging, @HHS_ASPE, and @HHSRegion10
Blaine, Washington
Joined December 2008
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Really funny and it poses a valid question: Will the American health care system defeat AI? (It's crushed pretty much everything else we've tried to deploy against it.)
Will AI replace healthcare professionals?
Here is an AI robot on its first day working in a hospital after finding out that:
• the EHR needs 17 clicks to order one test
• the medication list is different in three systems
• interoperability sometimes means making a phone call
• and fax machines are still critical infrastructure
What else?
The video is obviously AI-made.
John R. Graham retweeted
New Part D Prognosis by Boris Vabson:
Costs are exploding. Behind CMS's flat premium headline, the total cost of the basic benefit is up 25% per enrollee from 2026 to 2027, and the federal cost is up 28%.
ow.ly/FGTM50ZVuCb
John R. Graham retweeted
Paragon PIC: For over a decade, U.S. health spending tracked other wealthy nations almost exactly. Then the ACA took effect in 2014 and the U.S. pulled away — by 2025, real per-capita spending had roughly doubled since 2000, far outpacing the OECD. 📊 ow.ly/zwfj30sZ6mS
John R. Graham retweeted
The most concerning No Surprises Act data point: only 6% of 19.7M qualified claims entered arbitration in 2024. With awards and win rates climbing, costs could grow dramatically from there. ow.ly/XTA630sZ6mT
John R. Graham retweeted
NEW PROGNOSIS:
Claims of declining children's health coverage don't show up in the latest Census data.
From 2024 to 2025, the estimated child uninsured rate fell from 6.1% to 5.8%, with about 226,000 fewer uninsured children.
ow.ly/B3o450ZSBKG
John R. Graham retweeted
Hospital prices have jumped more than 250% since 2000, and former Kansas Rep. Todd Tiahrt says it’s time to put hospitals under the same scrutiny other parts of healthcare have faced for years.
His focus: prices, transparency and nonprofit accountability.
Read more in DC Journal.
dcjournal.com/from-hillaryca…
John R. Graham retweeted
NEW ANALYSIS:
Medicaid’s Disadvantage: Why Private Plans Work Better in Medicare Than in Medicaid
The key difference is built into how the programs pay private plans. @CPopeHC explains. 🧵
t2m.io/j4uDuTq
John R. Graham retweeted
🏥New Paragon Prognosis:
Tax-exempt hospitals receive billions of dollars in tax benefits, but the standards meant to ensure they provide sufficient public benefit are vague and outdated.
Congress is finally asking whether hospitals are earning that privilege. 🧵
t2m.io/sHiUMyv
John R. Graham retweeted
The New York Times gets Obamacare wrong.
Taxpayers now cover more than 80% of ACA exchange premiums, improper enrollment remains widespread, and Medicaid spending is still rising.
Read Paragon’s new Prognosis:
paragoninstitute.org/paragon…
John R. Graham retweeted
🔥New from Paragon: We estimate that 14.3 million people were improperly enrolled in the ACA exchanges and Medicaid expansion in 2024.
It's a nationwide problem, but it shows up differently by state. In expansion states it's mostly Medicaid; in non-expansion states, entirely the exchanges
t2m.io/evxePni
John R. Graham retweeted
Before 2014, U.S. health spending growth tracked other OECD countries. After the ACA’s major coverage provisions took effect, the U.S. pulled away.
New Paragon PIC: the pattern is more consistent with the ACA raising health spending than lowering it.
paragoninstitute.org/paragon…
John R. Graham retweeted
Nearly 500 more health care facilities serving rural and low-income Americans are operating than before the OBBB, despite warnings from critics that the law would lead to facility closures.
John R. Graham retweeted
Since the WFTCA’s passage, the number of RHCs and FQHCs nationwide has grown.
Between July 1, 2025 and July 17, 2026, there has been a net gain of nearly 500 facilities serving rural and lower-income communities.
.@Paragon_Inst: There are nearly 500 MORE health care facilities serving rural and low-income Americans today than before the Working Families Tax Cuts Act
John R. Graham retweeted
Can the CMS Innovation Center deliver meaningful savings while expanding patient choice and competition?
Join Paragon Sept. 3 at 1 PM ET for a virtual conversation with Abe Sutton (invited), Demetrios Kouzoukas, Jackson Hammond, and Brian Blase.
paragoninstitute.org/event/c…
John R. Graham retweeted
Everyone in my house always feels that they wash all their dirty dishes or put them in the dishwasher but the dishes keep piling up in the sink.
Perception is often not reality.
John R. Graham retweeted
The 340B program has exploded: drug purchases ballooned from $5 billion in 2010 to $81 billion in 2024. CMS's 2027 OPPS rule would pay 340B drugs at ASP minus 33.4%, saving Medicare $4.55 billion in year one and cutting patient out-of-pocket costs. 📊 ow.ly/AP3n30sY6nr
John R. Graham retweeted
New @Paragon_Inst PIC shows two clear trends:
1) Hospital prices continue their relentless increase, driving health care unaffordability.
2) Prescription drug prices had a historic decline over the past year. paragoninstitute.org/paragon…
John R. Graham retweeted
Wow! The OBBB Medicaid reforms are better than I thought, per a @HHS_ASPE analysis.
We knew taxpayers would benefit from lower spending.
In addition, ASPE finds that workers will benefit from lower health care prices and premiums between $502-$875B!
paragoninstitute.org/paragon…
John R. Graham retweeted
In new @Paragon_Inst, we estimate that fed taxpayers made ~$1B in expenditures on Kentucky Medicaid expansion enrollees who were not eligible in 2024.
Today, a Kentucky gov't audit found $800+M in Medicaid spending for ppl enrolled in other states. 1/2
spectrumlocalnews.com/produc…
