A resource for anyone caught in the Medicare SNAFU

Hey there—

There are times when I think, “Everything is trash.” With my job — tracking the U.S. health care system — that’s gonna happen. 

But here’s the other thing about this job: I keep stumbling across people doing terrific, inspiring, useful, helpful, smart, surprising things. 

You might remember — although I wouldn’t bet on it — in our last First Aid Kit, Emily and I mentioned that we’d come across a site that looked like it could be super-useful for people caught up in this fall’s Medicare Advantage chaos.

The site was called Is My Plan Ending? It allowed users to search by their zip code or county to learn which plans were ending, and what alternatives were left. 

It also had lots of well-organized answers to common questions, and referrals to solid resources. It looked great.

But, as we noted then, we hadn’t been able to vet it. It was anonymous. Whoever posted it wrote that they were independent — and didn’t take money from insurance. Which sounded good. 

But we needed to check, so I wrote in to ask. And heard back from a guy named James Thomas.

“Trying to find something fun”

He’s a tech worker for a finance company in California. Not a Medicare expert. “I’m just a regular person, you know?” he said when we talked a few days later. 

At his job, James told me he’d spent a lot of time over the past year-and-change learning to use Claude, the AI tool made by Anthropic.  

Recently, he’d started to look for a side project. 

“I love picking up and messing around with little projects,” he told me. “I was just trying to find something fun to do — and work on that actually impacted people, you know?”

He’d gone looking for data that some code could make accessible to more people, and he found federal data showing which plans were ending.

That was Friday, October 2nd. He spent the weekend using Claude to build Is My Plan Ending? It went live on Sunday the 4th, and he went back to his routine. The next weekend, he went to a music festival.

And a few days after that, he got my email. And went back to working on the site. 

“With that email came the thinking that, potentially people are gonna be using this a lot more,” he told me. So it had to be as accurate and useful as possible.

It gets so much better

In the five days between my email to him and our first conversation, James told me he’d spent five to seven hours a day working on the site — adding features, refining back-end functionality, editing for clarity and accuracy. 

I’d noticed some of those new features when I looked at the site just before our conversation, and they were all cataloged on an updates and corrections page that James had added. 

When we talked James asked me what other improvements he could add. I told him that I loved the page giving answers to frequently asked questions about Medicare, but that as a journalist, I wanted to see each answer cite its sources. 

The next day, they did. 

It was amazing, inspiring, and super-moving. It made me think in a new way about what tools like Claude could help do. 

The site names its data sources and describes how it analyzes them. James had answered all my questions about how he fact-checks for accuracy. 

And yet, I couldn’t shout to the world about James’s work. Because I wasn’t really competent to vet it. 

I’ve learned a lot about Medicare, but I’m not a Medicare data expert. And I don’t know enough about what Claude can really do, and what it can’t. So I needed more sources.

Sources say: It looks good

I wrote to Medicare experts, asking them what they thought of James’s work, including Gretchen Jacobson, vice president and senior Medicare policy scholar at the Commonwealth Fund, a health care think tank. 

She thought James had done an impressive job.

“Everything he has done, including analyses and explanatory information, looks correct,” she wrote.

“I do not have the capacity to double check all of his numbers – but he is using the correct CMS files and includes all of the caveats and information about the data that I would include.”

She also appreciated the way the site described people’s options and directed them to other resources. “Overall, this seems to be a great tool for consumers,” she wrote. “I appreciate you bringing to my attention.”

Ok, great! But as she said, she didn’t have the capacity to double-check James’s numbers. And I didn’t think I was going to find someone who would essentially re-do all of his math.

But maybe somebody — somebody who knows a heck of a lot more about tech than me — could check his code? I wrote to a few people.

And heard back from Joe Germuska, who runs the Knight Lab at Northwestern University — a design and development studio connected to the Medill School of Journalism. Joe’s official title is Chief Nerd. 

Here’s what he wrote: “The main thing I’ll say is, if the front end checks out, there’s not much point in worrying about the back end! I mean, facts are facts, right?”

The role of AI didn’t bother Joe. 

“While some people talk smack about AI produced code, they don’t own up to the fact that lots of human-produced code was also spaghetti under the hood,” he wrote. “And similarly with human data collection: people make mistakes too!”

Joe also liked the way James had documented his process, answered my questions, and responded to feedback. “I think transparency, caveats, and openness about corrections goes a long way,” he wrote.

Medicare resources for all

If you or someone you know is on Medicare Advantage and want answers: ismyplanending.com is from everything we’ve seen, the place to go.

And if anyone you know just needs an overview of what’s going on, we’ve been collaborating with other outlets:

• Is your Medicare Advantage plan ending next year? Here’s what to know. Emily’s writeup for NPR News.
• Want video instead? Medicare Advantage cuts leave millions scrambling to find coverage My explainer with PBS NewsHour. 

We’ve also been on the air on local stations in Dallas, Chicago, and Seattle.  

More good news

You may have already caught last week’s podcast, but if not: Go check it out.

We’ve talked a lot about charity care — financial assistance — from hospitals. 

In the last couple of years, some states have passed laws to force hospitals to do more.  We haven’t had the bandwidth to follow the results closely. 

But our pals at the podcast Tradeoffs spent a year teaming up with our colleagues at KFF Health News. They’ve produced some terrific reporting — with some excellent news — especially in this podcast episode we put in the Arm and a Leg feed last week. 

In short, Oregon and California both passed ambitious new laws. Oregon’s produced impressive results, and in California, the county of Los Angeles created a tool to help hospitals identify folks who qualify — more easily and effectively.  

We’ll have a new podcast episode for you next week, a new First Aid Kit — and we’ll kick off our annual fundraising drive in the next few days, with some more good news.

Till then, take care of yourself.

—Dan