Tradeoffs

Washington is one of 19 states that have received federal approval to enroll people in Medicaid before they leave jail or prison — a radical change in Medicaid policy that health care and law enforcement leaders believe will save lives. But this experiment in bringing Medicaid behind bars is now colliding with H.R. 1, the sweeping federal law that is forcing states to make major changes to Medicaid.Guest(s):Autumn Boylan, Deputy director, California Department of Health Care ServicesLauren Brinkley-Rubinstein, Professor, Population Health Sciences, Duke University School of MedicineCody CoughenourPete Croughan, Deputy secretary, Louisiana Department of HealthBruce Greenstein, Secretary, Louisiana Department of Health Tyron Nixon, Medicaid Reentry Transformation Implementation Manager, Washington State Health Care AuthorityEmma Sandoe, Medicaid director, OregonPenelope Sapp, Chief of corrections, Kitsap County Sheriff’s OfficeMarc Stern, Former assistant secretary for health care at the Washington Department of CorrectionsTamara Vanover, Mental health specialist, Clallam County Sheriff’s OfficeLearn more: Read the full reporting and explore additional resources on our website.Want more Tradeoffs? Join more than 5,500 readers who trust Tradeoffs for clear, deeply reported health policy insights. Sign up for our free weekly newsletter.Tradeoffs helps you cut through the noise with clear, deeply reported journalism on the forces driving health care's toughest choices — reporting you won't find anywhere else. If our work helps you stay informed, support it with a donation today.This episode was reported by Julie Wernau, edited by Dan Gorenstein and Ryan Levi, and mixed by Andrew Parrella and Cedric Wilson.The Tradeoffs theme song was composed by Ty Citerman. Additional music this episode from Blue Dot Sessions and Epidemic Sound.Special thanks to Gabrielle de la Gueronniere, Jody Rich and Kinda Serafi. Tradeoffs reporting for this story was supported, in part, by Arnold Ventures.

The No Surprises Act was designed to protect patients from unexpected medical bills, but nearly four years after the law took effect, many experts say parts of its implementation aren't working as intended. Insurers, hospitals, physician groups and federal regulators continue to battle over the law's payment dispute process, raising questions about whether one of the nation's most significant health care consumer protection laws is achieving its goals.In this special live episode of Tradeoffs, host Dan Gorenstein moderates a conversation with three leading experts on surprise medical billing, health insurance regulation and federal health policy. They explain how the No Surprises Act was implemented, how litigation has shaped the arbitration process, why providers have won a disproportionate share of payment disputes and what policymakers could do to improve the law.Guests:Zack Cooper, Associate Professor of Public Health and of Economics, Yale University; Director of Health Policy, Tobin Center for Economic Policy; Director, Health Care Affordability Lab at YaleBenjamin Chartock, Assistant Professor of Economics, Bentley UniversityLindsey Murtagh, Senior Fellow in Health Services, Policy and Practice, Brown University School of Public HealthRachel Werner, Executive Director, Leonard Davis Institute of Health Economics; Professor of Medicine, Perelman School of Medicine, University of PennsylvaniaLearn more: Read the full reporting and explore additional resources on our website.Want more Tradeoffs? Join more than 5,500 readers who trust Tradeoffs for clear, deeply reported health policy insights. Sign up for our free weekly newsletter.Tradeoffs helps you cut through the noise with clear, deeply reported journalism on the forces driving health care's toughest choices — reporting you won't find anywhere else. If our work helps you stay informed, support it with a donation today.

Hundreds of U.S. courts offer treatment over prison for some defendants with mental illness. But critics say mental health courts have outpaced research on their effectiveness.Guest(s):Grace Hauck, Investigative reporter, Illinois Answers Project Debra Pinals, Adjunct Clinical Professor of Psychiatry, University of Michigan Medical School and Law SchoolLearn more on our website.Check out our 2025 Impact Report: https://tradeoffs.org/2025-impact-report/.Want more Tradeoffs? Sign up for our free weekly newsletter featuring the latest health policy research and news.Support this type of journalism today, with a gift.

President Trump and other leading conservatives are pushing policies they hope will empower patients to shop more wisely for the health care they need.Guests:Brian Blase, President, Paragon Health InstituteSherry Glied, Professor of Public Service, New York UniversityAdam Leive, Assistant Professor of Public Policy, UC BerkeleyJason Levitis, Senior Fellow, Urban InstituteTony Lo Sasso, Professor of Public Affairs, University of Wisconsin–MadisonAvik Roy , Co-founder and Chairman, Foundation for Research on Equal OpportunityLearn more and read a full transcript on our website.Want more Tradeoffs? Sign up for our free weekly newsletter featuring the latest health policy research and news.Support this type of journalism today, with a gift.

New research from leading health economist David Cutler explores what’s behind a historic slowdown in health spending, even as millions of Americans struggle to afford their care.Guest:David M. Cutler, Dean of Social Science, Professor of Economics, Harvard UniversityLearn more and read a full transcript on our website.Want more Tradeoffs? Sign up for our free weekly newsletter featuring our latest reporting on health care's toughest choices.Donate to support our work. Tradeoffs is a nonprofit, powered by listeners.

A collaboration with American Public Media’s Call to Mind, highlighting how Durham, North Carolina, has reimagined its mental health crisis response system — and what it has learned.Find more reporting on mental health from Call to Mind on their website, on your local public radio station, or by subscribing to the Call to Mind podcast.Guests:Patrice Andrews, Police Chief, Durham Police DepartmentRyan Smith, Director, Durham Community Safety DepartmentSgt. Dan Leeder, Durham Police DepartmentAbena Bediako, Clinical Manager, Durham Community Safety DepartmentDavid Prater, Peer Support Specialist, Durham Community Safety DepartmentYolanda, Durham residentJohn Warasila, Real estate developer and architect, Alliance ArchitectureBo Ferguson, City Manager, DurhamLearn more and read a full transcript on our website.Want more Tradeoffs? Sign up for our free weekly newsletter featuring our latest reporting on health care's toughest choices. Donate to support our work. Tradeoffs is a nonprofit, powered by listeners.

Doctors are flocking to arbitration under the 2020 consumer protection law to settle pricing disputes with insurers. They’re winning, often securing high prices. Guest:Margot Sanger-Katz, reporter, The New York TimesLearn more and read a full transcript on our website.Want more Tradeoffs? Sign up for our free weekly newsletter featuring the latest health policy research and news.Support this type of journalism today, with a gift.

The state’s Medicaid director Amir Bassiri shares his plans for blunting the effects of Republican health reforms — starting with work requirements. Guest:Amir Bassiri, Medicaid Director, New York State Department of HealthLearn more and read a full transcript on our website.Want more Tradeoffs? Sign up for our free weekly newsletter featuring the latest health policy research and news.Support this type of journalism today, with a gift.