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Tradeoffs

@tradeoffs.org
2K followers 363 following 343 posts

Journalism that explores the complicated, costly, and often counterintuitive world of health care. New podcast episodes every Thursday, hosted by Dan Gorenstein. Subscribe to our weekly newsletter: tradeoffs.org/subscribe

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Tradeoffs @tradeoffs.org · 24/09/2026
Tradeoffs and @pennldi.bsky.social co-hosted a conversation with three state Medicaid officials to push past the political talking points and understand the state perspective on all the anti-fraud energy coming out of Washington. Listen to the special live episode:
tradeoffs.org
States Weigh In on Medicaid Fraud
A live conversation with a bipartisan group of state Medicaid leaders on the impact of the Trump administration’s aggressive anti-fraud push.
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Tradeoffs @tradeoffs.org · 17/09/2026
911 calls related to mental health are most likely to involve police use of force. A new book by Rebecca Neusteter offers a blueprint for a 911 redesign. We spoke with her and a Texas sheriff who describes how he’s seen 911 fail his community. Listen:
tradeoffs.org
911 Fails People in Mental Health Crises. Here's a Plan to Fix It.
911 calls related to mental health are the most likely to involve police use of force. A new book offers a blueprint for a 911 redesign that could save lives.
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Tradeoffs @tradeoffs.org · 17/09/2026
Join us and @pennldi.bsky.social today from 12:30-1:30 p.m. ET as a bipartisan panel of state Medicaid leaders share their perspectives on how they handle fraud, and the opportunities and challenges of the Trump administration’s aggressive anti-fraud push. Register:
upenn.zoom.us
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Tradeoffs @tradeoffs.org · 11/09/2026
The Trump administration says states aren’t doing enough to combat Medicaid fraud. States face demands for more data, frozen Medicaid payments and cuts to anti-fraud funding. What are the opportunities, challenges and tradeoffs? Join us + @pennldi.bsky.social on 9/17: tradeoffs.org/event/decodi...
tradeoffs.org
Decoding the Moment: States Weigh in on Medicaid Fraud
How much fraud is there and how do states try to prevent and prosecute it? In the next virtual event in the “Decoding the Moment” series, our panel of state Medicaid leaders will share their perspecti...
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Tradeoffs @tradeoffs.org · 10/09/2026
Cash-strapped states and struggling families are wrestling with the consequences of major reforms to the SNAP program passed as part of Republicans’ Big Beautiful Bill. Listen to today's episode of Tradeoffs to meet one man living with the consequences. tradeoffs.org/2026/09/10/a...
tradeoffs.org
As SNAP Shrinks, What's the Future of Food Aid in America?
Cash-strapped states and struggling families are wrestling with the consequences of major reforms to the SNAP program passed as part of President Trump’s Big Beautiful Bill.
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Tradeoffs @tradeoffs.org · 03/09/2026
In a live conversation recorded at Aspen Ideas: Health, executives from a hospital, insurer and pharmacy join a top Trump administration official and leading health economist to discuss how to collectively bring down health care costs. Listen to the Tradeoffs episode: tradeoffs.org/2026/09/03/b...
tradeoffs.org
Beyond Finger Pointing: The Fight to Lower Health Care Costs
In a live conversation recorded at Aspen Ideas: Health, executives from a hospital, insurer and pharmacy join a top Trump administration official and leading health economist to discuss how to collect...
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Tradeoffs @tradeoffs.org · 27/08/2026
Listen to a candid conversation between a professor and a Ph.D. candidate about potential funding cuts from the National Institutes of Health and their impact on the future of medical research.
tradeoffs.org
The Cost of Cutting NIH Research: Voices from the Frontlines
A candid conversation between a professor and a Ph.D. candidate about potential NIH funding cuts and their impact on the future of medical research.
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Tradeoffs @tradeoffs.org · 20/08/2026
Trump has nominated former health care executive Chris Klomp to help RFK Jr. get his health agenda back on track. With senators set to consider the nomination, we're bringing back our conversation with @ddiamond.bsky.social, who profiled Klomp in March. Listen:
tradeoffs.org
Trump's Pick to Quiet the Chaos at HHS
The administration is looking to former health care executive Chris Klomp to help RFK Jr. get Trump’s health agenda back on track.
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Tradeoffs @tradeoffs.org · 17/08/2026
Under new federal rules signed into law last year, ~20M people in 44 states will need to work, volunteer or attend school 80 hours per month to keep their Medicaid benefits. In Nebraska, these changes have already launched. We spoke to @marketplace.org about what these updates mean: bit.ly/45xNyik
marketplace.org
Roughly 200 people in Nebraska lost Medicaid on Aug. 1
It’s the first wave of terminations under new federal work requirements. And it may portend what’s to come for the rest of the country.
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Tradeoffs @tradeoffs.org · 30/07/2026
Nebraska Medicaid Director Drew Gonshorowski says the state’s data capabilities put it in a strong position to quickly implement the historic changes. Advocates and researchers warn that eligible people may still fall through the cracks. tradeoffs.org/2026/07/30/m...
tradeoffs.org
Meet the Man Launching Trump's Medicaid Work Requirements Months Early
Nebraska Medicaid Director Drew Gonshorowski says the state’s data capabilities put it in a strong position to quickly implement the historic changes. Advocates and researchers warn that eligible peop...
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Tradeoffs @tradeoffs.org · 23/07/2026
Meet Giovannina Anthony—she's spent the last four years juggling her work as an gynecologist and abortion provider in Wyoming with the new task of suing state lawmakers to keep abortion legal.
tradeoffs.org
A Wyoming Doctor’s Fight to Keep Abortion Legal in Her Deep Red State
Giovannina Anthony has spent the last four years juggling her work as an gynecologist and abortion provider in Wyoming with the new task of suing state lawmakers to keep abortion legal.
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Tradeoffs @tradeoffs.org · 16/07/2026
Today, listen to a deep dive on the unique mental health challenges faced by immigrants in America, produced by Call to Mind from American Public Media.
tradeoffs.org
Call to Mind: Immigration and the Challenge to Belong
A deep dive on the unique mental health challenges faced by immigrants in America, produced by Call to Mind from American Public Media.
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Lizzy Lawrence @lizzylawrence.bsky.social · 09/07/2026
Thank you @dgorenstein.bsky.social and @lesliemwalker.bsky.social for featuring my FDA reporting on @tradeoffs.org! It was a great conversation. Listen to the podcast episode here: tradeoffs.org/2026/07/09/a...
tradeoffs.org
As Drama at Trump's FDA Subsides, Doubts and Damage Linger
We talk with STAT News reporter Lizzy Lawrence about the agency’s recent turmoil and its hunt for a new leader.
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Tradeoffs @tradeoffs.org · 09/07/2026
From approving controversial products to losing thousands of staff, President Trump's Food and Drug Administration has been mired in controversy. Tradeoffs sat down with @statnews.com journalist @lizzylawrence.bsky.social_ who’s had a front row seat to that chaos. Listen to today's episode:
tradeoffs.org
As Drama at Trump's FDA Subsides, Doubts and Damage Linger
We talk with STAT News reporter Lizzy Lawrence about the agency’s recent turmoil and its hunt for a new leader.
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Tradeoffs @tradeoffs.org · 06/07/2026
Americans have nearly $200 billion in unpaid medical bills in collections. “If a debt collector is calling you up or is knocking on your door, more than half of the time, it’s for medical debt,” said economist @nealemahoney.bsky.social.
tradeoffs.org
With Millions Expected to Lose Coverage, States Look for New Ways to Prevent Medical Debt
Economist Neale Mahoney explains the latest research on solutions to medical debt and evaluates policy fixes designed to protect consumers.
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Tradeoffs @tradeoffs.org · 05/07/2026
How do you make good health care decisions when the science isn’t clear? @dgorenstein.bsky.social explored this question in a live conversation at @aspenideas.bsky.social: Health. Listen now: tradeoffs.org/2026/07/02/m...
tradeoffs.org
Making Medical Decisions with Uncertain Science
Two physicians and an ethicist discuss how to make the best decisions in areas like artificial intelligence and gender-affirming care when there is limited evidence in a live conversation recorded at ...
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Tradeoffs @tradeoffs.org · 02/07/2026
In the today's Tradeoffs episode, two physicians and an ethicist discuss how to make the best decisions in areas like artificial intelligence and gender-affirming care when there is limited evidence in a live conversation recorded at Aspen Ideas: Health @aspenideas.bsky.social.
tradeoffs.org
Making Medical Decisions with Uncertain Science
Two physicians and an ethicist discuss how to make the best decisions in areas like artificial intelligence and gender-affirming care when there is limited evidence in a live conversation recorded at Aspen Ideas: Health.
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Tradeoffs @tradeoffs.org · 29/06/2026
Economist @nealemahoney.bsky.social explains the research into strategies for relief from high healthcare costs and evaluates policy fixes to protect consumers. Listen to the episode: tradeoffs.org/2026/06/25/w...
tradeoffs.org
With Millions Expected to Lose Coverage, States Look for New Ways to Prevent Medical Debt
Economist Neale Mahoney explains the research into strategies for relief from high healthcare costs and evaluates policy fixes to protect consumers.
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Tradeoffs @tradeoffs.org · 21/06/2026
The No Suprises Act has stopped patients from receiving unexpected charges from doctors who were not covered by a patient’s insurance, even though they worked at covered hospitals. There were unexpected impacts—we discussed them with national experts. tradeoffs.org/2026/06/11/w...
tradeoffs.org
Where Did the No Surprises Act Go Wrong? And Can It Be Fixed?
A live conversation with national experts about the unexpected impacts of the consumer protection law, what could be done to change things, and what lessons can be learned about crafting complicated h...
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Tradeoffs @tradeoffs.org · 19/06/2026
States are enrolling people leaving prison and jail in Medicaid, the health insurance program for low-income and disabled Americans. But funding cuts and program changes required by H.R. 1 are likely to shape the future of this bipartisan experiment.
tradeoffs.org
Medicaid Overhaul Complicates States’ Plans to Bring Care Into Jails and Prisons
Funding cuts and program changes required by H.R. 1 are forcing states to make hard choices about the future of this bipartisan experiment.
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Tradeoffs @tradeoffs.org · 12/06/2026
Tradeoffs and @pennldi.bsky.social talked to Zack Cooper, @benchartock.bsky.social & Lindsey Murtagh about the unexpected impacts of the consumer protection law, what could be changed, and what lessons can be learned. Listen to today's special live episode:
tradeoffs.org
Where Did the No Surprises Act Go Wrong? And Can It Be Fixed?
A live conversation with national experts about the unexpected impacts of the consumer protection law, what could be done to change things, and what lessons can be learned about crafting complicated health policy.
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Tradeoffs @tradeoffs.org · 09/06/2026
Mental health courts offer treatment as an alternative to incarceration. But critics say they have outpaced research on their effectiveness. tradeoffs.org/2026/06/04/m...
tradeoffs.org
Mental Health Courts Offer People Facing Prison an Imperfect Alternative
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.
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Tradeoffs @tradeoffs.org · 07/06/2026
For more than a half century, health care spending in the U.S. has steadily gone up. But, over roughly the last 15 years, something unprecedented has happened—our health care spending slowed down. tradeoffs.org/2026/05/14/t...
tradeoffs.org
The U.S. Saved $1 Trillion on Health Care. Why Doesn't It Feel Like It?
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.
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Tradeoffs @tradeoffs.org · 05/06/2026
Hundreds of U.S. courts offer treatment over prison for some defendants with mental illness. @gracehauck.bsky.social and Josh McGhee investigated mental health courts in Illinois for @mindsitenews.bsky.social and the @illinoisanswers.bsky.social. Listen to our conversation with Hauck:
tradeoffs.org
Mental Health Courts Offer People Facing Prison an Imperfect Alternative
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.
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Grace Hauck @gracehauck.bsky.social · 04/06/2026
Today's @tradeoffs.org podcast episode features our @illinoisanswers.bsky.social @mindsitenews.bsky.social reporting on mental health courts, with context from Dr. Debra Pinals, a forensic psychiatrist who has spent 20 years studying + working in mental health courts. tradeoffs.org/2026/06/04/m...
tradeoffs.org
Mental Health Courts Offer People Facing Prison an Imperfect Alternative
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.
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Tradeoffs @tradeoffs.org · 03/06/2026
Health policy changed quickly in 2025. From Medicaid and Affordable Care Act subsidies to vaccine policy and health care affordability, Tradeoffs helped audiences understand what was changing, why it mattered and what might work better. Explore the 2025 Impact Report: tradeoffs.org/2025-impact-...
tradeoffs.org
2025 Impact Report
Explore the stories, people and partnerships that shaped Tradeoffs’ work during a year of extraordinary change.
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Tradeoffs @tradeoffs.org · 01/06/2026
High health care costs remain top of mind for many Americans. And yet, one of the best tools we have to rein in those costs is also the most hated: prior authorization. We took a closer look at the pros and the cons of this polarizing policy. Listen:
tradeoffs.org
A Closer Look at a Widely Despised Health Insurance Policy
Every year, millions of people’s medical care runs into the roadblock known as prior authorization, which requires a patient’s health insurer to sign off before chemotherapy, surgery or countless other services can proceed. Who does this often onerous process help, who does it hurt and how could it work better for everyone?
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PennLDI @pennldi.bsky.social · 28/05/2026
🎧LISTEN: LDI Fellow @aschwartz.bsky.social discusses the benefits and challenges of prior authorization in this episode of the @tradeoffs.org podcast.
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Tradeoffs @tradeoffs.org · 28/05/2026
Every year, millions of people’s medical care runs into the roadblock known as prior authorization. Who does this often onerous process help, who does it hurt and how could it work better for everyone?
tradeoffs.org
A Closer Look at a Widely Despised Health Insurance Policy
Every year, millions of people’s medical care runs into the roadblock known as prior authorization, which requires a patient’s health insurer to sign off before chemotherapy, surgery or countless other services can proceed. Who does this often onerous process help, who does it hurt and how could it work better for everyone?
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Tradeoffs @tradeoffs.org · 27/05/2026
With Republicans in control of Washington and health costs on the rise, there’s new momentum behind an old conservative policy: Put more cash in patients’ hands and let them buy their own health care.
tradeoffs.org
Republicans Want to Change How You Buy Health Care
President Trump and other leading conservatives are pushing policies they hope will empower patients to shop more wisely for the health care they need.
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Tradeoffs @tradeoffs.org · 26/05/2026
⏰ Last chance to register Join us and @pennldi.bsky.social today for a discussion about why the No Surprises Act has failed to deliver on its cost-cutting promise, what could be done to change things, and whether there are larger lessons for future policy change.
ldi.upenn.edu
Decoding the Moment: Can the No Surprises Act Be Fixed?
National experts will discuss why the No Surprises Act has failed to deliver on its cost-cutting promise, what could be done to change things, and whether there are larger lessons for future policy change.
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Tradeoffs @tradeoffs.org · 26/05/2026
Economist David Cutler has advised multiple presidents on health policy and was a key voice in crafting Obamacare. When he published a splashy new paper suggesting that America has actually saved money on health care, Tradeoffs had to give him a call.
tradeoffs.org
The U.S. Saved $1 Trillion on Health Care. Why Doesn't It Feel Like It?
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.
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Tradeoffs @tradeoffs.org · 21/05/2026
President Trump and other leading conservatives are pushing policies they hope will empower patients to shop more wisely for the health care they need. In today's episode, we break down the pros, the cons and the evidence behind these policies. Listen:
tradeoffs.org
Republicans Want to Change How You Buy Health Care
President Trump and other leading conservatives are pushing policies they hope will empower patients to shop more wisely for the health care they need.
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PennLDI @pennldi.bsky.social · 20/05/2026
Can the No Surprises Act be fixed? Join us and @tradeoffs.org on May 26 for a virtual conversation on why the law succeeded in protecting patients from surprise bills, but may be falling short on lowering costs. ldi.upenn.edu/events/decoding-the-m…
ldi.upenn.edu
Decoding the Moment: Can the No Surprises Act Be Fixed?
National experts will discuss why the No Surprises Act has failed to deliver on its cost-cutting promise, what could be done to change things, and whether there are larger lessons for future policy ch...
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Tradeoffs @tradeoffs.org · 19/05/2026
Can GLP-1s save employers money in the long run? Tradeoffs Reporter and Producer Julie Wernau joined The Indicator podcast from @npr.org @planetmoney.bsky.social to discuss her reporting on GLP-1s. Listen now:
open.spotify.com
Why GLP-1s aren't lowering employers' costs
The Indicator from Planet Money · Episode
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Jessica Bari @jessicabari.bsky.social · 15/05/2026
Has been thrilling to share Call to Mind w @mprnews.org listeners all week. This morning we end w a jewel. In Call to Mind: The Fifth Branch, @tradeoffs.org takes us to a city that's reimagined their crisis-response system. Incredible reporting. 9AM on MPR NEWS. 📻 = 91.1 🎧 = www.mprnews.org/listen
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Tradeoffs @tradeoffs.org · 15/05/2026
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. Listen: tradeoffs.org/2026/05/14/t...
tradeoffs.org
The U.S. Saved $1 Trillion on Health Care. Why Doesn't It Feel Like It?
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.
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Tradeoffs @tradeoffs.org · 08/05/2026
The latest episode of Tradeoffs is 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. Listen now or read the transcript: tradeoffs.org/2026/05/07/c...
tradeoffs.org
Call to Mind: The Fifth Branch
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.
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Tradeoffs @tradeoffs.org · 02/05/2026
Many people cheered in 2020 when Congress passed a wildly popular bill to protect patients from big, out of the blue health care bills. But new reporting by @nytimes.com finds some doctors keep sending big bills, and keep getting paid. tradeoffs.org/2026/04/30/d...
tradeoffs.org
Doctors Hated the No Surprises Act. Now Some Are Getting Rich Off of It.
Doctors are winning big paydays from insurers under a law intended to protect patients and rein in high prices.
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Jessica Bari @jessicabari.bsky.social · 01/05/2026
Happy #mentalhealthawarenessmonth! I’m celebrating with FIVE new public radio specials from Call to Mind 💚. Listen for them on your public radio station or subscribe to our new podcast channel! New episodes drop each Wednesday! www.calltomindnow.org/mental-healt... www.calltomindnow.org/podcast
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Tradeoffs @tradeoffs.org · 30/04/2026
Doctors are winning big paydays from insurers under a law intended to protect patients and rein in high prices. @nytimes.com reporter Margot Sanger-Katz @sangerkatz.bsky.social talked with Tradeoffs about how this is fueling higher premiums. Listen to the episode: tradeoffs.org/2026/04/30/d...
tradeoffs.org
Doctors Hated the No Surprises Act. Now Some Are Getting Rich Off of It.
Doctors are winning big paydays from insurers under a law intended to protect patients and rein in high prices.
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Tradeoffs @tradeoffs.org · 24/04/2026
New York’s Medicaid chief Amir Bassiri is navigating the new challenge of work requirements, "Our mission is to provide widespread coverage and access to low-income New Yorkers," he said. "...We’re not going to let them tear down what we’ve built."
tradeoffs.org
New York Braces for Trump's Big Medicaid Shakeup
The state’s Medicaid director Amir Bassiri shares his plans for blunting the effects of Republican health reforms — starting with work requirements.
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Tradeoffs @tradeoffs.org · 23/04/2026
New York is bracing for Trump's big Medicaid shakeup. The state's Medicaid director Amir Bassiri shares his plans for blunting the effects of Republican health reforms — starting with work requirements.
tradeoffs.org
New York Braces for Trump's Big Medicaid Shakeup
The state’s Medicaid director Amir Bassiri shares his plans for blunting the effects of Republican health reforms — starting with work requirements.
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Tradeoffs @tradeoffs.org · 17/04/2026
From obesity management programs to rebates and apps, employers are experimenting with new approaches to make GLP-1 costs more sustainable. tradeoffs.org/2026/04/16/g...
tradeoffs.org
GLP-1s Are Busting Employer Budgets. Some Are Getting Creative to Lower Costs.
From obesity management programs to rebates and apps, employers are experimenting with new approaches to make GLP-1 costs more sustainable.
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Tradeoffs @tradeoffs.org · 16/04/2026
As demand for new weight loss drugs soars, some employers are making workers track their diet and exercise in hopes of limiting use and keeping costs down. What's it’s like for employees who must prove they deserve obesity drugs?
tradeoffs.org
Should People Who Want GLP-1s Have to Work for Them?
As demand for new weight loss drugs soars, some employers are making workers track their diet and exercise in hopes of limiting use and keeping costs down.
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Tradeoffs @tradeoffs.org · 10/04/2026
Tradeoffs is now on Apple News 📰 Follow us there to keep up with the biggest health policy stories — without the noise: apple.news/TqZbur7r0R_-...
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Tradeoffs @tradeoffs.org · 09/04/2026
The White House wants states to drop certificate of need laws in hopes of lowering health care costs. Researchers and state leaders are split. Listen to the episode on how states are trying to use these wonky laws to make health care more affordable. tradeoffs.org/2026/04/09/h...
tradeoffs.org
High Health Care Costs Are Fueling a New Fight Over Old Laws
The White House wants states to drop certificate of need laws in hopes of lowering health care costs. Researchers and state leaders are split.
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Dan Diamond @ddiamond.bsky.social · 02/04/2026
Thrilled to join the great @tradeoffs.org podcast and talk about my recent WaPo profile of CHRIS KLOMP, the fast-rising official now running HHS operations. Thanks to @dgorenstein.bsky.social @ryan-levi.bsky.social for having me.
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Tradeoffs @tradeoffs.org · 02/04/2026
We talked with @washingtonpost.com White House reporter @ddiamond.bsky.social about what Chris Klomp’s rise in the Trump administration means for RFK Jr.’s agenda and U.S. health policy. “In some ways, he’s the secretary in all but name,” Diamond said.
tradeoffs.org
Trump's Pick to Quiet the Chaos at HHS
The administration is looking to former health care executive Chris Klomp to help RFK Jr. get Trump’s health agenda back on track.
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Tradeoffs @tradeoffs.org · 29/03/2026
Rachel Bernier-Green is an owner of one of the nation’s 36 million small businesses. She shared about what it takes to offer employees health insurance and what happens when that coverage gets super expensive. Listen: tradeoffs.org/2026/03/12/i...
tradeoffs.org
‘It Sucks’: Spiking Health Insurance Costs Hit Small Businesses
An employer in Chicago describes how another year of rising premiums forced her to consider dropping her workers’ insurance.
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