Tradeoffs

11/22/2025

We’re looking for a seasoned revenue development professional to lead Tradeoffs’ efforts to further develop and drive our plans to grow our revenue, elevate the visibility of our brand, serve on the leadership team, and work closely with our Executive Editor.

$125-155K, based anywhere in the continental US.

Visit our site to learn more & apply.
https://tradeoffs.org/about/jobs/

11/21/2025

Yesterday was National Rural Health day. Today, listen to our recent episode about how states are reckoning with republican health reforms, including a $50 billion pool of money for ‘Rural Health Transformation’ that states are jockeying for.

These are one-time grants states can get to invest in rural health. And a lot of states are pretty hard up for money given all the cuts. So how are they approaching this opportunity?

Hemi Tewarson, executive director of the National Academy for State Health Policy, said for some states, the money could be "completely transformational for the rural populations." For other states, it’s going to be a smaller amount of money that they’re going to have to prioritize.

Tewarson said one thing some states are considering is reimagining how they pay rural health providers, many who struggle to stay afloat. Rural areas stand to lose $150 billion in Medicaid spending as a result of the Big Beautiful Bill.

More than 300 rural hospitals face uncertain futures. Listen to the episode or read the transcript to hear more about what states might use this rural transformation money for.

It's been 90 days since Congress passed Trump’s megabill slashing health care spending and reshaping the Medicaid program. States are already knee-deep in dealing with the fallout.

11/20/2025

Jazmine Mapes has been homeless off and on for most of her adult life. The 31-year-old says sweeps — police officers and other city workers ordering her to leave so they can clear the area — are just part of living in tents and riverbeds in L.A.

"A lot of times I would lose everything. I mean everything," she said. Her sleeping bag, her medications for anxiety and depression. One time she lost a photo album with pictures of her four kids. Kids she’d given up for adoption.

"I remember trying to run back to the tent and telling them, please let me just grab just that," Mapes said. "Nothing else. I won’t grab anything. Please just let me grab that. No, if you grab it, you will be arrested."

Local governments across the U.S. have increasingly turned to sweeps and arrests as the number of people living on the nation’s streets exploded by nearly 60% between 2015 and 2024.

But growing evidence shows that forcing people to move can harm their health. That’s prompting several cities to try a new approach in some cases, which experts on homelessness say can get rid of encampments, while also protecting the health of people living there.

Is there such a thing as a "good sweep"? Listen to today's episode of Tradeoffs or read the article, published in partnership with The Marshall Project, to learn about the health consequences of forcing people to leave their homes on the streets and how cities can minimize those risks while still clearing encampments.

Several cities and counties are addressing street homelessness with a new approach, which experts say can clear encampments while protecting the health of people who are forced to move.

11/18/2025

More than 50 million seniors, and others with certain disabilities, rely on the Medicare Part D marketplace to find coverage for the medications they need.

But some troubling trends suggest that this essential part of Medicare is on shaky ground.

The number of drug plans available to those enrolled in the traditional Medicare program has plummeted by 50% in just the last two years. For some people, the cost of this drug coverage and out-of-pocket expenses are rising, too.

So what’s driving these changes? And where is the Medicare Part D marketplace headed next?

See our reporting at tradeoffs.org or by clicking the link in our bio.

✍️ Leslie Walker,
🎥 Kathryn Dugal & Leslie Walker,

11/17/2025

More than 50 million people rely on Medicare for prescription drug coverage. Coverage that’s meant to keep their medicines affordable for cancer, diabetes, high blood pressure.

But this market for prescription drug plans, known as Part D, is on some shaky ground.

Insurance companies are fleeing. Costs rising. And a whole lot of people are feeling pretty frustrated.

The latest episode of Tradeoffs explores where this market’s going wrong and what its troubles mean for consumers and the future of Medicare Part D.

Facing mounting financial pressures, insurance companies are changing the prescription drug coverage available to many consumers in Medicare Part D.

11/15/2025

A 2024 survey found that 1 in 6 American adults use AI chatbots at least once a month to get health information. Physicians are increasingly using AI too.

But both groups still have a lot of questions about how reliable the technology is, especially when it comes to making a diagnosis.

"It’s the most important challenge because everything else hinges on having the right diagnosis," said Dhruv Khullar, a physician and New Yorker contributing writer.

He shared with Tradeoffs three things every patient and doctor should know to get the most out of AI — safely.

Physician and New Yorker writer Dhruv Khullar says artificial intelligence is a powerful tool to get quicker and more accurate diagnoses. But it can also be dangerous.

11/14/2025

Are you shopping for a Medicare Part D prescription drug plan? We've got some good and bad news.

👍 The good news? No matter which plan you pick, as long as it includes all the drugs you take, your out-of-pocket costs are capped at $2,100, thanks to the Inflation Reduction Act.

👎 The bad news? You could still owe more out of pocket than you have in years past.

Insurance companies are facing higher costs, so they’re hiking some plans’ premiums and raising deductibles. Plus, they're shutting down a lot of traditional Medicare drug plans, so you might see fewer choices in your area.

Some people are turning to Medicare Advantage for cheaper drug coverage, but this version of Medicare gives insurance companies more control over your care and limits which doctors and hospitals you can use.

If you’re on Medicare Part D, shop carefully and stay informed, as the landscape is changing fast. Learn more about what's changing in the latest episode of Tradeoffs:

Facing mounting financial pressures, insurance companies are changing the prescription drug coverage available to many consumers in Medicare Part D.

11/13/2025

Facing mounting financial pressures, insurance companies are changing the prescription drug coverage available to many consumers in Medicare Part D, the market for Medicare prescription drug plans.

More than 50 million seniors, and others with certain disabilities, rely on this marketplace to find coverage for the medications they need. But some troubling trends suggest that this essential part of Medicare is on shaky ground.

The number of drug plans available to those enrolled in the traditional Medicare program has plummeted by 50% in just the last two years. For some people, the cost of this drug coverage is rising too.

Listen to the latest episode of Tradeoffs to hear what we learned from talking with researchers, seniors, advocates and industry experts about what’s driving these changes — and where this all might be headed next.

Facing mounting financial pressures, insurance companies are changing the prescription drug coverage available to many consumers in Medicare Part D.

11/12/2025

Federal subsidies for Affordable Care Act health plans are set to shrink next year. Many shoppers are expected to be priced out of the market, leaving those who stay with higher premiums. It’s a dynamic that threatens to repeat, leaving markets with fewer and more expensive options as insurers exit, too. How did we get here?

Federal subsidies for Affordable Care Act health plans are set to shrink next year. Many shoppers are expected to be priced out, leaving those who stay with higher premiums. The dynamic that threatens to leave markets with fewer and more expensive options as insurers exit, too. How did we get here?

11/10/2025

Extra federal support has helped millions of Americans access health insurance. What's going to happen if that aid goes away?

Excerpts of a live conversation with two top health economists about how extra federal support has helped millions of Americans access health insurance, and what would happen if that aid went away.

11/08/2025

Millions of Obamacare consumers found health insurance more affordable in the last few years, thanks to generous federal aid.

Now, that help is up in the air. Consumers will now need even more help finding a plan, but there’s less help available.

In about half of the country, Obamacare navigator programs are federally funded. And the Trump administration has cut that funding by 90%.

Jeremy Smith is program director for the West Virginia navigator program operated by First Choice Services, a nonprofit based in the state’s capital, Charleston. He said so far, open enrollment has been "chaotic."

Listen to the latest Tradeoffs episode as we talk with Smith about what’s at stake as consumers shop during this year’s upheaval.

Higher premiums and penalties have made shopping for Obamacare plans more confusing this year. Navigator programs, a resource for consumers, lost about 90% of federal funding across more than two dozen states earlier this year. How’s open enrollment going so far? “Chaotic,” says one remaining ...

11/06/2025

For more than a decade, Jeremy Smith has helped West Virginians buy health plans in Affordable Care Act markets.

Smith works as a navigator, a job created by the ACA to give consumers a guide in the complicated market for insurance. He has traveled the state, walking shoppers through their options. Record numbers of people have entered the market in the last few years, keeping him super busy.

This year, he’ll be busy for a very different reason. Last February, the White House cut federal spending for navigators across more than two dozen states by 90%. Smith still has a job, but First Choice Services, the nonprofit where he works, has closed four of five offices and laid off many of his colleagues.

At first, Smith told Tradeoffs, he was upset. “And then I kind of went into problem solving mode,” he said. “We're going to throw everything we got at it and see what we can do to still help the people, ’cause we know they need it.”

We hope you’ll listen or read the full interview to hear more about what Smith loves about West Virginia and what’s at stake as navigators and shoppers react to big policy changes in ACA markets.