Tradeoffs

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.

11/03/2025

Should you trust AI to diagnose you?

Physician and The 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.

Listen to our latest episode to hear our full conversation with Khullar or read the transcript. We’ve included audio of a human-sounding AI “doctor” Khullar met, as it reasons through a diagnosis. Plus, Dhruv Khullar answer questions from Tradeoffs listeners.

https://tradeoffs.org/2025/10/30/should-i-trust-ai-to-diagnose-me/

10/30/2025

Dhruv Khullar, a physician and professor at Weill Cornell Medicine, recently noticed his colleagues and his patients adding a new component to the diagnosis mix: artificial intelligence.

A KFF survey found that 1 in 6 American adults use AI chatbots at least once a month to get health information, and an American Medical Association survey showed that 2 in 3 physicians are using AI in their work.

Khullar — who is also a contributing writer at The New Yorker — shared with Tradeoffs what he thinks every doctor, nurse and patient should know to safely get the most out of AI in health care.

“I think there's this notion now that all a doctor has to be is an empathic human, because everything else can be looked up or given to you by an AI," Khullar said. "And that is not at all true."

Take a listen to the full conversation with Khullar or read the transcript: https://tradeoffs.org/2025/10/30/should-i-trust-ai-to-diagnose-me/

10/28/2025

Leading health experts told Tradeoffs that the various deals Trump's been hailing are unlikely to deliver substantive prescription drug savings.

What could the administration do that would make a meaningful difference in America’s drug spending?

We asked economists, drug policy scholars and industry insiders to share their answers, which include encouraging federal officials to go bigger at the negotiating table and overhauling current policies that push doctors to prescribe pricier drugs.

Read the latest article:

Some of America's top scholars on prescription drug pricing outline steps the Trump administration could take to make medicines more affordable.

10/25/2025

Facing unprecedented pressure from the Trump administration, some of the world’s top drugmakers promise to cut prices. But experts say the savings might not be what they seem.

10 health policy experts warn we shouldn’t expect most of these moves to deliver substantive savings — at least not yet. Here’s what we’ve learned so far:

-Discounts listed on TrumpRx are unlikely to benefit many people.
-Tying U.S. prices to those charged abroad does not guarantee that Americans will pay less.
-The deals being cut between Medicare and drugmakers should, indeed, deliver meaningful savings for the federal government.
-Despite its limited impact so far, the aggressive approach that Trump has taken to pressuring drugmakers has rattled the industry and set a controversial precedent.

Learn more in our latest episode: https://tradeoffs.org/2025/10/23/will-trumps-prescription-drug-deals-really-lower-prices/