Tradeoffs

01/12/2026

We’re bringing you a special bonus episode today that digs into some big health policy news that you might’ve missed over the holidays.

Just before New Year's, the Trump administration announced how much money each state would get from the $50 billion Rural Health Transformation Program.

Tradeoffs co-hosted a virtual event on Tuesday, Jan. 6 with the Leonard Davis Institute of Health Economics at the University of Pennsylvania to dig into this rare bit of new federal funding for rural health care.

Each state will get at least $100 million a year over the next five years. The rest of the money will be awarded based on a series of factors, including how rural a state is, what states propose to do with the money, and whether the states adopt policies aligned with the administration's Make America Healthy Again priorities.

Tradeoffs' Dan Gorenstein spoke with three of the country’s top experts on rural health care to break down how states will spend this new money, the evidence behind their policy plans and whether this will actually improve the health of rural Americans.

Listen or read the transcript:

Rural health experts dig into the Trump administration’s effort to transform rural health care.

01/09/2026

Generic drugs now fill 9 out of every 10 prescriptions in the U.S. Collectively, Americans have saved trillions of dollars, paying less for these drugs, on average, than people in any other major country.

But all these low prices have come with some hidden costs.

Listen to Part 2 of our series, Race to the Bottom, to learn how all those cuts are coming back to bite consumers and hobble a once booming generic drug industry. We shine a light on key weaknesses in the system, shortages of cancer drugs, and how companies are cutting dangerous corners.

https://tradeoffs.org/2024/09/19/race-to-the-bottom-generic-drug-shortages/

01/08/2026

We're looking back at the second episode of “Race to the Bottom,” our special series about the problems undermining the generic drugs we all rely on — and how we could fix them.

This week, we shine a light on some of this system’s weaknesses. We meet a mom whose daughter’s cancer treatment was threatened by a shortage of a decades-old generic medicine.

We hear from a drugmaker about the immense pressure companies like hers face to cut costs and how that leaves our supply of generic drugs increasingly vulnerable.

We hear what lawmakers could do to shore up this essential market.

Give the episode a listen or read the transcript, and stick around to the end for some updates on what’s happened to our generic drug supply since this story first ran in 2024.

America pays less, on average, than any other major country for our generic drugs. But selling essential medicines at such low prices comes with hidden costs — from quality problems to frequent shortages.

01/07/2026

Generic drugs are, in many ways, the unsung hero of our health care system.

They bring remarkable medical innovations within reach for millions more Americans — drugs that fight cancer, stop heart attacks and seizures, treat otherwise fatal infections — often for just a few bucks a bottle or less.

"When I found out that I could get, the generic version for the first time, there was like an exhale, like, honestly this will change my life," one patient said.

"This medication that was once $130,000 a year to, you know, nothing. The copay is zero dollars. It’s kind of hard to wrap your head around," said another.

These much cheaper copies of brand-name medications now fill 9 out of every 10 prescriptions in the U.S. They save us hundreds of billions of dollars a year.

But will affordable, high-quality generic drugs continue to be there when we need them?

Forty years ago this month, President Ronald Reagan signed groundbreaking, bipartisan legislation that gave birth to a new drug industry. In part one of Race to the Bottom, we get an inside look at the choices made back then that help explain the wild success and also the troubles we see today with....

01/05/2026

Make sure to join us tomorrow for Decoding the Moment: The $50 Billion Rural Health Program in Context.

Co-hosted with the University of Pennsylvania Leonard Davis Institute Davis Institute of Health Economics, hear from experts about the challenges facing health care access in rural America.

🗓️ Tomorrow, Jan. 6 from 12-1 p.m. ET.

🔗 Register here: https://tradeoffs.org/event/50-billion-rural-health-transformation-program/

01/02/2026

Generic drugs now fill 9 out of every 10 prescriptions in the U.S.

But experts warn that America’s market for these cheap, essential medicines is on shaky ground.

We explore why in Race to the Bottom, a special, three-part series that we originally aired in 2024.

Take a listen to the first episode:

Forty years ago this month, President Ronald Reagan signed groundbreaking, bipartisan legislation that gave birth to a new drug industry. In part one of Race to the Bottom, we get an inside look at the choices made back then that help explain the wild success and also the troubles we see today with....

01/01/2026

Policymakers — including President Trump — talk a lot about the high prices Americans pay for prescription drugs. While it's true that we pay big bucks for brand-name drugs, the bulk of the medicines we take are actually cheap copycats known as generics.

The U.S. generally pays much less than other wealthy countries for generic medicines, which now fill nine out of every ten prescriptions.

But will these affordable, high-quality copies continue to be there when we need them?

That's the question that drove “Race to the Bottom,” our three-part series about how America's heavy reliance on cheap generic drugs has begun to backfire.

Our dependence on these drugs has only grown since this series first aired in 2024, so over the next three weeks, we’re giving this reporting another look.

In this first episode, we take you behind the scenes of the bipartisan deal-making that gave birth to America’s modern generic drug market in the 1980s. It’s a fascinating tale of big ideas, arm-twisting and colorful characters.

Take a listen:

Forty years ago this month, President Ronald Reagan signed groundbreaking, bipartisan legislation that gave birth to a new drug industry. In part one of Race to the Bottom, we get an inside look at the choices made back then that help explain the wild success and also the troubles we see today with....

12/31/2025

If Tradeoffs has helped you make sense of health policy this year, today’s the day to show your support.

Your gift could help unlock a $5,000 match to help fuel our reporting in 2026 and beyond.

http://tradeoffs.org/donate

Support smarter health policy conversations.

12/31/2025

Make sure you sign up for our virtual event about the challenges facing health care access in rural America next week.

🗓️ When? Tuesday, Jan. 6 from 12-1 p.m. ET.

Hear from national experts at our talk, co-hosted with the University of Pennsylvania Leonard Davis Institute of Health Economics (Penn LDI).

🔗 Register here:

Discussing the challenges facing health care access in rural America, evidence-based solutions to those issues, and how states and the federal government are looking to use the RHTF.

12/29/2025

The Trump administration is handing out $50 billion to help states make health care better and easier to access in rural America.

But many experts worry that this funding will fail to deliver meaningful results for rural communities.

In the next Decoding the Moment event cohosted by Tradeoffs and the Leonard Davis Institute for Health Economics at the University of Pennsylvania, we’ll explore evidence-based solutions to rural America’s health care challenges, and how states and the federal government are looking to use this new pot of money.

Join us on Tuesday, January 6th at 12-1 p.m. ET for a live virtual conversation with national rural health experts.

Discussing the challenges facing health care access in rural America, evidence-based solutions to those issues, and how states and the federal government are looking to use the RHTF.

12/26/2025

Dr. Lisa Fitzpatrick founded Grapevine Health, a startup to help people better understand their health care. Grapevine creates short videos featuring Black and other doctors of color explaining everything from kidney disease to how to sign up for Medicaid.

Yvonne Smith is one person who said Fitzpatrick and Grapevine’s videos helped her control her diabetes and take more control of her health care.

“Grapevine Health and Dr. Lisa are the best kept secret that I wish everyone knew about,” Smith said.

Learn more about why Fitzpatrick believes plainspoken information from trusted messengers can help shrink health disparities, and why some insurers are buying in.

Dr. Lisa Fitzpatrick believes plainspoken information from trusted messengers can help shrink health disparities, and some insurers are buying in.

12/25/2025

In the spirit of the holiday season, Tradeoffs has been featuring people with innovative fixes to some of health care's most stubborn challenges.

People like Lisa Fitzpatrick, who almost seven years ago walked away from a prestigious 20-year career in government, academia and medicine to launch a health literacy startup to improve health outcomes — particularly among Black Americans — by offering plainspoken information from trusted messengers.

Her company Grapevine Health creates videos for social media breaking down health issues like diabetes management and Medicaid enrollment.

In the age of artificial intelligence, widespread medical misinformation and looming changes to Medicaid enrollment rules, listen to the episode or read the transcript to learn about Fitzpatrick’s efforts to improve people’s health literacy

And if you can, please consider donating $5 or $50 to help us continue this kind of solutions-focused journalism in 2026. tradeoffs.org/donate

https://tradeoffs.org/2023/02/02/health-literacy-disparities-lisa-fitzpatrick/

Dr. Lisa Fitzpatrick believes plainspoken information from trusted messengers can help shrink health disparities, and some insurers are buying in.