Tradeoffs

The Trump administration has made fighting fraud one of its top health care priorities, and Medicaid has been a particular focus.

Federal officials argue that states are not doing enough to protect the government health insurance program for low-income and disabled Americans from bad actors.

Some states and health policy experts say that Medicaid fraud is a much smaller problem than the administration claims, and that what the feds are doing threatens the care of vulnerable people.

Tradeoffs co-hosted a virtual event about the Medicaid fraud with the Leonard Davis Institute of Health Economics at the University of Pennsylvania. Dan Gorenstein moderated 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 edition of Tradeoffs, read the transcript, or watch the video. https://tradeoffs.org/2026/09/24/states-weigh-in-on-medicaid-fraud/

911 calls related to mental health are the most likely to involve police use of force. Between 2015 and 2024, police killed more than 2,000 people in a mental health crisis — one of every five police killings in that time.

“It's not about individual officers or 911 professionals making bad decisions, in many of these instances,” said Rebecca Neusteter, who has studied 911 for three decades. “It's more about structural design choices that have been baked into the founding of 911.”

Neusteter’s new book, "911, What’s Your Emergency? The Promise and Peril of Crisis Response," highlights several key structural challenges with 911 that she says harms staffers and people calling in. Those include call centers being overseen by law enforcement, chronic underfunding, and a lack of training and support for 911 professionals to deal with calls involving mental health crises.

Listen to today's new Tradeoffs episode or read the transcript. You’ll hear from Neusteter on her vision for a better 911, plus a Texas sheriff describes how he’s seen 911 fail his community and how he has put some of Neusteter’s proposals into action.

https://tradeoffs.org/2026/09/17/911-fails-people-in-mental-health-crises-heres-a-plan-to-fix-it/

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 to learn more about the upheaval happening with America’s food assistance program — and meet one man living with the consequences.

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.

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 latest Tradeoffs episode now:

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 collectively bring down health care costs.

Throughout August, we've brought you some of our favorite conversations we’ve had on the podcast over the last few years, and this week’s offering is a special one: a candid conversation between two academics about the future of health care research.

Yvonne Commodore-Mensah is an associate dean of research at the Johns Hopkins School of Nursing, and Laura Mata López is a Ph.D. candidate. Both women are immigrants, both study health disparities, and both were concerned they could lose their NIH funding as part of the administration’s anti-DEI efforts.

More than a year later, Commodore-Mensah’s NIH work continues to be funded uninterrupted. Mata López, on the other hand, saw her grant terminated last April in a slew of anti-DEI cancellations — and then reinstated a few months later after a judge ruled against the administration.

“I acknowledge that it's a challenging period,” Commodore-Mensah told Mata López. “But we have to be hopeful. I feel like we don't have an option. The opposite of that would be just despair. And I know that our communities are counting on us to still want to fight.”

Listen to the full conversation or read the transcript. Mata López shares her pain at feeling like her work is under attack, and Commodore-Mensah shares why, in the face of all the uncertainty, she remains hopeful – and the advice she hopes Mata López will take to heart.

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.

President Donald Trump has nominated Chris Klomp — a former health care executive with little political background — to be Robert F. Kennedy Jr.’s top deputy at the Department of Health and Human Services.

With senators set to consider Klomp’s nomination, we're bringing back our conversation with Washington Post White House reporter Dan Diamond, who profiled Klomp in March. Back then, Trump had just put Klomp in charge of day-to-day operations at HHS in hopes of quieting some of the chaos that has permeated the agency.

We talked with Diamond about who Klomp is, how he’s risen so quickly in the administration, and what his elevation means for Kennedy’s agenda and U.S. health policy.

Listen to the episode or read the transcript:

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.

The Trump administration took another major step this week to make it harder for transgender young people to access health care.

On Tuesday, health officials announced that they will no longer allow Medicaid dollars to be used for gender-affirming care for people 18 or younger. The ban includes hormone therapy, medications that pause puberty as well as surgeries.

This action comes on the heels of a series of other moves the administration has made to restrict access to care for transgender youth.

This week, we’re re-airing a conversation we had last summer with Harleigh Walker, a transgender teenager from Alabama, and her dad Jeff.

“There’s really no safety in the country [for transgender people],” Harleigh told us back then. “I feel unsafe almost everywhere. It’s really scary.”

Listen to the full episode or read the transcript to hear our original interview with Harleigh and Jeff. They talk about what it was like picking colleges when half the country is hostile to your health care, the increased fear the whole family has experienced since Trump was elected, and what — in spite of it all — brings them joy.

‘I Feel Unsafe Almost Everywhere’: How Trump Has Changed Life for One Transgender Teen A conversation with an 18-year-old and her dad about how anti-trans policies have impacted their lives in 2025.

This month, we’re going to bring you a few of our favorite conversations we’ve had over the last year, while we work on some exciting new episodes for the fall.

First up, our chat with physician and New Yorker writer Dhruv Khullar about the opportunities — and perils — of artificial intelligence helping doctors to diagnose us.

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

Listen to the episode or read the transcript:

Should I Trust AI to Diagnose Me? 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.

NPR featured Tradeoffs' interview with Nebraska Medicaid Director Drew Gonshorowski.

Read the article to learn about how Nebraska became the first state to remove people from Medicaid for failing to meet new work requirements signed into law by President Trump.

Gonshorowski told Tradeoffs that roughly 200 Nebraskans would lose their coverage on Aug. 1. "We've ensured that we have extra steps in place making sure we review any denial multiple times before it goes out the door," he said. "We don't want folks falling through the cracks on this."

In Nebraska, Americans begin to lose Medicaid under Trump's work rules Nebraska's Medicaid director, in an exclusive interview with nonprofit news organization Tradeoffs, said roughly 200 people will lose health coverage on Aug. 1.

Since the Supreme Court overturned Roe v. Wade, the fight over abortion access has shifted. Battle lines are now being drawn at the state level.

We talked with a Wyoming doctor about what it’s like to have a front-row seat to the ongoing abortion clashes.

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.