The Healthcare Policy Podcast ® Produced by David Introcaso

To state the obvious nutrition is considered the cornerstone of public health, a, if not the, primary preventative measure against chronic disease. Nevertheless, the OBBBA cut SNAP funding by an estimated $187 billion; since the start of the pandemic food prices have increased by roughly 30%; and, going forward are at risk due to uncertain trade policy, global shocks including the ongoing war in Iran, water supply/access and widespread drought and other climate-related issues include the looming super El Nino event that is expected to disrupt planting cycles worldwide and breach thermal safety margins - causing most major crops to suffer further yield declines. Add to all this the questionable science behind the MAHA movement.
Friedman School of Nutrition Science and Policy information is at: https://nutrition.tufts.edu/
Prof Masters’ bio is at: https://as.tufts.edu/economics/people/faculty/william-masters


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Not surprisingly healthcare affordability has risen to the top or #1 mid-term election campaign issue.
Largely due to pricing failure, that costs Americans about $250 billion annually, pricing power is the consequence of an increasingly concentrated healthcare market. Think: Herfindahl-Hirschman Index scores. Hospital pricing/prices are particularly noteworthy or moreover surgical procedures and patented drugs that have risen at multiples of the annual inflation. This means those insured pay increasingly higher coverage (premiums, deductibles, copays) and are forced into medical debt or bankruptcy, forced to avoid necessary care and/or make financial trade offs. Insurance plans, here we’re discussing self-insured employee plans, that capture roughly 65% of covered workers, face similarly challenging math. For example, recently reported news found the five largest managed care plans lost $226 billion in market value over the previous 12 months. As for solutions, federal price transparency laws, though well intended, have either gone un-headed and/or lack enforcement.
Mr. Robert Andrews is the CEO of the Health Transformation Alliance (HTA), a cooperative of approximately 80 large self-insured employer health plans. HTA was founded in 2016 by four pioneering employers from American Express, Macy’s, Verizon and Caterpillar. HTA member companies are collectively responsible for more than 5 US million lives and 8 million globally spending $450 billion annually in the US market. Mr. Andrews served NJ’s 1st congressional district in the US House of Representatives from 1990 to 2014.
Information on the Health Transformation Alliance is at: https://www.htahealth.com/about-us/.



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Per my May 2025 interview with Stanford’s Chris Callahan regarding his April 2025 “Nature” article titled, “Carbon Majors and the Scientific Case for Climate Liability,” we know that among the 90 companies responsible for 63% of industrial GHG emissions over the past 200 years, 83 are fossil fuel companies.
Two weeks ago Senator Cruz (R-TX) and four other Republican senators dropped their “Stop Climate Shakedown’s Act.” In part the legislation would prohibit retroactive liability, mandate dismissal of pending climate liability lawsuits in several states and preempt state authority, e.g., outlaw state climate superfund laws (think: NY and VT).
The bill was largely anticipated because the Heritage Foundation’s “Project 2025” report proposed policy recommendations designed to “dismantle legal and regulatory frameworks” in response to what the Foundation terms “woke lawfare.”
Mike Meno, The Center for Climate Integrity’s Communication Director, unpacks the who, what, why, how and where.
Information on the Center for Climate Integrity is at: https://climateintegrity.org/
See also the Center’s “No Immunity for Big Oil” page at: https://www.noimmunityforbigoil.org/



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Listeners are all well aware US healthcare is increasingly unaffordable. Among other stats nearly 50% of Americas are either uninsured, at 8% or 27 million, or underinsured, at 41% or 120 million. Upwards of 4.8 million Americans are expected to drop their ACA coverage; the average commercial family plan comes w/a $6,800 annual premium and 42% of Americans are now enrolled in high-deductible commercial health plans. As a result 36% of all adults now skip or postpone medical care. Though I’ve likely previously cited, the Noble Prize-winning Princeton economist Angus Deaton concluded in 2020, the US healthcare industry,
“is a cancer at the heart of the economy, one that has widely metastasized, bringing down wages, destroying good jobs and making it harder and harder for state and federal governments to afford what their constituents need. Public purpose and wellbeing of ordinary people are being subordinated to the private gain of the already well off. None of this would be possible without acquiescence – and sometimes enthusiastic participation – of the politicians who are supposed to act in the interest of the public.”


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Over the past 12 years the Affordable Care Act (ACA) has reduced the total number of uninsured Americans and low-income individuals more specifically by over 50% and by over 66% for young adults. In 2025 the ACA insured a record breaking 45 million Americans: 24 million through the federal and state exchanges; and, 21 million via the ACA’s expansion of the Medicaid program. Having been under nearly continual attack by Republicans, the proposed 2027 ACA rule, announced February 9th (with comments due March 13), was highly anticipated. Within a week after it was announced, Professor Keith and her colleague Matthew Fielder authored three lengthy essays unpacking numerous proposed rule provisions. Top of line the authors noted the proposed, if finalized, will decrease marketplace enrollment by 2 million in 2027 (marketplace enrollment is already down this year by one million due to the Congress’s refusal or failure to extend COVID-era enhanced premium tax credits) and will increase ACA-related reporting & record keeping by approximately $1.34 billion every year.
The first of three Health Affairs’ Forefront essays by Katie Keith and Matthew Fielder is at: https://www.healthaffairs.org/content/forefront/hhs-proposes-sweeping-changes-2027-marketplace-plans-part-1
The second is at: https://www.healthaffairs.org/content/forefront/hhs-proposes-sweeping-changes-2027-marketplace-plans-part-2
The third is at: https://www.healthaffairs.org/content/forefront/hhs-proposes-sweeping-changes-2027-marketplace-plans-part-3
The proposed rule is at: https://www.govinfo.gov/content/pkg/FR-2026-02-11/pdf/2026-02769.pdf
CMS’ related press release is at: https://www.cms.gov/newsroom/fact-sheets/hhs-notice-benefit-payment-parameters-2027-proposed-rule



This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit www.thehealthcarepolicypodcast.com