Health insurance veteran Mike Smith says ACA gains at risk as subsidies expire and costs climb

The $100 Billion Loophole: Why 340B Reform is Essential

Economist Wayne Winegarden joins the podcast to expose how the 340B Drug Discount Program evolved from a small safety net for rural clinics into a \$100 billion revenue engine for massive hospital systems. He explores how misaligned incentives drive up drug spending, fuel hospital consolidation, and why transparency is the first step toward reform.

The Human and Economic Toll of Treatment-Resistant Depression

Treatment-resistant depression (TRD) affects millions of Americans and carries significant personal, clinical, and economic consequences. In this episode of the Health Policy Podcast, host Bryan Hyde speaks with Dr. William Sauvé, Chief Medical Officer of Osmind, and Mark Desmarais, Principal at Health Management Associates, about new research examining the impact of TRD on patients and the healthcare system. Drawing on a comprehensive analysis of Medicare claims data, Desmarais explains how patients with TRD generate approximately $8,000 more in annual healthcare costs than patients whose depression is effectively managed. The discussion explores the reasons behind these costs, including higher rates of physician visits and hospitalizations, as well as their impact on both individuals and caregivers. Dr. Sauvé, a psychiatrist with extensive experience treating complex depression cases in both military and civilian settings, discusses TRD, the challenges patients face after multiple unsuccessful medication trials, and the importance of identifying effective treatments. The conversation also examines workforce shortages in mental health care, barriers posed by prior authorization requirements, and how delaying effective treatment can worsen patient outcomes and increase healthcare spending.

Layla Bou Harfouch: The Risks of Mandatory Interventions in Child Welfare

Drug policy analyst Layal Bou Harfouch discusses the unintended consequences of New Mexico's SB 42, which allows the state to mandate treatment or remove newborns based on substance exposure. She explores how centralized, one-size-fits-all mandates bypass clinical assessments and create dangerous disincentives for mothers seeking prenatal care.

Dr. Gail C. Christopher: Closing the Gap in Black Maternal Health

Dr. Gail C. Christopher, Executive Director of the National Collaborative for Health Equity, discusses the "Momnibus" Act and the multi-decade effort to eliminate racial disparities in maternal health. She shares promising policy shifts, including the expansion of Medicaid coverage for doula services and the bipartisan momentum behind comprehensive birth equity.

National Taxpayers Union's Pete Sepp: Why Medical Bills are High, Unpredictable, and Opaque

Pete Sepp, President of the National Taxpayers Union, joins the show to discuss why healthcare costs remain high, unpredictable, and opaque. Sepp breaks down the perverse incentives across the industry—from site-neutrality issues and "pay and chase" government models to the bureaucratic overhead that consumes up to 30% of expenditures.