Explorez tous les épisodes du podcast An Arm and a Leg

Charity care — financial assistance that nonprofit hospitals are required to offer — is one of the most powerful tools we have to avoid medical debt. But for too many people, that help is hidden. 

The journalists at the podcast Tradeoffs teamed up with our colleagues at KFF Health News to look at what happened when a new state law in Oregon brought charity care out of the shadows, forcing hospitals to auto-enroll people who qualify. 

Check out the rest of Tradeoffs and KFF Health News’s series Hidden Help.

Here’s a transcript of this episode. 

As always, please share your stories and questions. 

To get our best advice and updates, sign up for the First Aid Kit newsletter.

And: Donations from listeners are our single biggest source of funding.

We’d love for you to pitch in today.

Support the show: https://armandalegshow.com/support/

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By October 1, at least two million seniors will get alarming notices: Their health plans — which they got through Medicare Advantage, the version of Medicare run by private insurance companies — will disappear at the end of the year.  

Many of them will be stuck without a lot of options. In some cases, no other companies in their area may offer Medicare Advantage plans to replace them.

Almost three million seniors got stuck in similar situations last year, and experts say the scenario will likely keep playing out for years to come. 

For years, critics have warned that Medicare Advantage plans expose seniors to big risks: The insurance company can decline to cover meds and treatment. And when they do approve treatments, finding a provider who takes your plan can be a huge challenge.

Now, there’s a new and growing risk: Those plans could disappear, without a viable replacement.

In this episode, we take a close look at the fallout in one state: Minnesota, where the collapse of a major Medicare Advantage carrier last year led to “total chaos,” according to the director of the state’s Medicare assistance agency — and where everyday heroes stepped up to support one another.

Plus, we zoom out to look at how private health insurance companies have enmeshed themselves into Medicare as a whole, how that’s affecting the choices in front of us, and what we might do about it. 

Looking for help with Medicare?

• Find your state’s SHIP chapter.
• Check out our previous episode on Medicare vs. Medicare Advantage. 
• Read about Medicare pitfalls to avoid: Part One and Part Two

Here's a transcript of this episode. 

Send your stories and questions. Or call 724 ARM-N-LEG.

Reporting for this story was supported in part by Arnold Ventures. 

And... donations from listeners are our single biggest source of funding. We'd love for you to pitch in today.

Support the show: https://armandalegshow.com/support/

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Employer-sponsored health insurance covers 165.6 million Americans. It’s the default. For lots of workers, it’s a key reason to accept a job offer, or to stay in a job.  

But that system is slowly imploding. As premiums have grown explosively — the average employer plan now prices out at $27,000 for family coverage — businesses have passed more costs onto their workers. 

And, as STAT News reporter Bob Herman wrote in July: America's Small Businesses are Giving Up on Health Insurance.

That story kicked off a series, Out of Pocket, Out of Reach, with a subtitle that says it all: “How America's Employer-Based Healthcare System Continues to Crumble in Slow Motion.”   

Bob covers the business of health care for STAT News. His rigorous investigative journalism recently earned him the coveted title of “UnitedHealth’s least favorite reporter.”

He joins us to unpack how the skyrocketing cost of providing health insurance is affecting companies large and small. 

And he talks with Dan about how the hidden nature of those costs obscures our understanding of just how much the larger health care system is squeezing out of us, eroding our wages and even our freedom to leave crappy jobs. 

Here's a transcript of this episode. 

Subscribe to our newsletter, First Aid Kit.

Send your stories and questions. Or call 724 ARM-N-LEG.

Of course we’d love for you to support this show.

Support the show: https://armandalegshow.com/support/

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We’re bringing back a favorite episode from 2023 that raises a question as relevant as ever: What if we had a decent, publicly-funded health system, available to everybody, with or without insurance? 

We’ve got one, says Dr. Ricardo Nuila. It’s where he works.  

And it could be a model for the whole country. Yes, really. 

That’s the pitch he made in his 2023 book, The People’s Hospital: Hope and Peril in American Medicine. It’s a love letter to Houston’s Ben Taub hospital, and an argument for bringing Ben Taub’s model, efficient, innovative, and cheap, to the rest of the country.

And if that seems unlikely in today’s political climate, well: Ben Taub’s wild origin story was plenty unlikely too. 

That story takes us to the 1960s, when Dutch novelist and playwright Jan de Hartog moved to Houston. He fell in love with the bustling, futuristic home of NASA and the Astrodome. 

But he also discovered the city’s dreadful underside: a neglected charity hospital where largely African-American patients are left to seek health care in unsanitary and unsafe, hellish, conditions. 

De Hartog and a group of Quaker volunteers waged a campaign to change that, and eventually found an unlikely ally who brought it over the finish line. 

The People’s Hospital is a heck of a book. We might want to start a book group someday, just to talk about it. If you want to grab a copy, here’s a link. (Or: Audiobook, or ebook.)

Here's a transcript of this episode.

Send your stories and questions. Or call 724 ARM-N-LEG.

And of course we’d love for you to support this show.

Support the show: https://armandalegshow.com/support/

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Last May, just a few months into the second Trump Administration, changes to federal health programs were happening at a bewildering pace. We brought in KFF Heath News Chief Washington Correspondent Julie Rover to help give us — and you — a big picture look at what some changes would mean. 

A year-and-change later, we wanted to check back in. We talk about the “crumbling Jenga tower” of public health infrastructure, the fallout from cuts to Obamacare subsidies, and Medicaid, and what Julie sees happening in 2028 and beyond (including a whisper of hope.) 

Plus, we get an update on Julie’s growing t-shirt collection and a new series she’s starting on her health policy news podcast What the Health? 

You can read a transcript of this episode here. 

Want to dive deeper into those state Medicaid cuts we talked about? Julie did a whole episode of What the Health? about them. Listen here. 

Want weekly updates from the team, including some of our most practical advice for dealing with the outrageous cost of health care? Sign up for our newsletter, First Aid Kit. 

Send your stories and questions. Or call 724 ARM-N-LEG.

Of course we’d love for you to support this show.

Support the show: https://armandalegshow.com/support/

See omnystudio.com/listener for privacy information.

After her husband L was hospitalized for a severe mental health crisis, Teressa barely had a moment to breathe before the health insurance denials started coming in, burying their family in medical debt.

But Teressa’s a fighter, and an organized one at that — ready to endure months of back and forth until she stumbled on a "secret door" to reversing her husband’s insurance denials: the external review. 

In this episode of Paper Trail, a podcast from the investigative journalists at ProPublica, health care reporter Duaa Eldeib and host Jessica Lussenhop follow Teressa's journey to discovering this powerful and little-known tool — and putting it to work.

Could an external review help you? Check out ProPublica’s write-up, which includes the types of denials eligible for this kind of appeal. 

And for more stories about appealing health insurance denials, you can check out our Starter Pack, which features episodes like this one about writing a killer appeal letter.  

Here's a transcript of this episode. 

Want weekly updates from the team, including some of our most practical advice for dealing with the outrageous cost of health care? Sign up for our newsletter, First Aid Kit. 

Send your stories and questions. Or call 724 ARM-N-LEG.

Of course we’d love for you to support this show.

Support the show: https://armandalegshow.com/support/

See omnystudio.com/listener for privacy information.

While we’re busy working on some big projects this summer, we’re re-releasing some of our most ambitious and useful reporting to date. 

Last year, we set out on a mission: Collect all the best advice about what to do when your prescription drugs cost more than you can afford. 

Our listeners wrote to us about their experiences getting around this most demoralizing — and distinctly American — problem in order to get the medicine they need.

Those responses allowed us to map a whole landscape of potential fixes — none a guaranteed solution for everyone, every time — but all worth knowing about. 

In this episode, you’ll meet some of the intrepid navigators charting the path — including a dad on a mission to afford his daughter’s epilepsy medication, a Medicare coach who helps seniors save tens of thousands of dollars on meds, a pharmaceutical sales rep with a brilliant short-term fix, and other generous and smart fellow travelers.   

We documented all their advice and more in our Prescription Drug Playbook. 

Here’s a transcript of this episode. 

Want weekly updates from the Arm and a Leg team, including more practical advice for dealing with the outrageous cost of health care? Sign up for our newsletter, First Aid Kit. 

Send your stories and questions! Or call 724 ARM-N-LEG.

Of course we’d love for you to support this show.

Support the show: https://armandalegshow.com/support/

See omnystudio.com/listener for privacy information.

One place you might assume is safe from prying ears is your therapy session. 

But as more therapists struggle to negotiate with insurers, they’re turning to tech middlemen like BetterHelp and Headway that promise to take care of the insurance admin and match them with patients. 

And these companies are sometimes recording and transcribing your sessions — and then turning around and sharing that data with social media companies and investors. And there are concerns that these confidential discussions could be used to train the next generation of chatbot therapists.

So this week, we’re bringing you an episode from our pals at Organized Money, a show about corporate consolidation and monopolies, where they speak with Linda Michaels, a psychologist and co-founder of the Psychotherapy Action Network, about the tech companies sneaking into your therapy sessions and how we got here.

And they share some good news: How one state, Illinois, passed a law in 2025 that could be a national model for encouraging more therapists to stay in-network, and ultimately, reduce reliance on these platforms. 

For more on mental health coverage: Check out our episode about Abigail Burman, an attorney and expert on mental health “ghost networks” — lists of providers that turn out to be filled with inaccuracies, making it difficult for patients to get in-network care. Plus we have a whole guide from Burman on “ghostbusting” — AKA, getting your insurance to cover your mental health care. That’s in our First Aid Kit newsletter.

Here’s a transcript of this episode. We’ll be back with more Arm and a Leg in a few weeks. 

Send your stories and questions. Or call 724 ARM-N-LEG.

Of course we’d love for you to support this show.

Support the show: https://armandalegshow.com/support/

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It’s a case you’ve (probably) never heard of: This week, the Supreme Court is hearing oral arguments in Hikma v. Amarin — a legal battle that could impact how much you ultimately pay for prescription drugs. 

Here’s why the case matters: As soon as a generic version of a brand-name drug comes to market, its price typically drops by half. Within 10 years, by more than 75%. Meaning: the sooner we have access to generics, the less we pay at the pharmacy counter. 

But one of the fastest legal pathways for generic companies to get their drugs to market may be about to get a lot narrower – depending on how the court rules later this year.

Amarin, a brand-name drugmaker, has accused Hikma, a generic company, of encouraging doctors to infringe on their patent for a drug called Vascepa.  

The case revolves around the legal concept of skinny labels: a carveout in drug patent law that allows generic companies to bring drugs to market when one of the brand-name drug’s patents has expired, but others haven’t.

And it raises the (unexpected) question of whether it’s OK for a generic drug company to call their product the generic version of something. 

Legal experts help us unpack the nerdy details – including how this case came to be, and what’s at stake for both generic drug companies and anyone looking forward to one day paying less for an expensive brand-name drug. 

Want to learn how these drug monopolies work – and came to be in the first place? Check out our previous episode: Why drugs cost so much, 101: Medicine monopolies

Here's a copy of this episode's transcript. 

Send your stories and questions. Or call 724 ARM-N-LEG.

And of course we’d love for you to support this show.

Support the show: https://armandalegshow.com/support/

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We’re always asking: Why do drugs cost so freaking much? 

And it’s a complicated question. There are a bunch of reasons — to be sure. But in our reporting over the years, like our stories on insulin and tuberculosis drugs, experts cited one big reason over and over again: 

The pharmaceutical industry wages sophisticated legal battles to keep monopoly control over their best selling, most lucrative drugs — blocking generic competition, and increasing their prices along the way. 

How did it come to be this way? 

In this first episode of a new series – what we’re calling An Arm and a Leg 101 – we’re doing a crash course in the history of the drug patent system.

And the rags-to-riches story of one amazing guy is going to help us do it. 

Al Engelberg got schooled in the Art of the Hustle at a young age, collecting dimes at an illegal bingo game on the Atlantic City boardwalk. 

Later, he’d put those street smarts to use as he sat at the negotiation table in Washington D.C., hashing out the details of a law that would usher in the generic drug industry as we know it. Then made millions from the rules he helped write.

And as he admits, his legacy is mixed. 

On the one hand: The rules Al Engelberg helped write — a grand bargain between generic drugmakers and patent-holding brand pharma companies— unleashed the power of generic drugs to save Americans money. 

Nine out of ten prescriptions written today get filled with a generic.

On the other hand: In the process of making his fortune, Al Engelberg discovered loopholes, gaps, and perverse incentives in that grand bargain. 

Gaps that allowed brand and generic drugmakers to profit by keeping generics for many hit drugs off the market.  

So we now spend more than ever on medicine — and more than 20 percent of Americans report skipping their medication because they can’t afford it. 

Al Engelberg, now 86, has spent the last 30 years — and millions of his own dollars — trying to close those gaps. 

“I live in a world — a pharma world — where half the people think I’m dead, and the other half wish I was,” he tells us. 

You can read more of Al’s story — plus his prescription for fixing the crisis of high drug prices — in his book, Breaking the Medicine Monopolies: Reflections of a Generic Drug Pioneer.

And you can hear our earlier reporting on drug patents here:

John Green vs. Johnson & Johnson (part 1)

John Green vs. Johnson & Johnson (part 2)

The surprising history behind insulin's absurd price (and some hopeful signs in the wild)

Here's a copy of this episode's transcript. 

Send your stories and questions. Or call 724 ARM-N-LEG.

And of course we’d love for you to support this show.

An Arm and a Leg 101 is made possible in part by support from Arnold Ventures.

Support the show: https://armandalegshow.com/support/

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This year, the price of health insurance increased dramatically for millions of people. Tens of millions. Obamacare subsidies shrunk, and premiums skyrocketed. 

People asked themselves: how on earth am I supposed to make this work? 

Two of those folks — attorney Nicole Wipp and skate-shop owner Noah Hulsman — tell the story of how they chose among lousy options.

Nicole chose to dump health insurance altogether — even though she could have found a way to pay for it. Noah chose to pay for coverage that sucks, because it’s all he can afford. 

Each made their choice in the context of their broader stories: Noah is deeply rooted in Louisville, KY, and lives about a mile from where his grandmother started Louisville’s first skate shop, around the time he was born.

Nicole’s story includes an expensive, life-threatening medical adventure a decade ago — and a series of choices that’s taken her family from Michigan to Hawaii to South Carolina. 

Reporters with KFF Health News have been talking with dozens of people all over the country about these kinds of choices for their series on the health insurance crisis, Priced Out. KFF Health News senior correspondent Renuka Rayasam, who introduced us to Nicole and Noah after writing about their stories, joins us to reflect on what these stories mean. 

Read more of Renuka Rayasam’s reporting:

When Health Insurance Costs More Than the Mortgage

It’s 2026 and You’re Uninsured. Now What? 

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Hey, first! We’re looking for your help. Can you take a couple minutes and fill out our Audience Survey? 

We’re dying to know more about the community that’s using this show — and about what’s working for you and what you’d like to see. Let us know!

Today we’re switching it up. We’re sharing an episode from the new podcast Drug Story. In each episode, science journalist and self-described “public health nerd” Thomas Goetz goes deep on the story of a single drug — what it treats, how it came to be, and what it reveals about the business of health and disease. 

On this episode: the EpiPen, a device you’ll find in classrooms, on airplanes, in glove compartments — basically everywhere — because the EpiPen can be a literal life-saver for people with severe allergies.

And of course, the EpiPen is also one of the most infamous examples of pharmaceutical profiteering gone bananas. 

That part of the story makes us especially geeked to share this episode. 

And there are more threads here — on the drug’s discovery, on the science of severe food allergies, and on what researchers have learned about preventing them — that Goetz does a great job of weaving together. 

If you like it, new episodes of Drug Story come out every week. 

We’ll be back with more Arm and a Leg in a few weeks. Meanwhile, don’t forget to help us by filling out our quick survey.

Here’s a transcript of this episode.

Send your stories and questions. Or call 724 ARM-N-LEG.

Of course we’d love for you to support this show.

Support the show: https://armandalegshow.com/support/

See omnystudio.com/listener for privacy information.

Thirty-six hours before his wife was scheduled for a major surgery, New York Times personal finance columnist Ron Lieber got a letter in the mail that sent him reeling. 

Insurance was denying prior authorization for the surgery. The only way forward would be to appeal the decision. But it was Saturday night, and the surgery was Monday morning. There wouldn’t be any time. Should they even go to the hospital?

They decided to bet on being able to reverse the denial later on, but the last minute coverage  questions left Ron’s wife, New York Times reporter Jodi Kantor, going into surgery that Monday with a brand new sense of stress and anxiety. 

And along with worrying how his wife's surgery would go (spoiler: it was successful), and whether they’d end up on the hook for a bajillion dollars, it left Ron to wonder why no one had given them a heads-up earlier.

He set out to find answers — and whether there might be a way to prevent these last-minute denials from sneaking up on other people. 

Ron turned to his "Your Money" newsletter subscribers for ideas, and eventually published a draft letter in his New York Times column that doctors and other health care providers could give their patients to better prepare them for insurance curveballs. 

Check out the column here – and consider passing it along to any health care workers whose patients you think might benefit. 

Here’s a transcript of this episode. 

Send your stories and questions. Or call 724 ARM-N-LEG.

Of course we’d love for you to support this show. 

Support the show: https://armandalegshow.com/support/

See omnystudio.com/listener for privacy information.

For five years, we’ve been following the work of Dollar For and its founder Jared Walker, watching them quickly scale up their efforts to help people crush medical debt by tapping into “charity care” — the financial assistance that hospitals are legally required to offer some patients. 

Their work represents what a small, scrappy, thoughtful group of people can do. Last year, their tiny staff helped wipe out more than $55 million in medical bills. 

As we kick off 2026, we thought it was time to check in again. After all, this will be a year when millions more people will have trouble covering their medical bills — when Dollar For’s work may become more important to more people, and when we’re hungry for more ways to help each other. 

As Jared tells it, 2025 proved to be a pivotal – yet rocky – period in the organization’s story. Both their successes and their challenges put into stark relief exactly what we’re all up against. 

So we go deep with Jared on what they achieved while they weathered the chaos, and what it might mean for their – and our collective – next moves.  

Here's a transcript of this episode. 

Check out our Starter Pack: How to wipe out your bill with charity care.

And our previous coverage of Dollar For:

• Could billions in medical debt get zapped by the legal strategy from this 60-second video? (2021)
  We talked to Jared just weeks after Dollar For first went viral. The group’s early history — they’d been working locally for years — is fascinating.
• Badass volunteers help Jared level up, in the fight to crush medical debt (2021)
  Within six months, they’d recruited volunteers and built systems. 
• The Medical Bill “Negotiation Lab” (2022)
  In an experiment aimed at scaling up impact, Dollar For tried a different approach in 2022. We sat in.
• One last tip before 2024 (2023)
  Why Jared thinks you should ask for “charity care” by name -- even though, let’s face it, asking for “charity” does not feel good to most of us.
• New lessons from the fight for charity care (2024)
  Dollar For spent 2024 focusing on the big picture and starting to focus on policy advocacy.

Check out our history of charity care series (from 2021): 

• A legendary lawyer sued hospitals for price-gouging their patients. And got his butt handed to him.
  Dickie Scruggs is the guy who beat Big Tobacco. But when he took on hospitals, he lost.
• The wild backstory of a tiny but crucial Obamacare provision (ft. David Axelrod)
  Charity care wasn’t part of federal law until the Affordable Care Act passed. A Republican senator made sure it was part of the ACA — before deciding he wouldn’t vote for the law.
• “We just kept right on pushing” … and laws changed
  In New York, a grieving family’s story made headlines and helped advocates catch lawmakers’ attention.
• Wait, that was legal until now?!
  In 2021, Maryland barred hospitals from suing patients who qualified for charity care.

Send your stories and questions. Or call 724 ARM-N-LEG.

Of course we’d love for you to support this show. 

Support the show: https://armandalegshow.com/support/

See omnystudio.com/listener for privacy information.

Hey, first!  If you value what we do, we need your support to keep it going in 2026. 

We have SO much work ahead, and we can’t do it without you.  

Every little bit counts. Here’s where you can chip in. Thank you SO much!

Our listeners have been teaming up on an incredible project – kicked off earlier this year by a med student named Thomas Sanford. 

The idea: create a list of reliable resources to help with medical expenses and avoid debt, and circulate it where people might find it useful, like hospital waiting rooms. 

In this episode, we hear how that project is ready to level up – and how you can bring it to people in your community. 

Here’s how to help: 

Send this link to anyone you think might need it: armandalegshow.com/help 

Or go here to print it out, post it, pass it around, customize it for your community, or join with other volunteers: armandalegshow.com/helpers 

Support the show: https://armandalegshow.com/support/

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Hey, first!  If you value what we do, this is the best-ever time to support our work.

We have SO much work ahead in 2026. Donate here.

We’re back for another look at things that – believe it or not – did NOT suck in 2025. 

Specifically: new state laws from around the country aimed at protecting people from things like medical debt, insurance delays and denials, and corporate profiteering.  

In this episode, we dive into two examples from opposite sides of the country to look at how laws like these get made – and in some cases, defended. 

In Maine, lawmakers unanimously voted to remove medical debts from people’s credit reports. While a nationwide court ruling raises questions about the new law’s future, we’ll hear why consumer rights attorney Chi Chi Wu remains optimistic.  

And in Oregon, a law aims to prevent big corporations and private equity firms from taking over medical clinics and strip-mining them for profits.

Plus, a good-news update from our team at An Arm and a Leg. 

Here's a transcript of this episode. 

Send your stories and questions! Or call 724 ARM-N-LEG.

And, again… we’d love for you to support this show.

Support the show: https://armandalegshow.com/support/

See omnystudio.com/listener for privacy information.

Hey, first!  If you value what we do, this is the best-ever time to support our work:  This month, every donation gets matched two-for-one.  

We have SO much work ahead in 2026. Donate here — and get your money matched two-for-one.

It’s probably fair to say: this is the worst year ever for picking health insurance. Premiums are skyrocketing – whether you get insurance through work or from the Obamacare marketplace. 

And with enhanced subsidies almost definitely expiring, millions of people with Obamacare plans are grappling with drastic changes to their household budgets. 

We’re our own case study: You’ll hear us sorting through our own options. None of them are pretty, but because we know how to read the fine print, we figured out: Some are way, way less awful than others. 

And to help you do the same: We’ve boiled down our fine-print-reading expertise in this starter pack on how to pick insurance. 

Also in this episode: we talk with a listener who wonders: is paying for health insurance even worth it at this point? (Her ultimate answer: Yes, but argh.)

Read Julie Appleby’s reporting for KFF Health News about what could happen if Congress changes course and extends the subsidies. 

Here’s a transcript of this episode. 

Send your stories and questions! Or call 724 ARM-N-LEG.

And, again… we’d love for you to support this show. 

Support the show: https://armandalegshow.com/support/

See omnystudio.com/listener for privacy information.

Hey, first!  If you value what we do, this is the best-ever time to support our work:  This month, every donation gets matched two-for-one.  

We have SO much work ahead in 2026. Head to https://armandalegshow.com/support/ to donate — and get your money matched two-for-one.

This statement might shock you: some actual good things happened in 2025. Or, at least things that did not totally suck. 

Stuff like: new limits on the hoops insurance companies can make you jump through, and new protections from predatory debt collectors..  

These are just a couple examples of what state governments have been up to this year – in red, blue, and purple states alike. 

State governments can’t do it all, but across a couple of episodes, we’ll dive into a handful of meaningful wins, and learn how they came to pass. 

Today’s episode takes us to Nebraska, where the state passed aggressive new restrictions on prior authorization. 

And Virginia, where lawmakers banned wage garnishment for lots of medical debts.

Here's a transcript of this episode.

Support the show: https://armandalegshow.com/support/

See omnystudio.com/listener for privacy information.

Economist Vivian Ho has been researching the US health care system for four decades. These days she focuses on what she describes as the biggest burden on the average American: runaway hospital prices and rising health insurance premiums. (You know, Arm and a Leg stuff.) 

And she’s developed a strategy for addressing high insurance premiums – one based on a real-life success story.

So when she asked us to help her gather data for a new study, we were intrigued.

We break down Vivian’s theory of change, and how sharing your medical bills with her team could help build a data arsenal for the fight ahead. 

Want to share your documents with Vivian and her team? 

You can find all details about how to send them here.  

Here’s a transcript of this episode.

Send your stories and questions! Or call 724 ARM-N-LEG.

Of course we’d love for you to support this show.

Support the show: https://armandalegshow.com/support/

See omnystudio.com/listener for privacy information.

A listener named Thomas Sanford wrote to us earlier this year, asking for help with a little DIY project. And it’s turned into the most encouraging thing we’ve seen all year.

With input from the Arm and a Leg community — specifically folks who get our First Aid Kit newsletter — Thomas has drafted a one-page handout, packed with resources for anyone who needs help with medical bills.

It’s ready for you to use, and he wants your help making it better. 

You’ll hear all about Thomas’s story — he’s a medical resident, who started out just wanting something to hand to his own patients — in today’s mini-episode.

And now you can get involved. Thomas’s current version is great — and there’s also tons of room to improve it, with your help.

• Print out the current version and pass it around: Download it right here.
• Make suggestions for the next version: Anybody can comment on this Google doc.
• Volunteer to pitch in: Got design skills? Editorial chops? Language skills, to translate it? Other ideas?  Here’s a sign-up form.

And you can make your own adaptations! Thomas has registered it with a Creative Commons license. 

This project has been incubating in our First Aid Kit newsletter. If you’re not subscribed, this is a great time to sign up. 

Here’s a transcript of this episode. 

Send your stories and questions! Or call 724 ARM-N-LEG.

Of course we’d love for you to support this show.

Support the show: https://armandalegshow.com/support/

See omnystudio.com/listener for privacy information.

For the first time, our senior producer, Emily, has to sign up for Obamacare. And it turns out, it’s one heck of a year to do that. 

A recent headline from KFF Health News reads: “Insurers and customers brace for double whammy to Obamacare premiums.”

We break down what those “whammies” might mean in dollars and cents for Emily and the millions of others signing up for Obamacare in 2026.  

Plus, we cover what’s happening with ACA navigators – the people charged with helping you sign up for Obamacare, and what to expect in November when open enrollment kicks off.  

Learn more about what’s coming in 2026 in our First Aid Kit newsletter. 

Check out KFF’s Obamacare premium calculator. 

Learn whether your state funds its own navigator program. 

Read a transcript of this episode.

Send your stories and questions! Or call 724 ARM-N-LEG.

Of course we’d love for you to support this show.

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Hey first! We need your help: Financial help. Donations from listeners power this show, and we’ve got a goal: 100 people making their first-ever gift, this week. 

If you haven’t chipped in before, this is a great time — just click here.

OK, onwards…

Sharing a favorite from our archive – with lessons that are as relevant as ever. 

Laurie Todd calls herself The Insurance Warrior. She fights health insurance for a living. Her speciality: writing appeals when insurance companies deny high-stakes, high-dollar treatments.

Her first victory was fighting to get coverage for her own life-saving cancer surgery – which we chronicled in an episode tracing her origin story. 

Since then, she says she’s notched hundreds of other victories, and outlined her strategies in two books: Fight Your Health Insurer and Win and APPROVED: Win Your Insurance Appeal in 5 Days.

In this episode, we go deep on one of Laurie’s early, super-instructive cases, that taught Laurie one of the weirder truths about health insurance in America: fighting your health insurance often means fighting… your employer. 

And in this case, that employer was a $61 billion company. 

Want more about winning insurance appeals? Here’s our starter pack.

Here is a transcript of this episode. 

Send your stories and questions. Or call 724 ARM-N-LEG.

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When a New York couple purchased a health insurance plan from a telemarketer, everything sounded legit. Meds, doctors, tests?  All covered.

But it didn't take long for them to realize they'd been “hustled” – ending up with bills for thousands of dollars, and leaving them no choice but to skip important medical care. 

In their series “Health Care Hustlers,” Bloomberg reporters Zach Mider and Zeke Faux uncover the exact nature of the scheme – how this couple, as well as thousands of others, signed up for health plans by unknowingly agreeing to work “fake jobs.”  

Zach and Zeke join us to unpack the many surprising layers to this business— involving a subculture of unscrupulous telemarketers, a TV-sitcom-writer-turned-investor who masterminded the idea, and the legal gray area that allows these plans to proliferate. 

Reminder: If you need to sign up for health insurance, the place to go is healthcare.gov. (As we’ve warned before: Don’t even Google it.) 

No matter what, shopping for insurance requires a ton of homework. We’ve got a guide for you in this Starter Pack.

Here’s a transcript of this episode. 

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As a follow-up to our series The Prescription Drug Playbook — all about how you can get the meds you need at a price you can (maybe) afford — we’re stepping back to look at the big picture. 

From the start of this podcast, we’ve been trying to answer a major question: Why do my meds cost so freaking much? And we’ve highlighted the profit-seeking games that insurance, pharma, and middlemen play all around us in more than a half dozen episodes. 

But there’s one set of players on the field that we’ve never talked about: drug distributors, and how they play a role in another reason you may not be able to get your medicine: drug shortages. 

This story comes from our friends at Organized Money, a podcast about monopolies, from writers and journalists David Dayen and Matt Stoller. 

We think you’re going to like it. 

In the meantime, check out the latest installment of our First Aid Kit newsletter for a rundown of our previous coverage of drug costs. 

Here’s a transcript of this episode.

Send your stories and questions. Or call 724 ARM-N-LEG.

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In February, we asked you, our listeners, to share the tips, tricks, and tactics you’ve learned for getting the medicine you need at prices you can manage. 

And of course some of you work in health care and have insider knowledge. Which we’re passing along in this second episode of The Prescription Drug Playbook.

We’ll hear from a listener who works to help seniors find healthcare, a pharma sales rep, an employee benefits advisor, and a battle-worn hospital caseworker – all bringing something a little surprising, and possibly even life-saving to the table. 

Of course—for all their advice, there is a BIG caveat: there is no one solution for everyone. This is a set of patches, workarounds, bandaids.

We deserve SO much better. But in the meantime, maybe some of these tips can help. 

Here’s a link to the Find a Health Center Tool that we told you about in the episode—it’s worth checking out!

And here's the full drug-price song by producer Claire Davenport and some robots

Find the whole Prescription Drug Playbook series – including our First Aid Kit newsletters — at armandalegshow.com/drugs

Here’s a transcript of this episode. 

Send your stories and questions. Or call 724 ARM-N-LEG.

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Support the show: https://armandalegshow.com/support/

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Too many of us get sticker shock when we go to pick up our meds. 

We asked our listeners how they get by in this situation, and we learned dozens of tips. And in this two-part series, we’re sharing those strategies — including some advice from experts.

The next episode drops June 30. 

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In surveys, one in four Americans report having to skip their medications due to cost. We asked our listeners: what strategies have you used when you’ve been hit with pharmacy sticker shock? 

We heard from a ton of you – with stories, strategies and workarounds that surprised and encouraged us.

None of them will work for everybody. This is a set of patches and bandaids for a broken system. But if there’s one that’ll work for you, we want to help you find it. So we’re bringing you the most-complete, best-organized set of patches we can.  

In this episode — the first of two episodes — a dad named Bob tells us how he learned some hard-earned lessons. 

When Bob’s teenage daughter Mary was diagnosed with epilepsy, it took her doctors years of trial and error to find the right treatment. It finally worked, Mary's seizures stopped — and then, when Bob's insurance changed, the price tag for Mary's meds went through the roof.

What Bob did next represents one possible journey through the dizzying (and often exasperating) maze of potential workarounds for getting your medicine at a price you can afford. 

We’ve started compiling lessons from Bob’s story and others in our First Aid Kit newsletter. 

Our first installment features a price comparison spreadsheet… inspired by Bob (who we’d like to nominate for Dad of the Year). 

Here’s a transcript of this episode. 

Send your stories and questions. Or call 724 ARM-N-LEG.

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Support the show: https://armandalegshow.com/support/

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What do the KGB and the former CEO of Cincinnati Children's Hospital have in common?

At different times, they’ve each looked to a guy named Eugene Litvak for help. He only said yes to Cincinnati — but he saved that hospital more than a hundred million dollars a year.

For the last few decades, Litvak – a Soviet émigré with a PhD in math – has been on a mission: save U.S. hospitals from financial ruin, and improve the lives of doctors, nurses, and patients.

He says he has just the formula to do it, lots of prominent experts agree, and he’s documented impressive results so far: Financial savings, fewer hospital-related deaths, lower staff turnover, and shorter wait times.

But Litvak and his allies are still struggling to convince more hospital CEOs to try his method.  

We talk with Litvak about his wild life story and how he found the fix that he says could revolutionize American hospitals. And we speak with experts to determine why more hospitals don’t try it. 

Here’s a transcript of this episode. 

Send your stories and questions. Or call 724 ARM-N-LEG.

Of course we’d love for you to support this show.

Support the show: https://armandalegshow.com/support/

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With news blasting from Washington like a firehose, it feels impossible to take it all in — to stay on top of all the changes the Trump administration has been trying to make. 

But for health care, one person is probably closer to anyone than to understanding the full picture: KFF Heath News Chief Washington Correspondent Julie Rover.    

In this episode, Julie helps us see that picture, by telling us two stories:

The first concerns a teeny part of the health care system — an obscure federal agency, one of many that the Trump administration has taken a chainsaw to.

The other is anything but obscure: Possible cuts to Medicaid —which Julie thinks Republicans will actually find very difficult to make.

Plus, reporting from Julie’s KFF Health News colleague Arthur Allen. And a cameo from one of Julie’s beloved corgis.

Check out Julie’s weekly health policy news podcast: What the Health? 

Read more from Arthur Allen on cuts to AHRQ in KFF Health News:

What’s Lost: Trump Whacks Tiny Agency That Works To Make the Nation’s Health Care Safer

Trump HHS Eliminates Office That Sets Poverty Levels Tied to Benefits for at Least 80 Million People

Here’s a transcript of this episode. 

Send your stories and questions. Or call 724 ARM-N-LEG.

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People who work in real-life emergency rooms have raved about how accurately the new drama The Pitt (Max) captures the dynamics and the medical details of their workplaces.

Here at An Arm and a Leg, we’ve been nerding out about how the show depicts the financial forces that shape the ER’s day-to-day problems like crowding, eternal wait times, and scary bills. 

For this episode, we got Dr. Alex Janke, an emergency medicine doctor and health policy researcher to nerd out with us. 

Here’s a transcript of this episode. 

Send your stories and questions. Or call 724 ARM-N-LEG.

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Support the show: https://armandalegshow.com/support/

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A few months ago, we got a note from a listener named Meagan, who wanted to thank us. 

She said the stories she heard on this show had given her the advice and encouragement she needed to finally win a fight against a medical bill she didn’t owe — a battle she’d been waging for more than two years.

As Meagan tells us, those two years were filled with wild twists and turns and a lot of disappointment.

We hear what kept her motivated and encouraged despite all the setbacks – and after an insurance rep pointed her to a free legal resource — the tactic that finally led to a breakthrough. 

Here’s a resource we mention — with a spoiler alert: It’s the sample cease-and-desist letter that a lawyer shared with Meagan. 

We’ll break down the details — how a letter like this could work, in certain situations — in a future First Aid Kit newsletter.

Here’s a transcript of this episode. 

Send your stories and questions. Or call 724 ARM-N-LEG.

Of course we’d love for you to support this show.

Support the show: https://armandalegshow.com/support/

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A federal agency called the Consumer Financial Protection Bureau — CFPB for short — has taken big steps to help people with medical debt. In early February, the Trump administration moved to effectively shutter the agency. 

We talked with credit counselor Lara Ceccarelli about how the CFPB has helped clients at the nonprofit where she works, and how she’s navigating the sudden change. 

And consumer-rights advocate Chi Chi Wu — an attorney with the National Consumer Law Center — describes the court battle she and her colleagues are mounting to slow down the agency’s dismantling — and where things could go from here. 

We’ll track this developing story in next week’s First Aid Kit newsletter, so if you’re not signed up, this is a great time to start: www.armandalegshow.com/firstaidkit.

Here's a transcript of this episode. 

Send your stories and questions. Or call 724 ARM-N-LEG.

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Support the show: https://armandalegshow.com/support/

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Hey – real quick: some big news from the team at An Arm and a Leg. Our First Aid Kit newsletter is going weekly! First Aid Kit brings you advice from our show and more on how to survive and navigate America’s health care system. 

And allow us to introduce First Aid Kit’s new writer, Claire Davenport. 

When she was our intern last summer, she reviewed An Arm and a Leg’s entire catalog of episodes, and took notes along the way. Now she’s bringing the practical lessons from all that reporting straight to your inbox, every week. 

Get it while it’s hot: sign up for First Aid Kit here. 

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We’re kicking off a new reporting project about how much we pay for our medicine — and what we can maybe do about it — and we want to hear your stories.

Because: Getting a case of sticker shock with a prescription happens all the time. 

So we’re asking: What have you done — or tried to do — to get the medicines you need at prices you can afford? And what did you learn that might be useful for other people to know?

Maybe you learned a strategy that actually WORKED for you. Like using a coupon or ordering drugs from online pharmacies — even pharmacies in other countries.

Maybe it was, “Man, I learned about a new way I’m getting screwed.” 

However things went, tell us about it here: armandalegshow.com/drugs

Your story can be short or long, scary or uplifting – whatever you’ve gone through to get your meds, whether it worked or not, we want to hear about it.

The more we learn about these strategies, and about new ways we’re getting beat up, the more we can work together to do something about it. 

And over the next couple of months, we’ll dig into everything you bring us, call up some experts, and start bringing you what we’re learning.

Meanwhile, if you could use some tips right now for getting a better price for your prescription, we’ve just posted a batch to our First Aid Kit newsletter – check it out here.

Fair warning: It’s a collection of band-aids — that’s what you find in a first aid kit — but it’s a start.

Here’s a transcript of this episode. 

Send your stories and questions. Or call 724 ARM-N-LEG.

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Support the show: https://armandalegshow.com/support/

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You remember a guy named Martin Shkreli? If his name rings a bell, it’s probably because back in 2015, he jacked up the price of an old drug — from around $13 a pill to $750. The media dubbed him “the pharma bro,” and he became a symbol of brazen pharmaceutical greed. 

Now, he’s the namesake for the Shkreli Awards — a kind of Oscars for the most outrageous examples of greed, fraud, and general brokenness in American health care. 

Every year, a health care think tank called the Lown Institute ranks the top ten worst stories and holds an award ceremony to “honor” the winners. 

We’re bringing you highlights from this year’s ceremony – featuring things like human bones for sale without the consent of the deceased or their families, phantom urinary catheters, and so much more – and some reflections from the Lown Institute’s president, Dr. Vikas Saini. 

“Showing all these stories together paints a picture of a health care system in desperate need of transformation,” Saini said at the ceremony. “Not just because the stories are shocking, but because often what they're depicting, like Martin Shkreli's infamous price hike, is perfectly legal.” 

Here’s a transcript of this episode. 

Send your stories and questions. Or call 724 ARM-N-LEG.

Of course we’d love for you to support this show.

Support the show: https://armandalegshow.com/support/

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Support the show: https://armandalegshow.com/support/

See omnystudio.com/listener for privacy information.

A few weeks ago, a listener sent us a note with a link to a news article about a new resolution that had recently been adopted by the American Medical Association – the largest group representing doctors in the US. 

The resolution said: hospitals need to do more to guarantee charity care to patients who qualify. Legislators and regulators should make them. 

Our listener was the author of that resolution, and he told us he first learned about charity care through this podcast. 

His name is Joey Ballard and he’s an internal medicine resident at the University of Illinois-Chicago (UIC).

We talked with him about his early organizing as a medical student, bringing the resolution to the AMA, and the optimism he feels bringing the fight for charity care to the hospital he works at now.

Here’s a transcript of this episode. 

Send your stories and questions. Or call 724 ARM-N-LEG.

And again... we’d love for you to support this show.

Support the show: https://armandalegshow.com/support/

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Today we’re revisiting one of our favorite episodes from the archive – a story about giving – and bringing you an update.  

In 1980, a young father named Denny Buehler was battling leukemia and needed to travel from Cincinnati to Seattle for treatment. To raise the money, his friends and family threw a softball tournament. 

Denny passed away a few months later. But his friends and family turned the softball tournament into a beloved tradition, and a chance to give back. For more than 40 years, they’d host the games and sell hot dogs to raise money for people in the area who needed help with medical expenses. 

Then in 2019, the Denny Beuhler Memorial Fund found a way to make the money they’d fundraise go a hundred times farther. Literally. 

Inspired by a segment on Last Week Tonight, they partnered with a group to buy up old medical debt – and erase it. 

Now in 2024, that group – now known as Undue Medical Debt – has grown its influence and helped crush billions (!) in debt.

Here’s a transcript of this episode. 

Send your stories and questions. Or call 724 ARM-N-LEG.

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Support the show: https://armandalegshow.com/support/

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Longtime listeners to this show know we’ve been talking about something called “charity care” for years. Federal law requires that all nonprofit hospitals have charity care policies – that is, financial assistance policies — to reduce or remove people’s medical bills. 

The problem: people don’t know about it, and hospitals don’t always make it easy to access. New research suggests that the scale of this problem is huge: hospitals are failing to provide more than 14 billion dollars worth of charity care to people who qualify for it. Instead, that money becomes medical debt.

That research comes from the nonprofit Dollar For, an organization dedicated to helping people get charity care. We’ve been talking with Dollar For’s founder, Jared Walker, for years – following his team on their mission to crush medical debt, one charity care application at a time. 

Jared brings us up to speed on Dollar For’s latest research, their efforts to reach hospitals, and how new programs targeting medical debt in places like North Carolina may change things. 

That new program in North Carolina is estimated to wipe out $4 billion in medical debt. We look into how it took shape. 

Plus, we meet Clara, a listener who used her impressive research chops to get charity care from a hospital in New York. In the process, she crafted an expert charity care appeal letter, and shared a template with us. 

Use case: the hospital has denied you charity care after you applied, or offered you less than you need. Here’s the template. 

Of course, Dollar For has tons of resources, including a tool to help you quickly figure out if you qualify for help. And staff to help if you get stuck. Start here: https://dollarfor.org/help/

Here’s a transcript of this episode. 

Send your stories and questions. Or call 724 ARM-N-LEG.

Of course we’d love for you to support this show. This month, every dollar you give gets matched dollar-for-dollar, by NewsMatch, from the Institute for Nonprofit News."

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Several listeners sent us an article with the headline Make your health insurance cry, about a new AI tool to fight health insurance. We had to learn more. 

Meet Holden Karau: a Bay Area software engineer who says she’s “trying to make health insurance suck a little bit less.”

So she’s created an AI tool to appeal insurance denials.

Her project, Fight Health Insurance, is a labor of love (she’s not earning money from it) and fueled by hatred (of insurance companies). 

It draws on her tech expertise and on her years of experience fighting health insurance: for gender-affirming care, for rehab after getting hit by a car, and even for her dog, Professor Timbit. 

We talked with Holden about what it took to build the tool, how it works, and what she hopes comes next.

Here’s a transcript of this episode. 

Send your stories and questions. Or call 724 ARM-N-LEG.

Of course we’d love for you to support this show. This month, every dollar you give gets matched dollar-for-dollar, by NewsMatch, from the Institute for Nonprofit News.

Support the show: https://armandalegshow.com/support/

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Something different: We talk with journalist Cara Anthony about topics that don’t always come up in conversations about the cost of health care. 

For the last four years, she’s been reporting on the public health effects of racism, violence, and intergenerational trauma in a small Missouri town.. The result: A new documentary and podcast series called Silence in Sikeston.   

She sat down with us to talk about the value of breaking silences and the possibility for healing. 

Here’s a transcript of this episode. 

Send your stories and questions. Or call 724 ARM-N-LEG.

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Support the show: https://armandalegshow.com/support/

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We're sharing an episode of “To See Each Other,” about a question that’s SUPER-relevant to this show:  How do we pay for long-term care, like nursing homes?  

To See Each Other aims to complicate the narrative about small-town Americans. In this new season, host George Goehl heads to Lincoln County, Wisconsin — population, 28,000-and-some. And home to a publicly-run nursing home with a 5-star quality rating from the feds.  

A conservative county board plans to sell the home to a private operator, but senior citizens aren’t having it. They show up to board meetings, march in the Labor Day parade, and fight with… their last breath.

George goes deep into questions of aging in America, public versus private versions of long-term care, and the nuts and bolts of organizing. The show aims to put you in a fighting mood, and to think differently about aging.

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An $88 “observation room” fee for a check-up didn’t sit right with Kari Greene, a listener from Oregon. When the price went up to $99 the next year, Kari complained to her benefits rep; they thought it was weird, too — but couldn’t do anything about it. 

In states like Connecticut and Indiana, legislators are trying to do something about fees like these – often called “facility fees.” 

In this episode, we go deep on Kari’s bill, one of dozens that listeners have shared with us over the past few months. 

And we talk with Christine Monahan, a researcher and attorney who knows more about facility fees — and state efforts to limit them — than any other expert in the country.

Here’s a transcript of this episode. 

Send your stories and questions. Or call 724 ARM-N-LEG.

Of course we’d love for you to support this show.

Support the show: https://armandalegshow.com/support/

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What happens when a hospital gets hit by a ransomware attack? We’re sharing an episode from a podcast called Click Here that takes us inside the aftermath of a cyber attack on a rural hospital in Oregon.  

The story starts the minute the hospital’s IT director finds out they’ve been hacked, and follows him and his colleagues as they scramble to keep the place running while they try to get it back online. 

It’s a fascinating adventure, and it gives us a window into the growing problem of cyberattacks in health care – why places like hospitals have become such a major target for cyber-criminals and how the industry is dealing with it. 

Click Here is a bi-weekly tech news podcast from Recorded Future News, hosted by Dina Temple-Raston. 

We’ll be back with more episodes of An Arm and a Leg in a few weeks.

Send your stories and questions. Or call 724 ARM-N-LEG.

Of course we’d love for you to support this show.

Support the show: https://armandalegshow.com/support/

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Caitlyn Mai expected her share of a recent surgery bill to be about $2,000, with insurance covering the rest. 

Then she started getting alerts on her phone from the hospital that she owed $139,000 — the full cost of her surgery. 

But Caitlyn, a legal assistant in Oklahoma, instinctively knew a cardinal rule of the American healthcare system — “never pay the first bill.” 

It’s a lesson we first heard from the journalist Marshall Allen, whose 2021 book Never Pay the First Bill serves as a how-to guide for anyone facing down a potentially bogus medical bill, and whose passing earlier this year left a giant hole in the hearts of many. 

This episode is an extended version of a recent installment of the NPR and KFF Health News series Bill of the Month. 

Here’s a transcript of this episode. 

Send your stories and questions. Or call 724 ARM-N-LEG.

Of course we’d love for you to support this show.

Support the show: https://armandalegshow.com/support/

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We’re starting a new investigation and need your help. We’re looking into something we’ve talked about a lot on this show: hospital financial assistance – also known as “charity care” — which most hospitals are legally required to offer. 

Something like 60 percent of people might qualify to have their hospital bills reduced or even forgiven through charity care — but of course nowhere close to 60 percent of people actually get that assistance. 

A lot of people just don’t know about it. (A survey our friends at Dollar For ran last year found that more than half of patients who might qualify for charity care had never even heard of it.)

Which raises a question: How exactly are hospitals telling you and me about charity care — you know fulfilling their legal obligation to let us know we just might qualify to have our medical bill forgiven? 

This is where you come in: we want to see a LOT of bills from hospitals. If you got one any time in the last year would you please you share it with us here? 

Even if you weren’t worried about how you’d pay — we just want to see what your hospital was saying about your options (like payment plans vs charity care). We want to see what’s in bold type and what’s in fine print.

And if you were at all worried about how to pay, we’d like to hear the story. Did anyone mention charity care to you? Or what? And how’s it going? 

We also need your help spreading the word to friends and family. Spread the word to your friends and family, share our form with them. 

Finally, if you’re looking for charity care support, or just to see if you might qualify, you can go to Dollar For’s website and use their screening tool to see if you’re eligible, and their team of amazing volunteers can take it from there. And you can find more information on charity care in our First Aid Kit newsletter.

That’s all for now. Here's a transcript of this short episode. We’ll be back with more new episodes in a few weeks. 

In the meantime, you can send us other stories and questions. Or call 724 ARM-N-LEG.

Of course we’d love for you to support this show.

Support the show: https://armandalegshow.com/support/

See omnystudio.com/listener for privacy information.

Georgann Boatright's local hospital told her she'd need to pay an $8,000 "operating room" charge for a test she was pretty darn sure wouldn't involve an operating room. So she went elsewhere, even though it meant driving to another state.

Avoiding that charge required more than just a willingness to go — literally — way out of her way. Georgann Boatright has knowledge, skills, and grit that most of us don't — although we can maybe learn a thing or two from her.

More and more, people are noticing sneaky new fees like the one Georgann spotted. They’re often called “facility fees,” and they’re kind of like a cover charge for walking through the door. 

Hospitals say these fees go toward overhead on facilities with lots of specialized equipment —places like emergency rooms. But these fees have been increasing in recent years — and becoming more common: As hospitals buy up doctor’s offices, patients are starting to see them tacked onto bills for routine trips to the doctor.

We asked you to send us stories about facility fees. We heard from a ton of you and learned so much. 

We’ve got lots of stories to share. And we’re starting with this epic tale — which also involves the biggest facility fee charge we saw in all your submissions. 

Here’s a transcript of this episode. 

Send your stories and questions. Or call 724 ARM-N-LEG.

Of course we’d love for you to support this show.

Support the show: https://armandalegshow.com/support/

See omnystudio.com/listener for privacy information.

For months now, you’ve been sharing stories with us about facility fees, those sneaky fees that keep showing up on your medical bills. 

Facility fees are kind of like a cover charge for visiting a health care facility, usually one owned by a hospital. And many of you have been blindsided by them. 

Some of you have been going to the same place for years, only to one day get a brand new charge, seemingly out of nowhere. Many of you only found out about a facility fee after the fact, while some of you managed to avoid one by going somewhere else. Pretty much all of you were vexed, confused, and wanted answers. 

Next week, we’ll start unpacking these stories, starting with one that’s particularly epic. 

Stay tuned! 

In the meantime, got a story or tip you want to share? Send your stories and questions. Or call 724 ARM-N-LEG.

And of course we’d love for you to support this show.

Support the show: https://armandalegshow.com/support/

See omnystudio.com/listener for privacy information.

Folks who expected their health insurance to cover some out-of-network care have been getting stuck with enormous bills instead. Like one couple from Kansas City: Their insurance hung them out to dry for thousands of dollars, all while sending statements touting a “discount” the couple was supposedly getting. 

Turned out: A middleman was cutting their coverage — actually a middleman’s middleman — working with their insurance company. The couple’s insurer got the “discount,” and the middlemen got big fees. 

And of course this couple wasn’t alone. A recent New York Times investigation from reporter Chris Hamby documented and explained this Russian-nesting-dolls-of-middlemen scheme. 

Insurance companies (middleman #1) work with a with a company called MultiPlan (middleman #2), which slashes the amounts the insurance plans actually pay for care.

To show how it all works — and what we can maybe do about it — we dive into the hidden mechanics of health insurance.  

Here's a transcript of this episode.

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We take our first look at Medicaid— the big, federally-funded health insurance program for folks with lower incomes— for two reasons: 

First, it’s a huge part of our health-care system. Medicaid covers a quarter of all Americans, and four in ten children. 

Second, it’s timely: In the last year, more than 20 million people have lost Medicaid — even though there’s evidence to suggest a lot of those people probably still qualify. 

More than two-thirds have been dropped for “procedural reasons” — basically, missing paperwork.

Of folks who’ve been dropped, 70 percent have ended up either uninsured, or — in most cases — back on Medicaid. 

This is all because of a process called “the unwinding” of COVID-emergency protections that kept folks from getting dropped at all for a few years. It’s been messy.

We’ve been hearing the stories of folks who got dropped, and their fights to get re-enrolled.  

In this episode, we hear about two families in Tennessee who lost coverage they were entitled to — including one family who lost their coverage after their mail got sent to a horse pasture — with help from KFF Health News reporter Brett Kelman. 

Here’s a transcript of this episode.

Send your stories and questions. Or call 724 ARM-N-LEG.

Of course we’d love for you to support this show.

Support the show: https://armandalegshow.com/support/

See omnystudio.com/listener for privacy information.