
2025 Tradeoffs Impact Report
From Policy to People
A Note From Our Founder and Executive Editor
How do I express my gratitude to you, our donors, funders and audience, for making 2025 the most consequential year in Tradeoffs’ six-year history? Together, we made complicated U.S. health policy understandable in a tumultuous, confusing time.
Over the course of 54 podcast episodes, 21 events, and dozens of articles and newsletters, we helped Americans make sense of the costly and counterintuitive world of health policy and raised the profile of solutions to some of health care’s most vexing challenges.
With your help, we expanded the conversation beyond problems to what works.
And we heard from you about why you turn to Tradeoffs:
“The reporting, accuracy, level of depth, and research context are just the best health care journalism on the market today, regardless of format.”
In 2025, our reporting responded to the major changes the Trump administration made to health policy — including Medicaid eligibility, vaccine policy, and Affordable Care Act subsidies. We also explained longstanding issues facing the U.S. health care system, like how to improve care for people who struggle with addiction, and the budget crunch that rural providers face nationwide.
We shared stories of people from across the country, showcasing innovations and challenges in places often left out of the conversation. Like the story of a health navigator in West Virginia helping his neighbors select Affordable Care Act plans that are truly affordable. Or an Alabama father and his transgender daughter describing their journey to find appropriate care. Or a counselor at a violence prevention program in Chicago using cognitive behavioral therapy to help high-risk teens avoid incarceration.
And we heard from policymakers that Tradeoffs equipped them to make more informed decisions:
“[Tradeoffs] gives me clear, concise information directly from stakeholders on important health policy domains, and is always a balanced and non-partisan perspective.”
“While my goal is to influence policy locally, knowing what’s happening on a national scale is crucial.”
Like you, we at Tradeoffs want to see a more equitable U.S. health care system where effective policy improves care and lowers costs. We work everyday to make this a reality: connecting policy to practice, and uncovering the data and personal stories that help people understand the stakes and potential solutions.
In 2026, Tradeoffs continues to report on health care’s toughest choices with the same rigor, transparency and accessibility you’ve come to value in our work. We’re going deeper on changes to Medicaid, the fallout from Trump’s “One Big Beautiful Bill,” mental health and addiction, and health care affordability.
Each week, we’ll help decision makers on Main Street, Wall Street and Capitol Hill understand complex health policy and use the latest research to improve care and lower costs for the people and communities they serve.
Your financial support and partnership makes this work possible. Thank you for joining us.

Dan Gorenstein,
Founder and Executive Editor
The State of Health Policy:
Why This Moment Matters
In 2025, U.S. health policy moved quickly — and often unpredictably — reshaping how millions of people access and pay for care. Federal changes to Medicaid eligibility, Affordable Care Act subsidies, vaccine policy and broader health care regulation created ripple effects across states, employers, providers and households.
At the same time, longstanding pressures — including rising costs, uneven access to care and persistent gaps in behavioral health services —continued to strain a system already stretched thin. The use of artificial intelligence has also been sweeping across health care, changing how doctors practice medicine, how insurers approve procedures and pharmaceutical companies develop drugs. For patients, clinicians and policymakers alike, keeping up with these changes became increasingly difficult.
The capacity to inform the public about these shifts has narrowed. Newsrooms across the country continued to face layoffs and resource cuts, including among journalists who cover health care and policy. That contraction has left a growing gap in timely, independent reporting on decisions that affect coverage, costs and care delivery.

Our Response:
What We Did in 2025
In this environment, Tradeoffs’ role has become more essential: translating fast-moving policy into clear, accessible journalism that helps decision-makers and the public understand what is happening in health care, why it matters and what might work better.
Our mission is to help America have smarter, more honest conversations about health policy. Through rigorous reporting, data and human storytelling, we explain the economic and health implications of policies, highlight promising solutions, examine the tradeoffs and explore how decisions affect people’s lives.
In 2025, Tradeoffs reported on the most pressing and fast-changing issues in U.S. health policy and brought that reporting into the real world through trainings and convenings. Across live events, editorial partnerships and communications trainings, we helped policymakers, practitioners and the public engage more deeply with the evidence, ask better questions and have more informed conversations about health policy.

2025 Reporting Highlights
Tradeoffs’ reporting in 2025 focused on the policies, people, and ideas shaping the future of U.S. health care — from federal legislation to local solutions.
Health Care Affordability
As costs continued to rise, we examined the policies and market forces driving prices up, and the proposals aimed at bringing them down.
See more of our reporting on health care affordability.
Medicaid
With Medicaid at the center of national debate, we reported on how policy changes affect coverage, providers and patient outcomes in states across the country.
See more of our reporting on Medicaid.
Federal Policy Changes (HR1 and Beyond)
We tracked major federal legislation and what it meant for states, providers and patients navigating implementation.
See more of our reporting on federal policy and H.R.1.
Mental Health and Addiction
We explored the ongoing mental health and addiction crises and emerging solutions to improve care and prevent harm.
See more of our reporting on mental health and addiction.
See more of our reporting on public health.
Decoding the Moment
In 2025, Tradeoffs partnered with Penn’s Leonard Davis Institute of Health Economics (Penn LDI) to launch “Decoding the Moment,” a virtual event series designed to help audiences make sense of rapidly evolving federal health policy. Through timely, evidence-based conversations with leading experts, the series examined major policy changes — from the “One Big Beautiful Bill” and the future of ACA subsidies to new vaccine approval rules and cuts to violence prevention programs — and what they mean for the future of U.S. health care.
See all of the Decoding the Moment event recordings.
Our Audience & Reach
In 2025, Tradeoffs reached tens of thousands of people each week, spanning roles in government, health care delivery, research, and advocacy. From policymakers and providers to researchers and advocates, our audience relies on Tradeoffs to stay current on national developments, inform decisions, and better understand how policy changes affect care, cost, and coverage.
“Hearing the connection and perspectives of policy from affected persons and industries helps me as a researcher have a better understanding of the magnitudes of the factors that people are being affected by.”
– Joseph Benitez, PhD, Assistant Professor, Martin School of Public Policy and Administration, University of Kentucky
In our most recent audience survey, Tradeoffs listeners and readers told us they use Tradeoffs to inform themselves and those around them about health policy. Here’s what else they told us:



2025 Reach By the Numbers
- Nearly 40,000 people listened to our flagship podcast each week
- Episodes of ‘Tradeoffs’ were downloaded more than 2.3 million times
- Tradeoffs’ website had 170,000+ visitors and 275,000+ pageviews
- More than 1,400 people attended Tradeoffs-hosted events
- Tradeoffs reached audiences in all 50 states and Washington, D.C.
Bringing Our Reporting to New Audiences
In 2025, Tradeoffs’ reporting reached new audiences through partnerships with national and local news outlets across the country. These partnerships expand the reach of our reporting and bring nuanced health policy coverage to communities nationwide.
We partnered with 23 news organizations to republish or featured our work in 2025, including:
Houston Public Media
Illinois Public Media
KBIA (Columbia, MO)
KPBS (San Diego, CA)
KUOW (Seattle, WA)
North Carolina Health News
North Country Public Radio (NY)
WABE (Atlanta, GA)
WBAA (Greater Lafayette, IN)
WESA (Pittsburgh, PA)
WFAE (Charlotte, NC)
WFYI (Indianapolis, IN)
WGBH (Boston, MA)
WOSU (Ohio State University)
WSIU (Southern Illinois University)

(Erin Gromen)
Our Impact in 2025
In 2025, Tradeoffs helped audiences better understand fast-changing health policy, elevated evidence-based approaches to complex challenges and equipped decision-makers with trusted information to inform their work.
Making complicated health policy understandable
In a year of rapid policy change and growing confusion around health care, Tradeoffs helped audiences better understand the decisions shaping coverage, cost and care. Through explanatory reporting, live events and expert conversations, we translated complex issues into clear, accessible journalism for policymakers, clinicians, researchers and the public.
Our audience told us that work mattered: Ninety percent of surveyed audience members said Tradeoffs helped them better understand a health policy topic. Listeners, readers and event attendees said our reporting helped them better grasp emerging federal policy changes, navigate challenges in clinical practice and understand how policy decisions affect underserved communities.


IMPACT IN ACTION
An analyst at the Maryland Health Care Commission reached out after listening to Tradeoffs’ episode on federal investments in institutions for mental diseases (IMDs), seeking additional data and examples from other states to inform Maryland’s work estimating psychiatric bed needs.
Elevating evidence-based solutions
Tradeoffs went beyond documenting problems to examine what’s working in health care — and the evidence behind it.
Across our reporting, we highlighted promising approaches from communities around the country, exploring how policymakers, clinicians and researchers are responding to challenges in mental health, affordability, addiction and public health.
In 2025, nearly 40,000 people tuned in to our flagship podcast each week, and episodes examining health care solutions were downloaded more than 750,000 times. Our reporting also informed new research and policy agendas, including conversations with academics and policymakers exploring how emerging approaches could be adapted in their own work.


IMPACT IN ACTION
After engaging with Tradeoffs’ reporting on 988 and alternative crisis response, University of Virginia Professor Sebastian Tello-Trillo used the insights to shape new research, connecting with reporter Ryan Levi to explore data sources and research directions.
Equipping people to make more informed decisions
Tradeoffs’ reporting helped audiences apply health policy insights in their own work and decision-making.
Policymakers, health care professionals, researchers and advocates turned to Tradeoffs for trusted, nonpartisan reporting that connected policy developments to real-world consequences.
That impact was reflected in our audience survey: Ninety-two percent of respondents said Tradeoffs informed their thinking about health care or policy. Audience members described using our reporting to better support patients, understand policy tradeoffs and inform conversations and decisions in their professional roles.


IMPACT IN ACTION
Katie Abraham, a policy advisor with the Michigan Department of Health and Human Services, said Tradeoffs’ reporting helped inform her state’s work on providing Medicaid to incarcerated people before they leave jail or prison. She cited our episode breaking down how California and other states were approaching the issue as valuable in informing Michigan’s decisions around when to start coverage, how to ensure continuity of care and other implementation challenges.
“The combination of evidence-based reporting on how California structured its waiver along with the story from someone with personal experience who was impacted by not having insurance upon reentry was especially powerful.”
– Katie Abraham, MPH, Policy Advisor, Michigan Department of Health and Human Services
Awards

2025 National Edward R. Murrow Award from the Radio Television Digital News Association for “The Fifth Branch”
1st place, National Headliner Awards, Digital Conversational Podcast category for “She Didn’t Want to Die. But She Didn’t Want to Suffer”
2nd place, AHCJ Awards for Excellence in Health Care Journalism, Audio Reporting category (small newsroom division), for “One Doctor’s Quest to Improve Health Care for People with Disabilities”
3rd place, AHCJ Awards for Excellence in Health Care Journalism, Audio Reporting category (large newsroom division), for “The Fifth Branch”
Honorable mention, AHCJ Awards for Excellence in Health Care Journalism, Business category for “Race to the Bottom”
Financial Snapshot: What Our Journalism Costs
Tradeoffs is incorporated as a 501(c)3 nonprofit news organization which allows us to maintain independence in our rigorous, nonpartisan reporting. Our journalism and operating costs are paid for by individual donations, foundation grants and earned revenue — including advertising and contracted fees for speaking engagements and communications training.
Revenue

Expense

Our program services expenses reflect our reporting, producing, distribution and audience engagement, while management & general includes production, promotion and organizational operations expenses.
Financial data is preliminary and subject to revision pending completion of Tradeoffs annual audit by CBIZ, expected June of 2026.
Who Makes Our Work Possible
Your support and the generous support of the following foundations, sponsors and individual donors make critical health policy journalism possible. Whether you contribute monthly or invest annually in Tradeoffs’ work, we extend our wholehearted thanks!
Institutional Supporters
Thank you to the following partners who contracted Tradeoffs for speaking engagements and communications trainings in 2025:
- University of California San Francisco Philip R. Lee Institute for Health Policy Studies
- Tulane University School of Public Health and Tropical Medicine
- American Society of Health Economists
- Kaiser Permanente Institute for Health Policy
If you would like to make a tax-deductible gift or learn more about our trainings, please contact Eleanor Kootsey, Managing Director of Partnerships & Growth, at ekootsey@tradeoffs.org.

Financial contributions do not influence our editorial decision-making.
Board and Staff
Governing Board
Dan Gorenstein
Founder and Executive Editor, Tradeoffs
Graham Griffith
Independent Media Strategist
Stuart Kantor, Board Chair
Former Media Relations Manager, Urban Institute (Ret.)
John Sawyer
Senior Adviser, Waxman Strategies; Founder, Open Way Coaching
Melora Simon, MPH
Senior Strategist, California Health Care Foundation
Advisory Board
Katherine Baicker, PhD
Dean and the Emmett Dedmon Professor, University of Chicago Harris School of Public Policy
Amitabh Chandra, PhD
Henry and Allison McCance Professor of Business Administration, Harvard Business School; Malcolm Wiener Professor of Social Policy and Director of Health Policy Research, Harvard Kennedy School of Government
Stacie Dusetzina, PhD
Associate Professor of Health Policy, Vanderbilt University School of Medicine
Jose Figueroa, MD, MPH
Assistant Professor of Health Policy and Management, Harvard T.H. Chan School of Public Health (HSPH)
Erin Fuse Brown, JD, MPH
Catherine C. Henson Professor of Law; Director, Center for Law, Health & Society, Georgia State University
Ishani Ganguli, MD, MPH
Assistant Professor of Medicine, Harvard Medical School
Jill Horwitz, PhD, JD
Professor of Law, UCLA School of Law; Associate Director, UCLA Center for Law and Economics
Heather Klusaritz, PhD, MSW
Associate Director, Center for Community and Population Health, University of Pennsylvania Perelman School of Medicine; Director, Center for Public Health Initiatives, University of Pennsylvania
Adrianna McIntyre, PhD, MPP, MPH
Assistant Professor, Department of Health Policy and Management, Harvard T.H. Chan School of Public Health
Harold Pollack, PhD
Helen Ross Professor, University of Chicago School of Social Service Administration
Dan Polsky, PhD, MPP
Bloomberg Distinguished Professor of Health Economics, Bloomberg School of Public Health and Carey Business School
Yashaswini Singh, PhD
Assistant Professor of Health Services, Policy and Practice, Brown University
Sebastian Tello Trillo, PhD
Assistant Professor of Public Policy and Economics, Frank Batten School of Leadership and Public Policy, University of Virginia
Laura Wherry, PhD
Assistant Professor of Economics and Public Service, New York University

Members of the Tradeoffs team gather in Baltimore in April 2025. (Ryan Bowie for Tradeoffs)
Staff
Dan Gorenstein
Founder and Executive Editor
Colleen Scheck
Fractional Chief Operations Officer
Leslie Walker
Senior Producer and Reporter
Eleanor Kootsey
Managing Director of Partnerships & Growth
Kate Sepe
Operations Coordinator
Haley Lerner
Production Assistant
Ryan Levi
Managing Editor
Melanie Evans
Reporter and Producer
Julie Wernau
Reporter and Producer
Kathryn Dugal
Director of Marketing and Audience
Andrew Parrella
Producer and Sound Designer
Cedric Wilson
Production Engineer
What We’re Doing in 2026
In 2026, Tradeoffs is continuing to report on health care’s toughest choices, with the same rigor, transparency and accessibility you’ve come to value in our work. We’re going deeper on changes to Medicaid, the fallout from Trump’s “One Big Beautiful Bill,” mental health and addiction, and health care affordability.
Each week, we help decision-makers on Main Street, Wall Street and Capitol Hill understand complex health policy and use the latest research to improve care and lower costs for the people and communities they serve.
Your financial support and partnership makes this work possible.
Will you please join us again with a one-time or monthly donation for 2026?
Thank you!































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