Tradeoffs

Every year, millions of people’s medical care runs into the roadblock known as prior authorization.

Who does this often onerous process help, who does it hurt and how could it work better for everyone?

A Closer Look at a Widely Despised Health Insurance Policy Every year, millions of people’s medical care runs into the roadblock known as prior authorization, which requires a patient’s health insurer to sign off before chemotherapy, surgery or countless other services can proceed. Who does this often onerous process help, who does it hurt and how could...

With Republicans in control of Washington and health costs on the rise, there’s new momentum behind an old conservative policy: Put more cash in patients’ hands and let them buy their own health care.

“The more connected you are to what you're spending, the more likely you are to care about the cost and the price and the value that you're getting,” said Avik Roy, who has advised multiple Republican presidential candidates on health policy.

Republican lawmakers are pushing all sorts of policies built around this idea: HSAs, HFAs, ICHRAs. It’s a supersized serving of acronyms — all designed to give patients more tools and incentives to shop around for their care.

In this week’s episode, we highlight two of the policies getting the most buzz right now and break down the pros, the cons and the evidence behind these ideas. Give it a read or a listen: https://tradeoffs.org/2026/05/21/republicans-want-to-change-how-you-buy-health-care/