Two pivotal moments shaped American healthcare: the creation of Medicaid in 1965 and the signing of the Affordable Care Act in 2010. While the ACA slashed the uninsured rate by nearly half, the system remains fragile. In this episode “Insuring America’s Poor”, George Washington University Professor Sara Rosenbaum—a key architect of Medicaid expansion, including the Children’s Health Insurance Program (CHIP,) and the Vaccines for Children program—reflects on her career and issues a stark warning. She joins me to discuss the catastrophic implications of the One Big Beautiful Bill Act of 2025 and how it threatens to destabilize healthcare for millions of millions of middle- and low-income Americans.

