BiggerPockets Money Podcast

Episode: "Financial Independence Through the Unthinkable: A Healthcare Crisis"

Date: December 12, 2025
Guest: Regina Moore (Co-founder, Women’s Personal Finance)
Hosts: Mindy Jensen & Scott Trench

Episode Overview

This episode dives deep into the realities of pursuing FI/RE (Financial Independence, Retire Early) in the face of a catastrophic personal crisis—a child's cancer diagnosis. Regina Moore, a pharmacist and early FI/RE achiever, shares how her plans were derailed by her son's illness and how the nuances of healthcare coverage and subsidy cliffs have shaped her financial decisions. The conversation explores the intersection of personal finance, the “subsidy cliff” for healthcare, and the political and philosophical debates at the heart of the U.S. healthcare system—all against the backdrop of a very personal, high-stakes journey.

Key Discussion Points & Insights

Regina’s Path to FI/RE: Early Success & Savvy Moves

• Journey Begins

  • Regina’s interest in FI/RE sparked immediately after pharmacy school, starting with Dave Ramsey’s book but quickly gravitating to more in-depth blogs like Mr. Money Mustache ([01:34]).
  • Graduated pharmacy school at 23, with only $30K in loans thanks to parental help and scholarships ([02:58]).

• Early High Income

  • First full year as a pharmacist: earned ~$180,000 ([02:58]).
  • Prioritized paying off debts, bought a used car, then funneled savings into a house purchase ([02:58]).

• Home Ownership

  • Purchased a home in a new state (2013), putting 50% down, and paid it off within two years ([02:58]).
  • Peace of mind was more important than mathematical optimization—a choice that proved reassuring during ensuing turmoil ([08:55], [10:54]).

• Investing Basics

  • Consistently maxed out employer retirement accounts, utilized HSAs, and later moved investments primarily into VTSAX and VTI index funds ([13:55]).

  Quote:
  "Once the house was paid off, I realized that I needed to kind of step it up. And that's when I started to read a lot more personal finance content…"
  — Regina ([02:58])

The Unthinkable: Child’s Cancer Diagnosis

• Crisis Strikes

  • In December 2018, Regina’s son was diagnosed with cancer at age two ([20:07]).
  • Immediate reaction: assumed FI/RE dream was over due to expected “financial toxicity” ([20:20]).

• Adapting to ‘Lean FI’

  • Shut down all non-essential spending; lived mostly at Ronald McDonald House; continued pharmacist part-time, 1-4 days/month ([20:20]).
  • Net worth at diagnosis (excluding home): around $400K ([20:20]).

  Quote:
  "You hear so much about financial toxicity with major medical issues… I just assumed, if he survives, I'm sure this is going to drain us and we'll be starting over from square one."
  — Regina ([20:20])

• Outcome

  • Markets improved, frugality helped, able to avoid financial ruin despite drastically reduced work and high medical expenses ([20:20]).

Navigating the Healthcare Labyrinth

• Insurance & Out-of-Pocket Costs

  • Initially had a high-deductible HSA plan; out-of-pocket max $12,000/year, quickly reached due to cancer care ([23:40]).
  • By mid-2019, son qualified for CHIP (Children’s Medicaid) due to low AGI from reduced work ([23:40], [25:19]).

• CHIP/Medicaid Eligibility

  • AGI threshold (family of 3): ~$70K/year for CHIP; $50K/year for Oregon expanded Medicaid ([25:19], [36:45]).
  • Adjusted AGI via IRA conversions to remain under limits, ensuring ongoing eligibility ([36:45]).

  Quote:
  "I have to be really, really thoughtful about if increasing my income is actually paying off for my family, because we'll hit that subsidy cliff and potentially be out 15 to 20,000 minimal…"
  — Regina ([32:40])

• Healthcare Subsidy Cliff

  • Described the “cliff” effect: earning even slightly too much could immediately disqualify her family from affordable coverage, resulting in $15,000–$20,000/year extra in premiums and out-of-pocket costs ([35:54], [36:45], [39:22]).

  Scott’s Recap:
  “You might come out worse off by working 40-50 hours a week across a year at your highly paid profession than by just staying at home and not doing that. That's the effect of this cliff situation in the healthcare system… Is this the correct way to frame the situation? Am I doing right my rant here, Regina?”
  — Scott ([40:24])

• Work Disincentives

  • Regina explains how broken incentives force her (a highly trained pharmacist) to reject shifts and keep realized income low to avoid catastrophic healthcare costs ([36:45], [39:22]).
  • She balances financial impact with non-monetary costs, like lost time with family ([41:39]).

Ethics, Policy, and the FIRE Community

• Fairness and Criticism

  • Hosts anticipate criticism: is it “right” for a net-worth millionaire to use social benefits?

  • Regina’s response:

    • She’s using systems as designed (and paid into them via high taxes as a worker).
    • Proposes a preference for universal healthcare, even if it means paying higher taxes later ([44:13]).

    Quote:
    "I am using [these programs] fully as they’re designed... I am not opposed to paying more taxes on what I do earn so that more people, myself included, have access to more affordable health care."
    — Regina ([44:13])

• Political and Structural Debate

  • Both hosts acknowledge the complex, highly politicized nature of healthcare coverage in America ([47:06], [51:16]).
  • They strive to present both sides:
    • Healthcare as a right versus personal responsibility.
    • Implications for FI/RE planners and the unique options (e.g., controlling income to qualify for benefits) available in this community ([51:16]).

• Community Reflections

  • Urge FI/RE planners to bake in more conservative assumptions about future healthcare costs; discuss alternative options (medical tourism, health-shares) but stress the need for catastrophic coverage ([53:32], [54:03]).

  Memorable Final Moment ([55:28]):

  • Scott & Mindy, wryly, decline to give out their emails for this highly charged debate, welcoming only respectful, non-extreme feedback.

Timestamps for Important Segments

• Regina’s FI/RE Journey & Methods: [01:34] – [16:47]
• Paying Off the House/Philosophy: [08:55] – [10:54]
• Investing Choices & Progress to $1M Net Worth: [13:55]
• Crisis: Son’s Cancer Diagnosis and FI Impact: [20:07] – [23:34]
• Transition to CHIP/Medicaid & Navigating Eligibility: [23:40] – [26:35]
• Treatment Timeline and Financial Implications: [26:35] – [32:40]
• Healthcare Subsidy Cliff Discussion: [32:40] – [41:39]
• Policy & Ethics Discussion; System Critique: [44:13] – [48:24]
• Implications for FI/RE Community & Wrap-Up: [51:16] – [56:08]

Notable Quotes

• “If you have a hope of retiring early, if healthcare spending for individuals and families doesn't change very soon with some sort of major healthcare reform, it's making it feel less and less achievable and accessible.”
  — Regina ([32:40])

• "You can't know what the future is going to look like. And... I didn't have to worry about liquidating money... to keep paying the mortgage while we went through that process. So the math says it's not ideal. Um, but it... really did work out for peace of mind for me and my family."
  — Regina ([08:55])

• “This is so dumb what you just said here about the system.... You might even come out worse off by working 40 to 50 hours a week across a year at your highly paid profession than by just staying at home and not doing that. That's the effect of this cliff situation.”
  — Scott ([39:22])

• "I think it's a really tough situation... The challenge for the FIRE community will be thinking, planning around that. What are healthcare costs going to look like...once you hit early retirement and have the option to control your income?"
  — Scott ([51:16])

Tone & Takeaways

The episode is candid, deeply empathetic, and at times blunt—mirroring the emotional highs and lows of Regina’s journey and the hosts’ honest grappling with the system’s flaws. The story personalizes thorny, highly political issues for real-life FI/RE planners but avoids caricature or blame, instead calling for nuanced, respectful debate.

Where to Find Regina & Women’s Personal Finance

• Main site and social links: womenspersonalfinance.org/socials
• Active on Threads, Instagram, Facebook, TikTok.
• Weekly newsletter available via website ([49:19]).

Summary:
Regina Moore’s story is a must-listen for anyone serious about early retirement and financial independence, especially families. Her experience puts a human face on the abstract problems of “subsidy cliffs” and healthcare costs in the U.S., challenging conventional wisdom and forcing listeners to confront uncomfortable but vital policy questions.