The Find Out Podcast
Episode: How Trump is Destroying Medicare and Medicaid
Date: September 30, 2025
Host: Find Out Podcast Team
Guest: Chiquita Brooks-LaSure – former CMS Administrator under Biden
Episode Overview
This episode delivers a candid, unfiltered discussion about the sweeping changes to Medicare and Medicaid under Trump’s second term, centering on the so-called "Big Bullshit Bill" (BBB). The hosts are joined by Chiquita Brooks-LaSure, ex-Administrator for the Centers for Medicare and Medicaid Services (CMS), who brings both technical expertise and personal insight. Together, they unpack the massive trillion-dollar cuts, new bureaucratic hurdles, organizational chaos, and ideological motives behind gutting federal health programs. The conversation ranges from policy explanation to pointed analysis about the societal and political stakes, ending with pragmatic suggestions on what individuals can do in this fraught moment.
Key Themes & Discussion Points
1. The Scope and Impact of $1 Trillion Medicaid Cuts
- [00:53-03:01]
- Brooks-LaSure emphasizes just how “impossible to overstate” the consequences are; Medicaid isn’t just for the poorest – it’s a “lifeline for so many families,” including half of all births and much middle-class long-term care.
- Quote:
“Half of the births in this country are paid for by Medicaid... It has served as a lifeline for so many families that depend on this coverage to make sure their children get the care that they need.”
(Chiquita Brooks-LaSure, 01:25)
- New requirements meant to “add more friction” and make eligibility harder—contrary to modernization efforts.
2. Bureaucratic Barriers and the Intent to “Kick People Off”
- [03:01-07:13]
- Paperwork complications are not trivial for lower-income Americans with fluctuating jobs and life circumstances.
- Additional requirements create confusion and drop-offs, especially with frequent eligibility re-verification and work mandates.
- Quote:
“Even we found that we lost people just because the paperwork didn’t get submitted correctly... This bill adds so many requirements... not just work requirements. You have to go through eligibility more frequently.”
(Chiquita Brooks-LaSure, 03:47) - Host questions if these are deliberate:
“It sounds like they’re doing this just specifically to make sure they can kick as many people off Medicaid as possible. Is that generally, like why it seems like they have put these additional requirements in?"
(Host 1, 05:55) - Brooks-LaSure agrees:
“The only explanation that makes sense is... You don’t want people on coverage.”
(Chiquita Brooks-LaSure, 06:27)
3. Ideology, Starve-the-Beast, and Privatization
- [07:13-10:01]
- Host 2 references Reagan’s “starve the beast” and notes the current GOP approach feels less about efficiency, more about sabotage.
- The result: drastically reduced government capacity, increased red tape, and a shift to privatization, particularly alarming for veterans.
- Quote:
“They're actually trying to make it so bad that everybody looks around and they say, ‘Well, the government is bad at everything’... and so then they're forced to go through, you know, some for-profit, private sector route.”
(Host 2, 08:28) - VA impact: 30,000 employees ousted, veteran care privatized and complicated (Host 3, 10:01)
4. Institutional Chaos and Demoralization
- [11:01-14:13]
- Widespread, arbitrary federal workforce cuts; loss of expertise at CMS, HHS, VA.
- Quote:
“The haphazard way that people have been let go has been so devastating and demoralizing to the people that have stayed.”
(Chiquita Brooks-LaSure, 11:08) - Brooks-LaSure distinguishes between philosophical disagreements at CMS and outright “assault on science” at HHS and other agencies.
5. Leadership Crisis—Dr. Oz at CMS, RFK Jr. at HHS
- [13:02-17:04]
- Host 1 lampoons current CMS head Dr. Oz:
“A man who has made... between 100, $300 million peddling... false cures for things...” (Host 1, 13:04)
- Brooks-LaSure: More distress at HHS due to anti-science leadership; recounts stories illustrating traumatic consequences for women and families seeking care—especially with reproductive or pregnancy complications.
- Quote:
“My heart hurts for people who are trying to make good decisions and they can’t trust the science that’s coming out of the federal government.”
(Chiquita Brooks-LaSure, 16:27)
- Host 1 lampoons current CMS head Dr. Oz:
6. Work Requirements—False Premises and Administrative Waste
- [17:04-23:00]
- Host-driven exploration of work requirements as political theater rather than genuine reform.
- Brooks-LaSure:
“Georgia implemented work requirements... they spent more money administering their work requirements than they did actually for the people giving them health care. What a colossal waste of money.”
(Chiquita Brooks-LaSure, 19:20) - She draws on personal and professional anecdotes, emphasizing how people lose coverage at their most vulnerable moments ("two months postpartum," "a single man with disability and mental illness"), undermining the goal of making people healthier.
7. Systemic Distrust and Societal Impact
- [23:00-25:51]
- The GOP standpoint: assumed abuse of government by marginalized groups, default to punitive measures.
- Brooks-LaSure strikes back with classic analogy:
“Sort of like the equivalent of saying, well, we shouldn’t give a tax cut because there’s some people who cheat on their taxes. We don’t do that to the higher income people.”
(Chiquita Brooks-LaSure, 24:27) - The economy and healthcare system are deeply interlinked; hurting healthcare destabilizes hospitals and entire communities.
8. Real-World Consequences: Hospital Closures & Rural America
- [25:51-29:19]
- Reductions in Medicaid mean more ER visits, more uncompensated care, risk of rural hospital collapse, and the specter of Americans traveling hours for routine or emergency care.
- Brooks-LaSure:
“It is the rural hospitals that are really already on the edge in our country... we've already started to hear of hospitals closing their labor and delivery services, not planning expansions and talking about closing altogether...”
(Chiquita Brooks-LaSure, 28:17)
9. What Can Listeners Do?
- [29:19-31:07]
- Short-term: Pressure Congress to extend ACA subsidies and roll back administrative changes.
- Long-term: Medicaid cuts won’t fully hit until 2028; midterm elections will be crucial.
- Quote:
“Educating and pushing your members of Congress to overturn these provisions... there is still time...”
(Chiquita Brooks-LaSure, 30:19)
10. Government Shutdowns—Immediate Risks
- [31:07-33:38]
- If a shutdown happens, services like Medicare & Medicaid processing can halt; federal workers won’t be on the job, risking delayed payments and support.
- For a few days, no big impact. Drawn out, it becomes a crisis.
- Quote:
“The people who solve your problems are paid for by the government and then on Medicaid... staff that work with the states... aren’t going to be able to make sure we keep going.”
(Chiquita Brooks-LaSure, 32:43)
Notable Quotes & Memorable Moments
-
On the intent behind the cuts:
“You threw out rules to make this process simpler. You don’t want it to be simpler. You don’t want people on coverage.”
(Chiquita Brooks-LaSure, 06:27) -
On anti-government posturing:
“They are actually trying to make it so bad that everybody looks around and they say, ‘Well, the government is bad at everything’... and so then they're forced to go through some for-profit, private sector route.”
(Host 2, 08:28) -
On new leadership at CMS and HHS:
“If I’m a pregnant woman in America, I am just devastated... you are trying so hard to do all the right things by your child... you can’t trust the science that’s coming out of the federal government.”
(Chiquita Brooks-LaSure, 15:17 & 16:27) -
On work requirement inefficiencies:
“Georgia implemented work requirements... they spent more money administering their work requirements than they did actually for the people giving them health care.”
(Chiquita Brooks-LaSure, 19:20) -
On societal consequences:
“You could even only care about yourself and you should care that we have cut a trillion dollars... because we are linked, for better, for worse to each other when it comes to health care...”
(Chiquita Brooks-LaSure, 24:56) -
On real-world impact:
“It is the rural hospitals that are really already on the edge in our country... we've already started to hear of hospitals closing their labor and delivery services, not planning expansions and talking about closing altogether...”
(Chiquita Brooks-LaSure, 28:17)
Timestamps for Key Segments
- [00:51] - Chiquita Brooks-LaSure introduction
- [01:18] - Scale of Medicaid cuts explained
- [03:31] - Paperwork hurdles and administration
- [06:27] - Intent behind new requirements
- [08:28] - “Starve the beast” and privatization analysis
- [10:01] - VA cuts and impact on veterans
- [11:01] - Chaos and demoralization in federal agencies
- [13:02] - Dr. Oz and RFK Jr. as agency heads
- [17:04] - Work requirements—debunking the narrative
- [24:27] - Societal links and negative effects on everyone
- [28:17] - Hospital closures, especially rural
- [29:49] - What listeners can do now
- [31:56] - Effects of a government shutdown on Medicare/Medicaid
- [39:48-45:54] - Congressional strategy, shutdown blame game, and political implications
Overall Tone
Frank, acerbic, passionate, and deeply informed—with heavy doses of dark humor and personal storytelling, especially from Brooks-LaSure. The hosts mix irreverence, policy depth, and direct calls for action.
Actionable Takeaways
- Contact your representatives: Demand reversal of Medicaid administrative changes, push for ACA subsidy extensions.
- Stay informed: The cuts and requirements phase in over years—midterms matter.
- Narrative matters: Hosts urge leaders to demand clear compromises in public (e.g., partial Medicaid funding restored for a deal).
- Be aware: Hospital access, especially in rural areas, is at immediate risk due to these policies.
- Support the podcast: (Note: Final segment is about merch and supporting the show, not summarized in depth.)
For Listeners Who Missed the Episode
This episode provides a comprehensive, often biting insider’s analysis of how Trump’s second-term policies are systematically eroding Medicaid and Medicare. It connects policy details to everyday realities, exposes the ideological motives at play, and offers a roadmap for resistance, while never losing the show’s trademark humor and candor.