One place you might assume is safe from prying ears is your therapy session. But as more therapists struggle to negotiate with insurers, they’re turning to tech middlemen like BetterHelp and Headway that promise to take care of the insurance admin and match them with patients. And these companies are sometimes recording and transcribing your sessions — and then turning around and sharing that data with social media companies and investors. And there are concerns that these confidential discussio...
May 21, 2026•56 min•Season 15Ep. 7
It’s a case you’ve (probably) never heard of: This week, the Supreme Court is hearing oral arguments in Hikma v. Amarin — a legal battle that could impact how much you ultimately pay for prescription drugs. Here’s why the case matters: As soon as a generic version of a brand-name drug comes to market, its price typically drops by half. Within 10 years, by more than 75%. Meaning: the sooner we have access to generics, the less we pay at the pharmacy counter. But one of the fastest legal pathways ...
Apr 27, 2026•18 min•Season 15Ep. 6
We’re always asking: Why do drugs cost so freaking much? And it’s a complicated question. There are a bunch of reasons — to be sure . But in our reporting over the years, like our stories on insulin and tuberculosis drugs , experts cited one big reason over and over again: The pharmaceutical industry wages sophisticated legal battles to keep monopoly control over their best selling, most lucrative drugs — blocking generic competition, and increasing their prices along the way. How did it come to...
Apr 09, 2026•34 min•Season 15Ep. 5
This year, the price of health insurance increased dramatically for millions of people. Tens of millions. Obamacare subsidies shrunk, and premiums skyrocketed. People asked themselves: how on earth am I supposed to make this work? Two of those folks — attorney Nicole Wipp and skate-shop owner Noah Hulsman — tell the story of how they chose among lousy options. Nicole chose to dump health insurance altogether — even though she could have found a way to pay for it. Noah chose to pay for coverage t...
Mar 19, 2026•26 min•Season 15Ep. 4
Hey, first! We’re looking for your help. Can you take a couple minutes and fill out our Audience Survey ? We’re dying to know more about the community that’s using this show — and about what’s working for you and what you’d like to see. Let us know! Today we’re switching it up. We’re sharing an episode from the new podcast Drug Story . In each episode, science journalist and self-described “public health nerd” Thomas Goetz goes deep on the story of a single drug — what it treats, how it came to ...
Feb 26, 2026•59 min•Season 15Ep. 3
Thirty-six hours before his wife was scheduled for a major surgery, New York Times personal finance columnist Ron Lieber got a letter in the mail that sent him reeling. Insurance was denying prior authorization for the surgery. The only way forward would be to appeal the decision. But it was Saturday night, and the surgery was Monday morning. There wouldn’t be any time. Should they even go to the hospital? They decided to bet on being able to reverse the denial later on, but the last minute cove...
Feb 05, 2026•29 min•Season 15Ep. 2
For five years, we’ve been following the work of Dollar For and its founder Jared Walker, watching them quickly scale up their efforts to help people crush medical debt by tapping into “charity care” — the financial assistance that hospitals are legally required to offer some patients. Their work represents what a small, scrappy, thoughtful group of people can do. Last year, their tiny staff helped wipe out more than $55 million in medical bills. As we kick off 2026, we thought it was time to ch...
Jan 15, 2026•26 min•Season 15Ep. 1
Hey, first! If you value what we do, we need your support to keep it going in 2026. We have SO much work ahead, and we can’t do it without you. Every little bit counts. Here’s where you can chip in. Thank you SO much! Our listeners have been teaming up on an incredible project – kicked off earlier this year by a med student named Thomas Sanford. The idea: create a list of reliable resources to help with medical expenses and avoid debt, and circulate it where people might find it useful, like hos...
Dec 29, 2025•15 min•Season 14Ep. 7
Hey, first! If you value what we do, this is the best-ever time to support our work . We have SO much work ahead in 2026. Donate here . We’re back for another look at things that – believe it or not – did NOT suck in 2025. Specifically: new state laws from around the country aimed at protecting people from things like medical debt, insurance delays and denials, and corporate profiteering. In this episode, we dive into two examples from opposite sides of the country to look at how laws like these...
Dec 11, 2025•32 min•Season 14Ep. 6
Hey, first! If you value what we do, this is the best-ever time to support our work : This month, every donation gets matched two-for-one. We have SO much work ahead in 2026. Donate here — and get your money matched two-for-one. It’s probably fair to say: this is the worst year ever for picking health insurance. Premiums are skyrocketing – whether you get insurance through work or from the Obamacare marketplace. And with enhanced subsidies almost definitely expiring, millions of people with Obam...
Nov 20, 2025•30 min•Season 14Ep. 5
Hey, first! If you value what we do, this is the best-ever time to support our work : This month, every donation gets matched two-for-one . We have SO much work ahead in 2026. Head to https://armandalegshow.com/support/ to donate — and get your money matched two-for-one. This statement might shock you: some actual good things happened in 2025. Or, at least things that did not totally suck. Stuff like: new limits on the hoops insurance companies can make you jump through, and new protections from...
Nov 06, 2025•24 min•Season 14Ep. 4
Economist Vivian Ho has been researching the US health care system for four decades. These days she focuses on what she describes as the biggest burden on the average American: runaway hospital prices and rising health insurance premiums. (You know, Arm and a Leg stuff.) And she’s developed a strategy for addressing high insurance premiums – one based on a real-life success story. So when she asked us to help her gather data for a new study, we were intrigued. We break down Vivian’s theory of ch...
Oct 23, 2025•20 min•Season 14Ep. 3
A listener named Thomas Sanford wrote to us earlier this year, asking for help with a little DIY project. And it’s turned into the most encouraging thing we’ve seen all year. With input from the Arm and a Leg community — specifically folks who get our First Aid Kit newsletter — Thomas has drafted a one-page handout, packed with resources for anyone who needs help with medical bills. It’s ready for you to use, and he wants your help making it better. You’ll hear all about Thomas’s story — he’s a ...
Oct 09, 2025•11 min•Season 14Ep. 2
For the first time, our senior producer, Emily, has to sign up for Obamacare. And it turns out, it’s one heck of a year to do that. A recent headline from KFF Health News reads: “ Insurers and customers brace for double whammy to Obamacare premiums .” We break down what those “whammies” might mean in dollars and cents for Emily and the millions of others signing up for Obamacare in 2026. Plus, we cover what’s happening with ACA navigators – the people charged with helping you sign up for Obamaca...
Sep 18, 2025•29 min•Season 14Ep. 1
Hey first! We need your help: Financial help. Donations from listeners power this show, and we’ve got a goal: 100 people making their first-ever gift, this week. If you haven’t chipped in before, this is a great time — just click here . OK, onwards… Sharing a favorite from our archive – with lessons that are as relevant as ever. Laurie Todd calls herself The Insurance Warrior. She fights health insurance for a living. Her speciality: writing appeals when insurance companies deny high-stakes, hig...
Aug 28, 2025•24 min•Season 13Ep. 13
When a New York couple purchased a health insurance plan from a telemarketer, everything sounded legit. Meds, doctors, tests? All covered. But it didn't take long for them to realize they'd been “hustled” – ending up with bills for thousands of dollars, and leaving them no choice but to skip important medical care. In their series “Health Care Hustlers,” Bloomberg reporters Zach Mider and Zeke Faux uncover the exact nature of the scheme – how this couple, as well as thousands of others, signed u...
Aug 07, 2025•30 min•Season 13Ep. 12
As a follow-up to our series The Prescription Drug Playbook — all about how you can get the meds you need at a price you can (maybe) afford — we’re stepping back to look at the big picture. From the start of this podcast, we’ve been trying to answer a major question: Why do my meds cost so freaking much? And we’ve highlighted the profit-seeking games that insurance , pharma , and middlemen play all around us in more than a half dozen episodes. But there’s one set of players on the field that we’...
Jul 18, 2025•39 min•Season 13Ep. 11
In February, we asked you, our listeners, to share the tips, tricks, and tactics you’ve learned for getting the medicine you need at prices you can manage. And of course some of you work in health care and have insider knowledge. Which we’re passing along in this second episode of The Prescription Drug Playbook. We’ll hear from a listener who works to help seniors find healthcare, a pharma sales rep, an employee benefits advisor, and a battle-worn hospital caseworker – all bringing something a l...
Jun 30, 2025•28 min•Season 13Ep. 10
Too many of us get sticker shock when we go to pick up our meds. We asked our listeners how they get by in this situation, and we learned dozens of tips. And in this two-part series, we’re sharing those strategies — including some advice from experts. The next episode drops June 30. See omnystudio.com/listener for privacy information.
Jun 24, 2025•1 min
In surveys, one in four Americans report having to skip their medications due to cost. We asked our listeners: what strategies have you used when you’ve been hit with pharmacy sticker shock? We heard from a ton of you – with stories, strategies and workarounds that surprised and encouraged us. None of them will work for everybody. This is a set of patches and bandaids for a broken system. But if there’s one that’ll work for you, we want to help you find it. So we’re bringing you the most-complet...
Jun 12, 2025•26 min•Season 13Ep. 9
What do the KGB and the former CEO of Cincinnati Children's Hospital have in common? At different times, they’ve each looked to a guy named Eugene Litvak for help. He only said yes to Cincinnati — but he saved that hospital more than a hundred million dollars a year. For the last few decades, Litvak – a Soviet émigré with a PhD in math – has been on a mission: save U.S. hospitals from financial ruin, and improve the lives of doctors, nurses, and patients. He says he has just the formula to do it...
May 22, 2025•32 min•Season 13Ep. 8
With news blasting from Washington like a firehose, it feels impossible to take it all in — to stay on top of all the changes the Trump administration has been trying to make. But for health care, one person is probably closer to anyone than to understanding the full picture: KFF Heath News Chief Washington Correspondent Julie Rover. In this episode, Julie helps us see that picture, by telling us two stories: The first concerns a teeny part of the health care system — an obscure federal agency, ...
May 01, 2025•26 min•Season 13Ep. 7
People who work in real-life emergency rooms have raved about how accurately the new drama The Pitt (Max) captures the dynamics and the medical details of their workplaces. Here at An Arm and a Leg , we’ve been nerding out about how the show depicts the financial forces that shape the ER’s day-to-day problems like crowding, eternal wait times, and scary bills. For this episode, we got Dr. Alex Janke, an emergency medicine doctor and health policy researcher to nerd out with us. Here’s a transcri...
Apr 10, 2025•23 min•Season 13Ep. 6
A few months ago, we got a note from a listener named Meagan, who wanted to thank us. She said the stories she heard on this show had given her the advice and encouragement she needed to finally win a fight against a medical bill she didn’t owe — a battle she’d been waging for more than two years. As Meagan tells us, those two years were filled with wild twists and turns and a lot of disappointment. We hear what kept her motivated and encouraged despite all the setbacks – and after an insurance ...
Mar 20, 2025•24 min•Season 13Ep. 5
A federal agency called the Consumer Financial Protection Bureau — CFPB for short — has taken big steps to help people with medical debt. In early February, the Trump administration moved to effectively shutter the agency. We talked with credit counselor Lara Ceccarelli about how the CFPB has helped clients at the nonprofit where she works, and how she’s navigating the sudden change. And consumer-rights advocate Chi Chi Wu — an attorney with the National Consumer Law Center — describes the court...
Feb 27, 2025•20 min•Season 13Ep. 4
Hey – real quick: some big news from the team at An Arm and a Leg . Our First Aid Kit newsletter is going weekly! First Aid Kit brings you advice from our show and more on how to survive and navigate America’s health care system. And allow us to introduce First Aid Kit’s new writer, Claire Davenport. When she was our intern last summer, she reviewed An Arm and a Leg’s entire catalog of episodes, and took notes along the way. Now she’s bringing the practical lessons from all that reporting straig...
Feb 24, 2025•5 min•Season 13Ep. 3
We’re kicking off a new reporting project about how much we pay for our medicine — and what we can maybe do about it — and we want to hear your stories. Because: Getting a case of sticker shock with a prescription happens all the time. So we’re asking: What have you done — or tried to do — to get the medicines you need at prices you can afford? And what did you learn that might be useful for other people to know? Maybe you learned a strategy that actually WORKED for you. Like using a coupon or o...
Feb 03, 2025•10 min•Season 13Ep. 2
You remember a guy named Martin Shkreli? If his name rings a bell, it’s probably because back in 2015, he jacked up the price of an old drug — from around $13 a pill to $750. The media dubbed him “the pharma bro,” and he became a symbol of brazen pharmaceutical greed. Now, he’s the namesake for the Shkreli Awards — a kind of Oscars for the most outrageous examples of greed, fraud, and general brokenness in American health care. Every year, a health care think tank called the Lown Institute ranks...
Jan 16, 2025•25 min•Season 13Ep. 1
An Arm and a Leg is a show about why health care costs so freaking much, and what we can (maybe) do about it. New episodes every three weeks. See omnystudio.com/listener for privacy information.
Jan 06, 2025•57 sec
A few weeks ago, a listener sent us a note with a link to a news article about a new resolution that had recently been adopted by the American Medical Association – the largest group representing doctors in the US. The resolution said: hospitals need to do more to guarantee charity care to patients who qualify. Legislators and regulators should make them. Our listener was the author of that resolution, and he told us he first learned about charity care through this podcast. His name is Joey Ball...
Dec 30, 2024•12 min•Season 12Ep. 10
