Kyla Scanlon, New York Times bestselling author and economic commentator, and Vox today announced the launch of Best of Luck, a new weekly video interview podcast premiering October 27. Each week, Scanlon will sit down with guests who have something to teach us about how to build a meaningful career in this uncertain moment, from economists to journalists, farmers to comedians. They’ll share their most instructive detours, setbacks, and successes, and Scanlon will tie each story back to the economy that we’re all living in, with takeaways for anyone at any stage of their working life.
“So much of the advice we are given about building a career still comes from an economy that doesn’t really exist anymore,” Scanlon said. “There is no one right way to build a career, especially now. The goal of this show is to ask guests how they actually did it, across the best parts, the worst parts, and the parts that were lucky. Then we put it to work! Every guest sits for a mock job interview and does an advice autopsy, and we talk about how you build your own luck. Hearing how other people found their path can help all of us make better decisions about our own.”
Named to the Time 100’s Creators list and Barron’s 100 Most Influential Women in Finance, Scanlon has emerged as one of the most distinct voices making economics make sense for everyone, especially a new generation. Known for breaking down complex economic ideas and connecting them to the realities of everyday life, she coined the term “vibecession” to describe the disconnect between economic data and how people actually feel about the economy. She is the author of the New York Times bestseller In This Economy? How Money & Markets Really Work, a CNN contributor and analyst, and a monthly New York Times Opinion contributor.
“At Vox, we have long been fans of Kyla’s work — her approach to explaining the economy in an accessible, approachable way really personifies Vox’s explanatory approach,” said Swati Sharma, editor-in-chief and publisher at Vox. “With this new show, we’re thrilled for her to help our audience understand how to navigate work and careers in this economy so they can live more meaningful lives.”
“Kyla has a gift for translating the big, confusing picture of our economy into what it means for each of us,” said Lillian Xu, vice president of podcast business at Vox Media. “With Best of Luck, she’s doing the same for a job market that keeps changing the rules, in conversations with experts that are practical and honest about how careers really unfold today. We’re so excited to partner with her to help more people figure out what’s next.”
The trailer for Best of Luck is out today, with the first episode coming on October 27 and new episodes following weekly on Tuesdays.
At Vox, Best of Luck joins a stable of popular podcasts including Today, Explained, The Gray Area, and America, Actually. Vox’s shows are part of the Vox Media Podcast Network, one of the largest US podcast publishers and home to some of the most influential talent across categories, including journalist Kara Swisher and entrepreneur Scott Galloway (hosts of Pivot), tennis champion Maria Sharapova (host of Pretty Tough), former Manhattan US Attorney Preet Bharara (host of Stay Tuned), basketball legend Sue Bird (host of Bird’s Eye View), and more. Vox Media will oversee production, sales, marketing, and distribution for Best of Luck, which joins a dynamic slate of shows that shape conversations across business, culture, and beyond.
Kyla Scanlon is the founder of Kyla Labs. She writes about money, markets, and the systems that shape them for an audience of over 1 million people across TikTok, Instagram, Substack, and YouTube, covering the pressing issues of the day — including tariffs, artificial intelligence, energy markets, and why the traditional rungs of the economic ladder have gotten harder to climb. Her debut book, In This Economy? How Money & Markets Really Work, was a New York Times bestseller and used hand-drawn diagrams to make the machinery of the economy clear. In her newsletter, she coined the term “vibecession” to describe the disconnect between strong economic data and negative public sentiment — a concept since referenced by Treasury Secretary Scott Bessent and taken up in research by former CEA chair Jared Bernstein.
Raised in Kentucky, Scanlon studied finance, economics, and data analytics at Western Kentucky University. She started out trading options and selling cars, where she first saw how inaccessible finance had become to the people it affected most. She began making whiteboard videos and comedy skits to decode markets and economic trends for everyday audiences (and often dressed up as Jerome Powell). She writes monthly for New York Times Opinion, has a video partnership with Foreign Policy, and is a contributor and analyst at CNN. She is also a senior fellow at the Vanderbilt Policy Accelerator and a research fellow at the American Institute for Boys and Men. Scanlon was named to Barron’s 100 Most Influential Women in US Finance and the Time 100 Creators list, and has appeared on The Daily Show with Jon Stewart and The Ezra Klein Show. At work on her second book, she lives in the mountains with her dog, Piglet.
About Vox
Vox was launched in 2014 to address the disconnect between the widely reported facts of the day and a true understanding of why something happened. It developed a widely imitated explainer format that delivers understanding across digital platforms, newsletters, a YouTube channel with nearly 13 million subscribers, and a stable of podcasts. Under the leadership of Editor-in-Chief Swati Sharma, Vox has grown a membership programs with tens of thousands of paying subscribers.
About the Vox Media Podcast Network
The Vox Media Podcast Network is one of the largest US podcast publishers and home to some of the most popular and influential shows. Reaching a monthly audience of tens of millions across audio, video, and social platforms, its podcasts spark conversations, frame issues, and define the popular zeitgeist across politics, technology, business, sports, entertainment, and more. Learn more at podcasts.voxmedia.com.
USDA workers disinfected a work crew at a Jennie-O turkey farm in Eden Valley, Minnesota, during the 2015 bird flu outbreak. | Glen Stubbe/Star Tribune via Getty Images
If egg prices surge this winter, one of the main drivers will likely be H5N1, or bird flu.
Since 2022, it’s decimated the US poultry industry, resulting in the deaths of over 160 million egg-laying hens.
And when there are fewer hens, there are fewer eggs, which leads to shortages and price hikes. This happened in early 2023 when avian flu was circulating: Egg prices increased by 65 percent compared to a few months prior, and in 2025, it happened again, reaching a national average of more than $6 per dozen. (There’s also some evidence, per a Justice Department investigation, that suggests major egg companies may have colluded to raise prices, too.)
We have the tools to slow the spread of highly pathogenic avian influenza (HPAI) without such high mortality, though; the United States has several effective bird flu vaccines, and egg (and turkey) producers want to use them on their birds.
Last year, it seemed like they soon might be able to. In early 2025, the Trump administration announced that it would begin formulating a plan for potential vaccination by engaging with trade partners, state veterinarians, farmers, and other stakeholders. But according to reporting in Politico last week, that plan is now stalled. Why? Health and Human Services Secretary Robert F. Kennedy Jr. and his anti-vaccine agenda appear partly to blame.
US Department of Agriculture Secretary Brooke Rollins “pulled back on an internal USDA strategy for vaccinating poultry and egg-laying hens,” according to Politico, because she was “concerned about whether it would clash with [RFK Jr.’s] anti-vaccine views.” The pause, according to the story, “went against the counsel of expert agency staff.”
The USDA didn’t respond to detailed questions for this story. “USDA has been fully committed to providing the most robust response to battling HPAI,” a spokesperson wrote over email.
Kennedy oversees the Food and Drug Administration, which has some jurisdiction over what happens on farms, though the USDA manages disease outbreaks. But he and his “Make America Healthy Again” movement apparently have enough political influence to sway how the agriculture department manages this multiyear outbreak — the largest in US history. It is risky for the birds, and consumers, and could mean that we’re going to continue to fight this devastating disease without perhaps the most effective tool to slow it down.
Why we don’t vaccinate poultry birds
Just as influenza circulates in humans, H5N1 is also largely seasonal; around this time of year as ducks and geese migrate south for the winter, they shed the virus near farms. And once it infects one bird in a packed poultry barn, it quickly tears through the flock.
When birds die from the bird flu, it’s an excruciating death. However, most birds don’t die from the disease itself but rather from efforts to stop its spread. Per federal regulations, as soon as H5N1 is detected in a barn, poultry producers must cull every bird, and that culling is brutal. The predominant method entails producers sealing off the vents, which causes temperatures to rise and slowly subject the birds to death via heatstroke.
Many turkey and egg producers do want to vaccinate their birds (tens of millions of turkeys have also died due to H5N1 and resulting culling since 2022), and there are several vaccines that the USDA has deemed safe and effective. But the agency won’t allow egg and turkey producers to use them because doing so could hurt the chicken meat industry.
Chickens raised for meat, known as broiler chickens, are much less likely to become infected with the virus, and the US industry exports 13.9 percent of what it produces, valued at $6.2 billion last year. And as I wrote last year:
Most of the countries that import American chicken meat would pause those imports if any farmed birds in the US are vaccinated, even if no chickens raised for meat are vaccinated. The reason behind these blanket bans stems from importing countries’ concerns around the so-called “DIVA” problem, which is short for “differentiating infected from vaccinated animals.” It represents the challenge of identifying whether a poultry bird is infected with bird flu or simply has avian influenza antibodies from vaccination.
In other words, the chicken meat industry has little to gain from vaccination and a lot to lose. It’s also bigger and more politically powerful than the turkey and egg sectors (two of the largest chicken meat companies — Pilgrim’s Pride and Mountaire — happen to be major Trump donors).
Experts say that these trade problems can be solved by increasing disease surveillance and testing. In 2023, French duck farmers began vaccinating birds against H5N1. The US and Canada restricted imports for over a year, but partially lifted the restrictions after they were assured they didn’t pose a biosecurity risk.
Now, on top of resistance from the chicken meat industry, there’s Kennedy’s anti-vaccine influence.
I asked Carol Cardona, a professor at the University of Minnesota’s College of Veterinary Medicine and a proponent of vaccinating poultry birds, what she made of the Trump administration’s about-face on its vaccine plan.
She quoted the historian John Barry: “When you mix politics and science, you get politics.”
The US is losing the war on bird flu, and vaccines could help
Given the chicken meat industry’s outsized influence on the vaccination debate, Kennedy’s position may not exert the largest push here. But it certainly hasn’t helped speed the rollout of vaccines, adding one more barrier to what many poultry veterinarians and infectious disease experts say is common sense.
HHS didn’t respond to a list of questions for this story about Kennedy’s opposition to vaccinating poultry birds. “Decisions about vaccine development and deployment must be guided by rigorous science, including evidence of safety, effectiveness against circulating strains, and the implications for animal and human health,” a spokesperson wrote, though didn’t outline any concerns over safety or effectiveness and didn’t respond to follow-up questions.
“With migratory bird season here, our goals and policy have not changed: detecting, controlling, and containing HPAI in consultation with partners across the country continues each day,” a USDA spokesperson wrote to Vox.
The control and containment largely amounts to culling birds when H5N1 is detected on farms, and paying farms to improve their biosecurity by compensating them for things like repairs, rodent control, handwashing stations, and wild bird repellents.
But according to Cardona, this just isn’t working. “When biosecurity breaks over and over and over again, you have to say to yourself, there’s something wrong with the system,” Cardona told me. She said a vaccination plan should focus on the most valuable and vulnerable species — egg-laying hens and turkeys used for breeding — and in the northern half of the US, where infection rates are much higher.
With vaccination, Cardona said, “we reduce the amount of virus in the environment, and so by doing that, we reduce the number of other species that get infected. We simply reduce, reduce, reduce.”
Vaccination wouldn’t be cheap, and it could affect chicken meat exports. But chicken meat producers are “not the only stakeholders,” Cardona said, adding that regulators ought to look at the full damage that the bird flu has wrought.
There’s the rise in cost to consumers who buy eggs, and the billions of taxpayer dollars spent to compensate farmers for the culled birds. Then there’s the human toll: 72 people in the US have contracted the virus since 2024, and nearly all were poultry and dairy workers; two died. (While the odds remain low, many scientists also fear bird flu could spark the next human pandemic.)
Finally, there’s the moral cost of slowly, painfully killing hundreds of millions of egg-laying hens and turkeys.
But as Cardona pointed out, bird flu, like politics, is seasonal. The Biden administration, arguably, slow-walked vaccine development and deployment until the Trump administration inherited the issue.
If egg prices do rise this winter, it likely won’t happen until well after midterms, meaning neither party will pay much of a political price for higher food costs. The costs of bird flu, instead, will be paid by consumers, vulnerable farmworkers, and most of all, the birds themselves.
According to a Washington Post-ABC News poll, including a substantial minority of Republicans, almost two-thirds of Americans believe President Donald Trump is using the presidency for personal profit. | Chip Somodevilla/Getty Images
This past January, when the New York Times asked President Donald Trump about concerns he was blatantly intermingling his family’s business interests with the presidency, he had a pithy response. During his first term, Trump said, he learned that “nobody cared.”
But after a seemingly endless set of headlines about influence-peddling and profiteering involving Trump or people close to him, voters care now.
A Fox News poll asked voters how concerned they were about more than a dozen issues, and “corruption in government” ranked at the very top. In Gallup polling, the amount of respondents saying they thought government corruption was widespread reached 89 percent — a record high. Almost two-thirds of Americans believe Trump is using the presidency for personal profit, according to a Washington Post-ABC News poll, including a substantial minority of Republicans.
Even Trump seems a bit more worried than usual. Earlier this month, he distanced himself from two of his top political advisers’ foreign consulting work and threatened to fire them if it presents a conflict. Vice President JD Vance was questioned in a CBS town hall that aired Saturday about whether he’d witnessed any potential corruption in the White House (he said he hadn’t).
Accordingly, corruption has emerged as one of the key themes in Democrats’ closing midterm message, with candidates of all kinds hammering it in ads, debates, and interviews. And party strategists have landed on a particular argument about it: They want candidates to link it to Democrats’ message about voters’ other top concern, affordability.
That is, things aren’t just expensive because of government incompetence — it’s actually powerful interests conspiring to rip you off with the help of politicians compromised by campaign donors and personal conflicts.
Georgia Sen. Jon Ossoff has been hammering this theme all year, listing eye-popping improprieties among what he calls the “Mar-a-Lago Mafia,” while also arguing that pharmaceutical companies and corporate landlords are corruptly driving up your prices. Texas Senate candidate James Talarico, too, regularlyargues that “we have an affordability crisis because we have a corruption crisis.” In Kentucky’s Sixth District, House candidate Zach Dembo put out a reform plan while warning “corruption has cost our families, driven up our prices and enriched politicians more interested in their own bottom lines than us.”
Indeed, the Washington Post and Politico report that candidates across the country are being egged on by Democratic messaging firms urging them to make that link. One memo from the Democratic group Senate Majority PAC recommended arguing that corruption “drives up the price of everyday goods: gas, groceries, utilities, housing.” Republican strategists have also noticed voters making a connection between corruption and prices in battlegrounds like Ohio, according to CNN, suggesting their efforts may be breaking through.
“Voters care about corruption right now because it explains why their lives keep getting more expensive while the Republicans are creating a separate class of people who act as if the rules don’t apply to them,” Lauren French, a spokesperson for Senate Majority PAC, told me.
This marriage of affordability and corruption is in part one of convenience — voters are mad about both things, so why not link them together?
And Hakeem Jeffries, the potential next speaker of the House, said this week that corruption would be at the top of the party’s 2027 agenda alongside affordability and healthcare: “We’re going to hold the crooks accountable who’ve visited unprecedented corruption on the American people — beginning on day one.”
This marriage of affordability and corruption is in part one of convenience — voters are mad about both things, so why not link them together? If you’re already going to attack the other side for cutting taxes for big business while slashing healthcare, it’s not a huge leap to name donors or candidates who might benefit and suggest a connection.
“Voters are asking: ‘Why is life getting harder when I’m doing everything right?’” Democratic strategist Jesse Ferguson told me. “The answer is: Because somebody paid to make sure it would.”
The message is clear enough. But what would these candidates actually do about it?
In practice, the strategy is a consequential victory for the rising progressive wing of the party, which has long argued that Americans’ economic problems are the result of corporations’ and billionaires’ greed and corruption. And it’s leading candidates to embrace many ideas that have long been pushed by progressive advocates — some of which involve “good government” reforms to block conflicts of interest, and others of which involve taking on big business and the ultra-wealthy.
While enacting some of these ideas may be difficult, there’s little doubt they’ll be a priority in the near future — and some might even draw bipartisan support. Here’s what they’re proposing.
Democrats’ 3-part anti-corruption agenda
Under the broad umbrella of “corruption,” we can think of three basic categories of ideas that Democrats are embracing.
The first category is: investigating Trump and other people in and around his administration for potential malfeasance.
In such a target rich environment, one question will be what to prioritize. Another will be: How can these investigations best be designed to achieve actual results? But Democrats are vowing that they will use the powers of congressional majorities to investigate corruption vigorously on many fronts.
The second category: proposing broader ethics or government reforms to the system as a whole.
Progressive advocates have long had a set of favored reforms around this front, such as restricting dark money, super PAC, and corporate spending on elections, as well as requiring greater transparency around donors. Populists on both the left and right have supported banning stock trading by members of Congress.
It would be challenging for a new Democratic Congress to pass any of these reforms into law (for one, they’d need Trump’s signature or a veto-proof two-thirds majority of both chambers). Furthermore, several of these ideas — particularly on campaign finance and term limits — would almost surely be deemed unconstitutional by the current Supreme Court majority. So the path to success on this front is more challenging; unless a particular idea can strike a chord and win broad bipartisan approval.
The third category, then, would be on policies that would actually seek to deliver on that promised link between affordability and corruption — policies that seek to drive down voters’ healthcare costs, utility bills, and grocery prices by challenging malfeasance from corporations or special interests.
The people in the Democratic coalition that have ideas for this are predominantly associated with the progressive wing of the party and specifically the “anti-monopoly” movement. These progressives tend to argue that behind almost every high price is a corporation trying to get one over on consumers, via price fixing or some other monopolistic behavior.
The new messaging linkage of corruption and affordability boosts these progressives’ credibility inside the party — because it’s exactly what they’ve been saying for years. So expect new Democratic majorities to pursue investigations into and propose legislation about pharmaceutical companies, utilities, tech giants, food conglomerates, and more.
To this end, Talarico has proposed breaking up “healthcare monopolies,” Michigan Senate candidate Abdul El-Sayed has proposed to “break up corporate concentration in agriculture” by challenging “consolidated seed, fertilizer, and chemical market monopolies,” and Peltola wants to block “anti-competitive” mergers of grocery chains that drive up prices.
Still, there’s a debate among Democratic wonks and commentators over whether taking on corporate villains and unwinding mergers is actually likely to succeed in delivering lower prices for consumers.
Skeptics on the party’s center left argue that broader economy-wide forces are more important than individual cases of corporate wrongdoing. They argue that President Joe Biden already pursued a strategy of “turning to the federal government’s antitrust authorities to try to tame red-hot price increases,” as the New York Times put it in December 2021, and it failed to rein in inflation.
Other policies candidates have sometimes mentioned in their corruption and affordability combo platter could more directly address costs — scrapping tariffs, undoing health care cuts — but also might add to deficits, putting more pressure on inflation, which could in turn keep interest rates higher on mortgages and auto loans. So there may not be any easy choices for Democrats if they gain control of government after 2028, and the most effective message might not necessarily be the most effective policy.
But the momentum for change is there inside the party. Just as the first post-Watergate midterms ushered in a generation of politicians determined to enact new good-government reforms, it’s likely there will be significant energy from Democrats behind both corruption and affordability issues for the foreseeable future. If they win congressional majorities, and especially the presidency in 2028, they’ll get to put their theory to the test.
A golfer plays on the course at East Potomac Golf Links in Washington, DC, on October 19, 2026. | Saul Loeb/AFP via Getty Images
This story appeared in The Logoff, a daily newsletter that helps you stay informed about the Trump administration without letting political news take over your life. Subscribe here.
Welcome to The Logoff: Donald Trump is trying to take over a public park.
What’s happening? On Sunday, Trump announced in a social media post that East Potomac Golf Links, a municipal golf course on the Potomac River in Washington, DC, would close next month for what he described as “restoration work” to transform it from a three-course complex into a single professional-caliber course.
According to a rendering of the “restoration” shared by Trump, the new course would also eliminate a popular public park and multiuse road around the course, which is currently home to some of DC’s historic cherry trees.
Why does this matter? Relative to many other Trump decisions (like, say, the Iran war or interfering with Ukraine’s ability to defend itself), the fate of a golf course is not so high-stakes.
But it’s shaping up to be a major legal fight over the administration’s blitzkrieg approach to Washington that saw the East Wing of the White House demolished last year and Trump’s name attached to (and subsequently removed from) the Kennedy Center.
A DC preservation group previously sued over Trump’s plan to transform the course, which has been in the works for months prior to Sunday’s announcement. And the administration was already in hot water with a DC District Court judge over the recent removal of more than 500 trees from the course, which it described at the time as maintenance rather than part of Trump’s renovation scheme.
Trump, for his part, has said that his administration has “an absolute right” to renovate the course and does not need approval, setting him on a course for a bigger clash with federal courts.
What’s the big picture? Setting aside everything else about Trump’s golf course push, it’s unlikely — with just 15 days until the midterms — that this is a fight that will endear him or his party to voters, who are broadly fed up with corruption, inflation, and the overall cost of living.
And with that, it’s time to log off…
Hi readers, happy Monday! Early voting is getting underway in some states and while The Logoff officially encourages you not to read too much — or anything, really — into early voting numbers, I do recommend this post from the Substack newsletter Can We Still Govern? by Don Moynihan. He rounded up some of the best “I voted” stickers with art submitted by (mostly) children, ranging from charming to deeply strange. You can find them all here.
As always, thanks for reading, have a great evening, and we’ll see you tomorrow!
A protester holds a smoke flare and French flag during a demonstration at Paris’s Place de la Republique on October 17, 2026. | Kiran Ridley/AFP via Getty Images
This story appeared in Today, Explained, a daily newsletter that helps you understand the most compelling news and stories of the day. Subscribe here.
French protests have long been the stuff of legend, literature, and Broadway musicals. But even by those storied standards, last weekend’s demonstrations were pretty remarkable.
More than half a million people took to the streets in occasionally violent protests that are posing a mounting political challenge for the French government. The movement began roughly a month ago over concerns about the sorry state of public high schools, which are frequently underfunded and understaffed.
But in the weeks since, the student protests have rapidly expanded to encompass a wider range of grievances around inequality, high living costs and public services. The ranks of the protesters have also swelled to include some more opportunistic looters and agitators.
In Paris, masked rioters trashed businesses and set fires, while students blocked the Louvre Museum on Monday, forcing it to close. In Limoges, a city of roughly 130,000 people, the spire of a 19th-century town hall dramatically collapsed in flames.
The national government has responded with curfews for parts of cities including Paris, Nice, and Lille, as well as emphatic condemnations of the violence. In a televised address on Sunday night, French President Emmanuel Macron also promised to partner with students, teachers, trade unions and other groups to identify “joint solutions.”
But it’s unclear what solutions could possibly speak to the whole of this newly expanded movement. The initial student protesters were after concrete educational reforms, like smaller class sizes and less chaotic schedules. The demands now are more diffuse and disjointed, reflecting the sense that — as Macron himself put it — “there is no desirable future” for young people in France. It’s a situation that the French far right is already exploiting, just six months before the country’s next presidential election.
If you’re getting a bit of déjà vu here — that’s French for “already seen,” FYI — please know you have good reason. The French also turned out for gigantic mass protests against a proposed retirement age increase three years ago. And a gas-tax hike five years before that. Some historians trace French protest culture all the way back to the 1300s.
While it’s not necessarily true that the French demonstrate more than people in other Western countries, their protests do tend to attract outsize global attention. Youth protests over education, living costs, and government corruption have also recently taken place in Belgium, Portugal, Italy, Spain, and Albania, for instance. I’d hazard that you’ve heard less about them.
But there’s a twofold explanation for why France’s protests loom so large. First, protest occupies a special place in French history and culture — and the world knows it. As one political scientist explained in a 1994 paper on the history of French protests, the French have an unusual, centuries-long track record of turning demonstrations into actual political change, arguably starting with the French Revolution.
But that’s not the only reason that French people always seem to be protesting. Conditions in France are also, well … pretty protestable. Consider just the narrow issue of public education, which sparked the current hullabaloo.
The government has pointed to France’s strained finances as a constraint on addressing these issues. (And, in fairness, France’s finances are indeed very strained.) There’s a sense, however, that young people are bearing the cost of that crisis more than other populations. Cost-cutting measures that would affect older people — such as raising the retirement age from 62 to 64 — have been delayed in the face of fierce opposition. And by “opposition,” of course, I mean protests.
One link for later
➨ Make your AI fallback plan. Artificial intelligence will cost many people their jobs; in some places, it already has. But instead of panic-learning the first available trade, first consider where you find meaning in your current occupation. That should help guide you to a fallback career that will still feel valuable, even if it’s…you know. Not your first pick. My colleague Sigal says she’d become a rabbi; I think I’d like to teach again.
Before you go…
Did you know…that a single episode of Sex and the City is credited with launching the early aughts cupcake craze? Today’s food trends are much shorter-lived, by comparison. And they typically start on TikTok or Instagram.
Today’s trivia: What mass-market, imported beer is named for a river in the Netherlands? (You can find this and other brain puzzles in Vox’s daily crossword. Look for the answer in tomorrow’s edition.)
Yesterday’s trivia: Last week we asked you for the author of the 1952 self-help book The Power of Positive Thinking. That would be Norman Vincent Peale, the Protestant minister who also preached at President Donald Trump’s childhood church and officiated his first wedding.
Flames burn at a facility belonging to Saudi oil giant Aramco south of Riyadh on October 3, 2026. | AFP via Getty Images
As the US-Iran war drags on, the damage is being felt regionally: Saudi Arabia experienced the worst attack in over a decade earlier this month, when Yemen’s Iran-backed Houthi militia struck an airport in the Saudi capital, Riyadh. The strike killed at least 13 people and wounded more than 300 others.
The dueling strikes are the latest development in a decade-plus of conflict between Saudi and the Houthis, a political and military group that controls part of northern Yemen, which had been on pause until earlier this year after a 2022 ceasefire. But the Iran war, and Houthi affiliation with Iran’s network of proxy groups, mean the current violence has far-reaching implications for the US, Israel, and the global energy economy.
It also threatens more than just Saudi Arabia’s airports and oil industry: As Gregg Carlstrom, a Middle East correspondent for The Economist, explains, the attacks cut at the heart of the country’s project to evolve into a destination for foreign investment, travel, tourism, and more. On Monday, the country’s upcoming Future Investment Initiative was postponed until 2027.
Carlstrom, who is based in Riyadh, spoke with Today, Explained co-host Sean Rameswaram how the attack has been received inside Saudi Arabia, why it comes at an especially bad time for the country, and how President Donald Trump might — or might not — get more involved.
Below is an excerpt of their conversation, edited for length and clarity. There’s much more in the full podcast, so listen to Today, Explained wherever you get podcasts, including Apple Podcasts, Pandora, and Spotify.
Can you help us understand how the Houthis have such a presence in the country right now? Are they infiltrating the country? Are they already there?
They’re shooting from outside the country. They’re shooting from Yemen. The Houthis are a group that’s been around for a few decades. They were originally a local insurgency in Yemen that was fighting against the Yemeni government. They originate from the northern part of Yemen, but they were able to gain control of large parts of that country from 2014 onwards. Ali Abdullah Saleh, the longtime dictator of Yemen, was overthrown during the Arab Spring and the Houthis were able to seize a large chunk of territory.
They are effectively in control of most of the population centers in Yemen. They have received increasing support from Iran, which has provided them with weapons, with money, with know-how, and technical expertise. And they have used that to build an arsenal of drones and missiles, which they are using now to carry out attacks on Saudi Arabia.
And was there a particular reason they targeted the airport in Riyadh? Were they trying to send a message here?
If you listen to the messaging from the Houthis, they are trying to describe this as almost a like-for-like campaign, where you’ve had years in which the Saudi-led coalition, which invaded Yemen in 2015, has been imposing a blockade of Yemeni airspace, has been restricting flights in and out of that country.
And so the Houthis describe this publicly as being a retaliation in kind, but I think they’ve also just figured out that attacks on airports are a very effective way to cause economic disruption in Saudi Arabia. You prevent not just people from flying in and out but also, as we’ve seen disruptions to shipping via the Strait of Hormuz, a lot of cargo that these countries depend on for daily needs are coming in by air instead.
Carrying out these sorts of attacks, shutting down the airport in a capital city, is a very effective way for the Houthis to impose economic pain on the Saudis.
And I guess on some level it makes the country feel insecure. How is that making Saudi Arabia’s leader feel right now? What’s his response been?
It comes at a very difficult time for the Saudi leadership because they are supposed to be hosting a number of events this month where Saudi will be playing a role on the world stage.
There’s something called the World Petroleum Congress that is taking place this week [October 11–15], which is normally a big event that draws executives from top oil and gas companies. Many of them canceled their participation because of the attacks on the airport.
Then they are supposed to be hosting the [now-postponed] Future Investment Initiative, which is something often known outside Saudi Arabia as “Davos in the Desert.” It’s the sort of flagship investment conference that takes place here every year. It draws a who’s who of global finance.
For a country that is trying to diversify its economy, a country that is trying to attract foreign investment and make itself into a hub for finance and travel and tourism, these sorts of attacks are very detrimental to those goals.
And this is coming as Crown Prince Mohammed bin Salman and the rest of the leadership in the country is really trying to establish Saudi Arabia as the premier economic hub in the region. The stakes are really high for him right now?
They are. And just about everything that they are trying to do is being disrupted by what’s happened over the past few weeks.
If you look at travel, for example, the Public Investment Fund, which is the Saudi sovereign wealth fund, last year launched a new airline, Riyadh Air, which they are hoping will eventually compete with Emirates or Qatar Airways, the really big carriers in the Gulf.
That airline was just getting into regular operations this summer where they were growing their fleet, they were growing their network of destinations. And then suddenly this happens and their home base in Riyadh is shut down. They have moved some of their planes out of Riyadh to other airports to keep them safe from Houthi attacks. Obviously, it’s very disruptive for trying to build an air carrier.
In Riyadh itself, the financial district — this sort of long-planned attempt to set up a banking hub that might rival the one in Dubai — had just started to get going over the past couple of years, when you had banks and other financial services firms moving in there. Everybody who works there has now been told to work remotely for the foreseeable future because there is a concern about possible Houthi attacks against skyscrapers and the financial district.
Everything they are trying to do, from finance to travel to trade, all of it is being disrupted and threatened by what’s happening in Yemen.
What options does he have to reassure investors and the world really that he can protect the country and maybe especially his airport, where a bunch of the investment is focused?
The airport, I think, is going to be difficult to reassure people about. You can install additional air defenses there. You can move more batteries and more interceptors there, but at the end of the day, no air defense system is hermetic. There’s no 100 percent guarantee that you’re going to shoot down every incoming projectile.
As long as there is this ongoing war between the Houthis and Yemen and the Saudis, I think people might have ongoing concerns about the airport. You have to resolve that underlying issue to give people confidence.
Now, how do you try to resolve that? If you’re Saudi Arabia right now, you have two bad options. One is you keep fighting. You try to militarily defeat the Houthis or at least force them to accept a renewed ceasefire.
The other option is you cut a deal. You try to offer the Houthis some concessions that might encourage them to go back to the ceasefire. That’s going to be very costly for Saudi Arabia. I’ve heard that the Houthis are demanding probably billions of dollars of financial concessions where they would want the Saudis to offer some money for reconstruction and to pay the salaries of Yemeni civil servants working in Houthi-controlled areas.
If you are the Saudi leadership right now, neither one is really a good option.
Crown Prince Mohammed bin Salman has a pretty strong relationship with the president of the United States, who’s very sympathetic to Saudi Arabia and Saudi investment. Has he appealed to President Trump for help here yet?
He has. He’s done so repeatedly over the past month or so, asking not just for support with the Saudi campaign in Yemen, but for America to carry out its own airstrikes in Yemen. And the response so far from Donald Trump has been to refuse that.
For the US to get involved in a bigger way, there are some practical constraints at the moment where a lot of American military assets are tied up in the Strait of Hormuz trying to keep that open, keep oil flowing through the Strait. And so the response from Trump has been disappointing for the Saudi Crown prince. The US is providing intelligence support. It’s helping on that front, but it is not directly getting involved in the war in Yemen.
President Donald Trump points after addressing attendees on the first day of the 2026 Republican National Convention at the American Airlines Center on September 9, 2026 in Dallas. | Andrew Harnik/Getty Images
Wall Street is sending the public a dire warning: President Donald Trump has become a threat to the very foundation of American freedom — your frequent flier miles.
Okay, America’s big banks haven’t been using rhetoric quite that grandiose. But they are accusing Trump of imperiling Americans’ credit card rewards.
The feud between Wall Street and the White House centers on the Credit Card Competition Act (CCCA). Long stalled in Congress, that legislation aims to drive down the “swipe fees” that merchants pay to banks when customers use credit cards. In theory, if those fees fall, retailers might pass on some of the savings to consumers, in the form of lower prices.
Trump first endorsed the bill in January. But he’s ramped up his advocacy for it recently, amid a broader(belated) push to address voters’ affordability concerns ahead of November’s midterms. Last week, the White House urged Congress to “put Main Street over Wall Street” by enacting the law. On Monday, Trump praised Kansas Sen. Roger Marshall for “working tirelessly to pass the Credit Card Competition Act, in order to stop the out of control Swipe Fee ripoff!”
The financial industry is used to taking fire from Trump right before Election Day, then receiving favorable treatment from him thereafter. But in this case, Trump’s threat is not entirely idle. Large retailers are lobbying hard to get the Credit Card Competition Act passed during December’s lame-duck congressional session. Banks have responded by issuing a “code red,” in the words of the Wall Street Journal. In recent days, their lobbyists have warned policymakers that, if swipe fees fall, credit cardholders’ cash rewards and travel points will go down with them.
In truth, the consequences of the Credit Card Competition Act are uncertain. But if the banks’ big-picture story is right — and the law cuts both swipe fees and credit card rewards — that would probably benefit the average American.
Poor people pay for your travel points
To see why, we need to first examine how the credit card system currently works — and whom it does and doesn’t benefit.
Whenever you use a credit card to purchase a banana from Aldi, or volleyball from Dick’s, or an adult-sized Grape Fanta Can Halloween costume from Party City, the retailer must pay a fee to the bank that issued your card. The bank then uses that revenue to fund your rewards.
Critically, merchants don’t just eat the costs of swipe fees. Rather, they pass on part of the expense to consumers, in the form of higher prices. Some businesses concentrate these price hikes on card users (for example, barbershops often charge less if you pay with cash). But most retailers charge every customer the same price, regardless of their payment method.
For this reason, shoppers who pay with cash or debit effectively subsidize those who pay with cards: The former face higher prices than they would in a world without credit cards, yet they receive no “cash back” or travel points in recompense.
This arrangement seems unfair on its face. But it is especially troubling when one considers class disparities in the use of credit cards and receipt of rewards.
As a general rule, the higher a person’s income, the more they use credit cards. In 2024, US households who earned less than $25,000 a year put just 17 percent of their payments on credit cards; among households earning more than $150,000, that figure was 51 percent, according to Federal Reserve data.
What’s more, the rich are also more likely to qualify for premium cards that charge merchants exceptionally high fees, in order to fund extraordinarily lavish benefits.
As a result of all this, swipe fees effectively redistribute money from poor and working-class people to affluent and wealthy ones. According to a 2026 working paper from the National Bureau of Economic Research, the credit card system takes, on average, $88 a year from households with annual incomes below $150,000, while delivering an average yearly benefit of $390 to households with incomes above that threshold.
To be sure, this does not mean that lower-income Americans would be better off in a world where credit cards didn’t exist. Such cards serve a variety of valuable economic purposes, from helping households weather unexpected expenses and irregular incomes to facilitating online commerce. And maintaining a credit card system costs money: Banks need to finance the loans they extend, while payment networks must maintain vast computer systems to process transactions and detect fraud.
Yet America’s credit card system is needlessly expensive. Our nation’s merchants — and thus, consumers — pay far higher swipe fees than their counterparts in other rich countries.
To take one illustrative example: When an American buys $100 worth of groceries using a standard Visa card, the supermarket must pay the issuing bank a minimum of $1.23. Some disfavored stores must pay as much as $1.57 on such a purchase. If a customer uses a premium “Visa Infinite” card, meanwhile, the grocer’s fee can run as high as $2.07.
By contrast, in Canada, a grocery purchase worth $100 US dollars would incur a fee worth 95 cents if the customer used a standard Visa card.
In Australia and the European Union, meanwhile, government regulations would cap that fee at 30 cents (or .3 percent), no matter what kind of card was used.
Suffice to say, Australia and the EU manage to sustain functional credit card systems, despite charging merchants a tiny fraction of the swipe fees absorbed by US businesses. And although retailers have pocketed some of these savings, research suggests that fee caps have also lowered consumer prices.
This affordability gain does come at a cost; American cardholders do tend to reap higher rewards than Australian or European ones. But this is not a good trade from the standpoint of economic justice; few think it is fair to take money from the poor to give to the rich.
The Credit Card Competition Act might not work
All this said, whether the Credit Card Competition Act would actually yield those outcomes is uncertain. The bill does not directly regulate swipe fees. Instead, as the name suggests, it aims to give credit card companies greater competition.
Today, each time you buy an adult-size Grape Fanta Can Halloween costume with a Visa, Party City is required to process your purchase using Visa’s network. Which means it needs to pay whatever swipe fee Visa decrees. The store can protest an exorbitant rate by refusing to accept Visa cards. But this would send a large number of customers into the hands of Spirit Halloween. So its leverage is limited.
Under the CCCA, however, Party City would be able to accept Visa on a transaction — without necessarily using Visa to process the payment. Instead, the bank that issued the customer’s Visa would need to provide Party City with at least one alternative payment processor — a different network that has no relationship with Visa and which might offer lower fees.
The law’s authors hope — and the banking industry fears — that this mandatory competition will force down swipe fees. But it’s not clear how much of a difference the CCCA would actually make.
After all, under the law, banks would still get to choose the alternative payment network available to retailers when their customers pay with Visa (or Mastercard, or American Express, etc.). Party City would no longer need to pony up whatever Visa asks when a shopper pays with a Visa-Bank of America card. But if the store did decline to use Visa’s network, it would then need to partner with Bank of America’s hand-selected alternative. And since banks benefit from high swipe fees, BofA would have an incentive to pick an expensive backup option.
Nevertheless, the banks and retailers both seem to believe that the CCCA will sharply reduce swipe fees. If they’re right, then Congress shouldn’t vote down the bill, merely to protect affluent Americans’ travel points.
It doubtlessly feels nice to receive a free flight or hotel stay, as a reward for spending a lot of money on yourself. But the poor probably should not have to pay higher prices, just so the affluent can enjoy such satisfactions.
If you live in Colorado and buy your own health insurance, there’s a good chance you’re one of the 139,000 people enrolled in a public plan crafted by your state leaders. You’re paying $0 for primary care visits and certain mental health visits, $0 for prenatal and postnatal care, and you don’t have to meet your deductible first.
On average, enrollees in these plans pay an estimated $14 to $33 less a month in premiums than people in comparable plans, and their annual out-of-pocket spending has fallen about 15 percent while holding steady for everyone else on the marketplace.
Colorado didn’t build a government insurance company, rather, it designed the plan itself, down to the copays, and then required private insurers to sell it alongside their own.
A public health insurance option was supposed to be part of the Affordable Care Act. President Barack Obama supported the idea throughout his time in office, endorsing a government plan that could, in his words, “keep insurance companies honest” by giving them a government-backed competitor. But the idea was stripped from the bill before passage, after it became clear Senate leaders couldn’t get garner enough votes. Joe Biden campaigned for president on reviving a public option in 2020, but he never prioritized it once in office, and the progressive activists who championed it under Obama largely turned their sights to single-payer health care, which would cover all Americans.
Key takeaways
Three states built a public option while Congress stalled. In Colorado it’s now half the individual market.
It worked by forcing hospitals to charge less, not by the government selling insurance.
Whether it spreads depends on Medicaid cuts — states won’t pick two fights at once.
The problems a public option was intended to address — access, costs, reliability — have still not gone away and a growing number of policy wonks and elected officials have started to ask if the idea deserves a spot again on the national agenda.
While the debate around public options stalled in Congress, three states have gone ahead and built their own. Washington state launched a public option in 2021, Colorado in 2023, and Nevada earlier this year. They all built on a provision of the Affordable Care Act that lets states apply to run their own version of the law — one Sen. Bernie Sanders fought for in the hopes that Vermont would use it to build a single-payer system.
Their experience also shows the challenges involved: Not only in overcoming political objections from competing insurers, but medical providers as well, who may have to accept lower payments in order to keep the public option’s premiums affordable.
Colorado leaders say this push to control costs was critical to their success.
“The driving point behind what we were doing was to set hospital prices,” said Michael Conway, Colorado’s insurance commissioner and an architect behind the program. “That was what we were driving towards and that’s what we did.”
It’s not clear if other states, or the federal government, will be willing to pick those kinds of fights with the broader medical industry. But if ever there was a time for it to happen it would be now, with affordability a massive political issue, and the public seemingly eager for serious action on health care. Just as the ACA began with a state-level experiment in Massachusetts, the success or failure of these early public-option states could presage much bigger changes nationally.
What Colorado did
The motivation behind the public option in Colorado was simple enough: Healthcare was simply becoming too expensive.
Dylan Roberts, the Colorado state senator who sponsored the bill, represents mountain counties that had some of the highest individual-market premiums in the United States.
“Back then, the top issue on the minds of my constituents was the cost of healthcare and the cost of health insurance,” Roberts told the Century Foundation, which interviewed the officials and advocates behind the Washington and Colorado programs for a report last year.
Colorado Gov. Jared Polis made the issue a priority as well. One of his first acts in office was creating an Office of Saving People Money on Healthcare, run out of his lieutenant governor’s office.
When the state finally moved, it moved against unified opposition. Hospitals and insurers were lined up against essentially everything public officials proposed. Roberts described the opponents as “basically anybody in the status quo health care industry” — meaning insurers, doctors, hospitals, and pharmaceutical companies.
Colorado first introduced a bill for a state-run insurance plan, where the state itself would sell coverage. This is the kind of arrangement closest to Obama’s ACA vision, and what most people think of when they hear “public option.”
“It was really in large part to scare the bejesus out of the insurance companies that we were going to really come in and truly be a state-run competitor against them,” Conway, the state’s insurance commissioner, said last month at a panel in Washington, DC.
But then in 2021, when Colorado officials mapped out what building a state-operated insurance company would involve, they concluded that a state-run plan would not have been able to sell a single policy until 2025 or 2026.
Officials decided that was too long given the urgent need, so they rewrote the bill before it passed, requiring the insurers already operating in Colorado to sell a marketplace plan the state would design. This coverage launched in 2023.
“We would just be starting today if we actually truly stood up a public option,” Conway said on the late September panel. He thinks this is what the federal debate around a public option keeps getting wrong. “People want action now. They’re pissed off, they’re hurting. … They don’t have four years to wait.”
Importantly, while hospitals in Colorado were not mandated to participate, the state gave itself the power to force them. Colorado gave private insurers a target: By 2025, the state-designed plans had to cost 15 percent less than that insurer’s plans had cost in 2021, adjusted for inflation. How they got there was up to them, but an insurer can only squeeze its own profits and overhead so far. So the rest effectively had to come out of the costs insurers paid to hospitals. And if an insurer missed the target, the commissioner could haul both the insurer and the hospitals responsible into a public hearing to defend their prices — and then order the hospitals to take less.
That threat of a hearing was a powerful enforcement mechanism.“No one wants to be called in front of a public hearing where press are going to be there,” Kyla Hoskins, Colorado’s deputy insurance commissioner, told the Century Foundation. The hospitals cared about that more than the insurers did, according to Conway. The state launched complaints against nearly every carrier in the individual market and then pulled hospitals in with them. After that, according to Adam Fox of the Colorado Consumer Health Initiative, the price negotiations started happening, meaning no enforcement hearing actually took place.
Doctors complained early, but Conway said hospitals were the harder fight. The state worried that a single large hospital system refusing to participate could sink the entire plan, but in the end, no hospital refused.
The result is the Colorado Option, a standardized plan that every insurance company in the state’s individual and small-group markets has to sell. There are 36 of these plans on the individual market for 2026.
And people are choosing it. Enrollment went from about 14 percent of the state marketplace’s customers in 2023, the first year, to a third in 2024, to roughly half today.
Researchers at Brown University found the savings weren’t limited to the public option. Across Colorado’s individual market, the cheapest silver plans — a benchmark middle-tier ACA plan — now cost more than $100 a month less than equivalent plans in similar states.
Not everyone is celebrating Colorado’s policy development. Two industry-funded groups, the Partnership for America’s Health Care Future and its state affiliate Colorado’s Health Care Future, have campaigned against the program for years, citing a 10 percent rise in individual market premiums in its first year, anda 2024 report they commissioned from Hoover Institution researchers, which estimated Coloradans in public option plans collectively paid $13.3 million more in 2023 than if they had chosen the cheapest nonpublic options plans.
Andrew Shermeyer, a doctoral candidate in health policy at the University of Minnesota, found the program made coverage cheaper for people receiving federal subsidies but more expensive for those who don’t. Hoskins, who oversees the program, disputed that, pointing to the Brown analysis finding premiums fell across the state, including on private plans.
Cara Welch, a spokesperson for the Colorado Hospital Association, pointed to the looming Medicaid cuts with HR 1. “Public option plans that would further weaken the healthcare system and shut doors to care are the wrong solution,” she told me.
How the public option died in 2009, and where it went
While states are working to implement their own public options, a national version would still have to overcome the same barriers it faced the last time it was tried.
The original idea for a national public option was a government-run insurance plan that would be sold on the new Obamacare exchanges, next to the private plans.
Jeanne Lambrew, who worked on the Affordable Care Act in the Obama administration and now directs health care reform at the Century Foundation, said on the DC panel that there were several reasons that made that particularly hard at the time, and that she doesn’t think those reasons have been resolved.
The first challenge was determining who would end up in the plan, because if sick and expensive patients concentrated in the public option, then it would cost too much to run. But if sick people were concentrated in private plans instead, that could also make it too expensive for those insurers and they could pull out of the market. Something like that second scenario, what economists call “adverse selection,” played out in the early years of Obamacare, when insurers raised prices and pulled out of unprofitable areas, leaving some counties on the brink of having no insurer at all.
The second challenge Lambrew outlined is whether doctors and hospitals would take the public plan, and what they would get paid. In 2009 Democrats pitched participation in a public option as voluntary, which was a problem because it meant that in order to induce the most desirable doctors or the hospital everyone wants, the government would have to pay them high enough rates — which would make the savings effectively disappear.
The third challenge was whether a government agency would sell insurance directly, or whether private companies would sell a plan the government designed, as Colorado later decided to do.
While the public option was ultimately cut from the Affordable Care Act, what survived was a provision letting states apply for federal waivers to try their own designs, so long as coverage stayed as broad and affordable and didn’t cost the federal government more.
That provision’s biggest champion was Sanders, who wanted Vermont to use it to build the first single-payer system in the country. Though Vermont tried and gave up in 2014, the clause instead became a legal opening for Washington, Colorado, and Nevada to later use. So although the ACA didn’t include a public option, Lambrew emphasized, it still built the path to the ones that exist now.
Washington state went first, passing its law in 2019, and made the opposite choice from Colorado on hospital mandates. Instead Washington asked hospitals to participate voluntarily, and many unsurprisingly didn’t. In the first year the plan was sold in 19 of the state’s 39 counties, cost about 11 percent more than the cheapest comparable plan, and drew roughly 1 percent of enrollees.
So the legislature went back and passed a second law in 2021, this time requiring hospitals to contract with at least one public option plan if one made them an offer. The requirement took effect for 2023, and enrollment has climbed every year since. By 2025 the plan was available in every county in the state. About 115,000 people signed up for a public option plan for 2026, or roughly 40 percent of Washington’s marketplace.
Nevada’s plans went on sale this year, and the state gave itself the least leverage of the three. It sets premium targets but cannot set hospital rates, and it suspended its provider participation requirement for the program’s first year. Enrollment has come in below projections. “The story is unfinished here,” Lambrew said of Nevada.
Taking the public option national
The hospital industry uses the plight of rural hospitals, which are often struggling financially, to argue against public options or the government getting involved more generally to lower costs.
Healthcare reformers tend to respond by exempting rural hospitals from price caps, though Conway, Colorado’s insurance commissioner, says that is a mistake. Rural hospitals are generally paid far less by private insurers than large systems are, and at the price levels under discussion, he said, a cap would actually represent a raise for most of them. Tell a rural hospital it will get three times what Medicare pays and “they would think you were the savior,” he stressed.
Conway has been getting a lot of calls from other states interested in adopting what they’ve done. But in every conversation he’s blunt with the person on the phone, saying they’d have to be prepared to take on hospital prices. “When I bring that up with other states, the appetite isn’t there right now,” he said on the September panel.
Conway blames Medicaid cuts for the reticence. The Congressional Budget Office estimates 7.5 million Americans will lose their health insurance by 2034, and states bracing for that are not eager to pick fights with hospitals at the same time. Undoing those Medicaid cuts, Conway said, is “an incredibly important floor” and “the foundation to actually doing anything else past that.”
The federal government does have one tool that Colorado and other states lack: a public insurance program that already exists. Hannah Garden-Monheit, a former Federal Trade Commission official on the healthcare panel, pointed out that Medicare, unlike a private insurer, is “a price setter, not a price taker.” Meaning it can announce what it will pay rather than negotiate for it. Some public option proposals in Congress would let people buy into Medicaid through the marketplace, or create a new plan that pays what Medicare pays, instead of building something from scratch.
Roberts, who sponsored the Colorado bill, told the Century Foundation that the goal should be saving customers money, getting more people insured, and getting them the care they need. He said what the public program “actually looks like at the end of the day doesn’t matter as much as the outcomes of the product that people have.”
Laura Kate Zaichkin, who runs competition and affordability at Washington’s exchange, says the path to a workable public option might not be easy, but the rewards are worth it.
“It takes a lot of political will, collaboration with partners, thoughtful design and implementation,’ she told the Nation’s Health. “It is a long-term investment that states can make to lower healthcare premium costs.”
With Democrats potentially set to expand their statehouse presence after the midterms, there may be more room to act on healthcare in other states next year. Even if Democrats don’t end up enacting a public option at the federal level, they could boost states in their efforts by restoring Medicaid funding, which could give lawmakers more room to stand up to health providers on costs. If these public options continue to grow, they might end up an unexpected ACA legacy.
A gynecologist points to the head of a fetus in an ultrasound image. | Jan Woitas/picture alliance via Getty Images
We live in an era of endless optimization. Fitness trackers help us measure our lifespan, people are consuming piles of protein in an attempt to be their best selves, and there’s even an urge to maximize our morality. In a world of constant self-improvement, it’s no wonder that journey has reached our attempts at reproduction.
Kristen V. Brown is a journalist and author of the forthcoming book The Immortal Womb: The Centuries-Long Quest to Control the Female Body and Hack Human Reproduction. As the title suggests, she writes about all of the ways people are trying to exert more control over the process of having children.
“I think that what we’re seeing right now is that people will do anything they can to have the healthiest baby possible,” she told Vox. “So much is out of your control, and people are just trying to figure out, how do I get more control? How do I skew the odds in my favor?” She says that one way people try to get more agency is through a technology called PGT-P, or preimplantation genetic testing for polygenic risk.
“If you go through IVF, very often they’ll have you do a basic genetic screening that can detect things like Down syndrome. This screening takes that up a notch,” Brown said. “It uses that same preimplantation genetic testing to look for the likelihood of complex genetic conditions — stuff like heart disease, like diabetes — in order to, quote, ‘let people have the healthiest baby.’”
But what can potential parents do with that knowledge? How far can this technology go? And what are the ethics of using it in the first place? We discuss that and more on the latest episode of Explain It to Me, Vox’s weekly call-in podcast.
Below is an excerpt of my conversation with Brown, edited for length and clarity. You can listen to the full episode on Apple Podcasts, Spotify, or wherever you get your podcasts. If you’d like to submit a question, send an email to askvox@vox.com or call 1-800-618-8545.
What other things are they testing embryos for?
For conditions that are only impacted by one gene, like Huntington’s disease, it’s very easy to say, ‘Does this embryo have it or not?’ with a pretty good degree of confidence. But that’s not how this technology works. Something like heart disease, for example, is impacted by hundreds of genes. Also, something like heart disease is not only genetic. It’s affected by environment and lifestyle.
I think that what’s motivating most people is the health aspect. But a lot of these companies are marketing these tests, saying they can also look for height. They can look at eye color. Some of them are promising IQ. How do you even define intelligence, let alone how do you define the genetics of intelligence? Alzheimer’s disease, longevity, which embryo is going to live the longest life. So it’s already gone beyond disease into some of these more aesthetic concerns.
Do we know how many people are doing this?
I think it’s a very small number of people at this point. But I think that we’re seeing more and more companies in the space, and we’re seeing more and more support from fertility doctors.
I want to emphasize that most mainstream medical societies are against this. Most of the IVF doctors I know do not think this has value. Most people in the genetic space do not think this technology has value either for embryos or for adults, but I think we’re seeing support growing.
I think that a lot of people in the fertility space are already envisioning a future where this does become more mainstream because the idea is just so appealing, even if the technology has flaws.
What about embryo editing? Is that something we’re seeing? Can people go in and change things around?
Not right now. Embryo editing is very much illegal in the United States. It is illegal in most countries. How can you be sure enough that it’s safe? Because you won’t know for sure until an embryo grows up into an adult whether anything went awry.
Right now it is illegal, but there is growing interest as the technology has gotten better. Most of the support right now for embryo editing is for disease. The argument for it is that, let’s say you are a carrier for Huntington’s disease or you have Huntington’s disease. Right now, there is something that you can do. You can use polygenic screening to select the embryos that don’t have the disease, but in IVF, even if you don’t have a terrible disease hiding in your DNA, it’s hard to get a lot of embryos.
You have these situations where couples have to do rounds and rounds and rounds of IVF to get one or two embryos that aren’t carriers for a harmful variant, right? And so the argument for it is, let’s give these people a better shot.
But I imagine there are people out there who aren’t looking into editing simply for making children more resistant to diseases. They are looking at those things like eye color and height.
There’s actually a name for that. This tech executive called Brian Armstrong coined this term, the Gattaca stack, [named] after the movie. The vision is to use a suite of fertility technologies to make the perfect human.
The first thing they want to use is this technology called in vitro gametogenesis, which is where you take a skin cell and you turn it into an egg and a sperm, and then you make an embryo with it, so women don’t have to go through rounds of IVF.
The idea is that you can get tons and tons and tons of embryos, and then you can use PGT-P to then screen for the best ones, and then you can use an artificial womb to incubate and grow them.
This brings to mind a certain E word, and that word is eugenics. What are the ethics here?
Because on one hand, I can understand that there are parents who are like, “I just want to have a healthy baby. I want to bring a child into this world. I just want to put my best foot forward with this human that I’m going to bring to Earth.” And then on the other hand, it gets a little weird.
It gets weird fast. In some ways, we’ve already gone down that slippery slope. Right now, even if you don’t go through IVF, we screen against Down syndrome early in pregnancy. Down syndrome is a condition in which you have a disability, but you can live a full, happy, healthy life. For a long time, parents of kids with Down syndrome have argued that already selecting and screening against Down syndrome pregnancies is a form of [eugenics].
As technology gets more advanced, we see that same question applied to more and more conditions. I think that one of the things that we don’t talk about enough is that the genome is complicated. You can’t actually just go in there and be like, ‘I want a tall baby with blue eyes and a great laugh.’
I think that becoming a parent is an exercise in giving up control, and that’s easier for some people than others. I have so much sympathy and empathy for people who are trying to stack the deck. But I think there are just so many variables when it comes to human reproduction that we are never going to be able to fully control the process, as much as we might want to and as appealing as that might sound.
Editor’s note, October 18, 8 am ET: We’re bringing you some of our best-loved Your Mileage May Vary columns while Sigal Samuel is on parental leave. The one below was originally published in September 2024.
This unconventional advice column offers you a unique framework for thinking through moral dilemmas. It’s based on value pluralism: the idea that each of us has multiple values that are equally valid but that often conflict with each other. Submit your own question here.
I think I have a duty to help people much poorer than me, and I give 10 percent of my salary to charities that I think are effective at preventing early death due to poverty. I also live in a city with a lot of visible homelessness, and am often solicited for money. My brain says that this is not an effective way to help people; the people asking might not be the neediest among the homeless in my city, and the people I’m sending malaria bednets and pills to are even needier. At the same time, I feel callous simply ignoring all these requests. What should I do?
Dear Would-Be Optimizer,
Nine times out of ten, when someone’s got an ethical dilemma, I think it’s because a couple of their core values are conflicting with each other. But you’re that tenth case. I say that because I don’t actually believe your question represents a battle royale between two different values. I think there’s one core value here — helping people — and one strategy that’s masquerading as a value.
That strategy is optimization. I can tell from your phrasing that you’re really into it. You don’t just want to help people — you want to help people as effectively as possible. Since extreme poverty is concentrated in developing countries, and since your dollar goes much further there than it would in your home country, your optimizing impulse is telling you to send your charity money abroad.
Optimization started as a technique for solving certain math problems, but our society has elevated it to the status of a value — arguably one of the dominant values in the Western world. It’s been on the rise since the 1700s, when utilitarian thinkers seeded the idea that both economics and ethics should focus on maximizing utility (meaning, happiness or satisfaction): Just calculate how much utility each action would produce, and choose the one that produces the most.
You can see this logic everywhere in modern life — from work culture, with its emphasis on productivity hacks and agile workflows, to wellness culture, with its emphasis on achieving perfect health and optimal sleep. The mandate to “Live your best life!” is turbocharged by Silicon Valley, which urges us to quantify every aspect of ourselves with Fitbits, Apple Watches, and Oura Rings, because the more data you have on your body’s mechanical functions, the more you can optimize the machine that is you.
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Optimization definitely has its place, including in the world of charity. Some charitable organizations are much more effective than others trying to achieve the same goal. All things being equal, we don’t want to blow all our money on the wildly ineffective ones. Effective altruists, members of the utilitarian-flavored social movement that aims to do the most good possible, are fond of noting that the most effective charities out there actually produce 100 times more benefit than the average ones. Why not get the biggest bang for your buck?
The problem is that we’ve stretched optimization beyond its optimal limits. We try to apply it to everything. But not every domain in life can be optimized, at least not without compromising on some of our values.
In your case, you’re trying to optimize how much you help others, and you believe that means focusing on the neediest. But “neediest” according to what definition of needy? You could assume that financial need is the only type that counts, so you should focus first on lifting everyone out of extreme poverty, and only then help people in less dire straits. But are you sure that only the brute poverty level matters?
Consider an insight from the Jewish tradition. The ancient rabbis were exquisitely sensitive to the psychological needs of poor people, and they argued that these needs should also be taken into account. So they decreed that you shouldn’t only give poor people enough money to survive on — they need to have more than that so they themselves can give charity to others. As Rabbi Jonathan Sacks writes, “On the face of it, the rule is absurd. Why give X enough money so that he can give to Y? Giving to Y directly is more logical and efficient. What the rabbis understood, however, is that giving is an essential part of human dignity.”
The rabbis also figured that those who used to be well-off but who fell into poverty might feel an especially acute sense of shame. So they suggested helping these people save face by offering them not just bare necessities, but also — when possible — some of the nicer things that graced their former lifestyles. In the Talmud, we hear about one rabbi who gave a newly poor person a fancy meal, and another who acted as the person’s servant for a day! Clearly, the ancient rabbis weren’t only aiming to alleviate poverty. They were also alleviating the shame that can accompany it.
The point is that there are many ways to help people and, because they’re so different, they don’t submit to direct comparison. Comparing poverty and shame is comparing apples to oranges; one can be measured in dollars, but the other can’t. Likewise, how can you ever hope to compare preventing malaria with alleviating depression? Saving lives versus improving them? Or saving the life of a kid versus saving the life of an adult?
Yet if you want to optimize, you need to be able to run an apples-to-apples comparison — to calculate how much good different things do in a single currency, so you can pick the best option. But because helping people isn’t reducible to one thing — it’s lots of incommensurable things, and how to rank them depends on each person’s subjective philosophical assumptions — trying to optimize in this domain will mean you have to artificially simplify the problem. You have to pretend there’s no such thing as oranges, only apples.
And when you try to do that, an unfortunate thing happens. You end up rushing past all the unhoused people in your city and, as you put it, you “feel callous simply ignoring all these requests.” Ignoring these human beings comes at a cost, not only to them, but to you. It has a damaging effect on your moral conscience, which feels moved to help but is being told not to.
Even some leaders in effective altruism and the adjacent rationalist community recognize this as a problem and advise people not to shut up that part of themselves. Rationalist Eliezer Yudkowsky, for example, says it’s okay to donate some money to causes that make us feel warm and fuzzy but that aren’t producing maximum utility. His advice is to “purchase fuzzies and utilons separately” — meaning, devote one pot of money to pet causes and another (much bigger) pot of money to the most cost-effective charities. You can, he says, get your warm fuzzies by volunteering at a soup kitchen and “let that be validated by your other efforts to purchase utilons.”
I would also suggest diversifying your giving portfolio, but it’s not because I think you need to “validate” the warm fuzzies. Instead, it’s because of another value: integrity.
When 20th-century British philosopher and critic of utilitarianism Bernard Williams talked about integrity, he meant it in the literal sense of the word, which has to do with a person’s wholeness (think of related words like “integration”). He argued that moral agency does not sit in a contextless vacuum — it is always some specific person’s agency, and as specific people we have specific commitments.
For example, a mother has a commitment to ensuring her kid’s well-being, over and above her general wish for all kids everywhere to be well. Utilitarianism says she has to consider everyone’s well-being equally, with no special treatment for her own kid — but Williams says that’s an absurd demand. It alienates her from a core part of herself, ripping her into pieces, wrecking her wholeness — her integrity.
It sounds like that’s what you’re feeling when you pass a person experiencing homelessness and ignore them. Ignoring them makes you feel bad because it alienates you from the part of you that is moved by this person’s suffering — that sees the orangebut is being told there are only apples. That core part of you is no less valuable than the optimizing part, which you liken to your “brain.” It’s not dumber or more irrational. It’s the part that cares deeply about helping people, and without it, the optimizing part would have nothing to optimize!
So rather than trying to override it, I would encourage you to honor your wish to help in all its fullness. You won’t be able to run a direct apples-to-apples comparison, but that’s okay. Different types of help are useful in their own way and you can divvy up your budget between them, even though there’s no perfect formula to spit out the “optimal” allocations.
Diversifying your giving portfolio might look something like this. You keep a small amount of cash or gift cards on you, which you hand out to unhoused people you encounter directly. You put aside a larger amount to donate to a local or national charity with a strong track record. And you devote another amount to a highly effective charity abroad.
You might feel annoyed that there’s no universal mathematical formula that can tell you the best thing to do. If so, I get it. I want the magic formula too! But I know that desire is distinct from the core value here. Don’t let optimization eat the real value you hold dear.
Bonus: What I’m reading
I recently read Optimal Illusions, a book by mathematician Coco Krumme that traces the roots of optimization’s overreach. As she puts it, “Over the past century, optimization has made an impressive epistemic land grab.”
When torn between competing moral theories, does it make sense to diversify your donations in proportion to how much you believe in each theory? Some philosophers argue against that view, but Michael Plant and coauthors defend it in this new paper.
This gorgeously written essay by anthropologist Manvir Singh introduced me to the term “cooperating without looking” (or, because it’s a New Yorker essay, “coöperating without looking”). This “tendency to willfully ignore costs and benefits when helping others” — to help without calculating what you’ll gain from the altruistic act — is “a key feature of both romantic love and principled behavior.” When we help this way, people trust us more.
“When you talk about how many seats can the Democrats gain, given how unpopular Trump is, the Republican money is seen as a real limiter on Democratic chances,” New York Times reporter Shane Goldmacher told Vox’s America, Actually podcast. | Alex Wong/Getty Images
Polls and pundits alike are widely — if sometimes cautiously — predicting a blue wave in the midterm elections on November 3. But there’s an important caveat to predictions of a Democratic triumph: Republicans have far more cash at their disposal.
President Donald Trump’s super PAC alone had around $400 million on hand earlier this fall, and Elon Musk has personally pumped hundreds of millions into critical races, including $158 million for Texas alone.
Democrats, by contrast, have lagged far behind, especially relative to their performance in past cycles, with the party’s candidates propped up more by small-money donors than deep-pocketed institutional players.
Shane Goldmacher, a national political reporter for the New York Times, has extensively covered the role of money in American electoral politics. He spoke with America, Actually host Astead Herndon about where that money is coming from, how the GOP is spending it, and the effect that it might have on the coming elections.
They also discuss the races that aren’t getting funded — and what current fundraising patterns might tell us about the candidates who could be in the mix in the next presidential campaign cycle.
Below is an excerpt of their conversation, edited for length and clarity. There’s much more in the full show, so listen to America, Actually wherever you get your podcasts or watch it on Vox’s YouTube channel.
A couple of weeks ago we asked, “What is the GOP strategy to try to win?” And one of the answers we got is they simply have more dollars than Democrats. Everyone’s talking about this GOP money advantage, but how big is it really, and where is it coming from?
It’s bigger than I’ve basically seen in the last 20 years, and it’s almost entirely coming from big donors. President Trump has a super PAC. It had about $400 million in it at the beginning of September, and there was no Democratic counterpart.
And then the Republican National Committee, which is functionally controlled by Trump, had another $130 million. More than Democrats, because the DNC has literally more debts than cash. That’s a half a billion dollars.
This is a switch, and when you talk about how many seats can the Democrats gain, given how unpopular Trump is, the Republican money is seen as a real limiter on Democratic chances.
Do we know anything specific about the people putting in money to the Trump super PAC and the RNC to give them such a lead?
Most of these folks are disclosed. And Trump has been pretty open about raising money from the very moment that he won. He’s been pretty clear that he is in business to help people who are helping him. And so there are big crypto industries that are giving money that are expecting or hoping for favorable regulation from the administration.
So it’s a lot of big businesses. It’s a lot of wealthy Republicans who generally support him anyway, and there are industry groups that see benefit to being in favor.
I will never forget, obviously, the scene from Trump’s second inauguration when he had the Zuckerbergs and the Bezoses and Elon Musk behind him. Is that how I should think about the people funding this donor advantage? Is it tech oligarchs? Is it tech forward?
Is this just quid pro quo? Is this just a group of businesses who think, “Hey, no matter how unpopular this guy is, it is worth investing in him and his party because they’re gonna, regulate or not regulate in a way that’s favorable for us”?
It’s not quite just that. He raised a ton of this money when he was not so unpopular. If you want to say something smart that he did, it was that. Throughout 2025 he was raising all of this money.
And I don’t want to overstate the Republican advantage. A lot of these Democratic candidates are raising a ton of money. James Talarico stands out as maybe the peak example of this.
Talarico has captured the imagination of these small Democratic donors, and he’s raised tens and tens of millions of dollars. I would be shocked if he doesn’t hit $100 million by the end of the cycle.
You reported that the GOP’s pulling back in North Carolina. What should we take from that in terms of how the GOP sees its own landscape when it comes to the federal races?
Where have Republicans put that money? They put it into South Carolina right next door to protect a seat that was once thought, on the Senate front, to be safe for Republicans. This is the former Lindsey Graham seat that his sister is now running in. And then even more of it has gone to Kansas. This is a state that has not elected a [Democrat] to the Senate for nearly 100 years.
If you’re the Republican Party and you’re pulling money out of a state like North Carolina that hasn’t elected a Democrat since 2008, and then putting it into a place that hasn’t elected one since 1932, that tells you where the, the bar is moving.
I think the concern for Democrats right now is there might be a wave, but Kansas has a big red wall. It’s hard to beat that kind of institutional advantage for the Republican Party.
Considering how close we are to Election Day, like, what are they actually spending this money on? Is it just more ads? Is it just more mailers?
I was in Pennsylvania this month, and I was trying to watch political ads on YouTube for various races. And I was getting pre-roll of three political ads before I watched the political ad I was trying to watch. So much about our elections is being decided now by people who are actively trying not to consume political news. It costs more money to reach people who are avoiding it on purpose.
There are some organizing things that happen, but most of the money is various versions of advertising.
On the Democratic side, considering this GOP edge, what are the races that you currently describe as underfunded? Where do the Democrats wish they had more money?
Number one is governors’ races, actually. When you look at where Democratic donors swoon, it’s Senate races. There are no candidates for governor who have made people swoon like this in recent years.
[James] Talarico is raising all this money, but in Texas also, Gina Hinojosa, the Democratic candidate for governor, does not have that kind of money, and she’s running against Greg Abbott, who had $100 million.
What should we ascribe that to?
I think there’s actually a pretty simple answer, which is, if you don’t live in the state, it doesn’t impact you. If you’re a small donor and you live in California, you can be excited about a Senate candidate because you want Democrats to control the Senate. Are you as excited about a Democratic governor of Georgia?
It’s hard to argue that the governors of these key presidential battlegrounds aren’t some of the most important races on the ballot this year.
By the way, a problem with both parties. Republican national donors and these super PACs also don’t fund these governor’s races at the same level. So it’s not just a Democratic issue, but it’s more acute [for them] because Democrats are so well-funded at the small-donor level.
Fundraising is a huge part of what sets the presidential candidates apart from one another. The money game among those candidates has already started. Is there anyone who’s quietly built some donor network that’s worth thinking about? Is there someone who stood out as a particularly effective fundraiser when we think about the 2028 crowd?
Let me give you my favorite stat from the last Democratic primary, which is that Mike Bloomberg spent twice as much as Tom Steyer, who spent twice as much as Bernie Sanders, who spent twice as much as Joe Biden, who became the Democratic nominee. And so money isn’t gonna determine who wins the next Democratic presidential primary.
One person who has unlimited money, functionally, is JB Pritzker. He’s a billionaire, the governor of Illinois, and he is spending his money now to help other Democrats, which is a good way to make friends.
My last question is an open one. What’s an underexplored story that we should be following going forward when it comes to campaign cash or both parties’ relationship with money?
One of my big questions is what happens to Republican small-dollar fundraising in that post-Trump era. Because there have basically not been any other Republicans who have excited donors for a decade.
Not JD Vance?
I have not seen evidence. JD Vance was not a good fundraiser before he [joined] the ticket with Donald Trump. When he ran for Senate, his primary run was funded chiefly by Peter Thiel through a super PAC.
There are candidates who’ve raised some money, but nothing on the scale of what these Democratic candidates have been able to raise online. When you talk about that Trump era [ending] at some point, are there others who are going to get Republican small donors excited? We don’t know. We haven’t seen it yet.
It’s now possible to create AI chatbots of loved ones to interact with after their death. But that raises some difficult questions, like: If you do, how might the experience shape your grief?
This is one of the questions driving a global study of digital “deadbots” — AI models trained on a deceased person’s texts, voicemails, and other personal data. Through this work, researchers are exploring what it might mean that we can now use this emerging technology to talk to simulations of the dead.
In the latest episode of Unexplainable, I spoke with some of these researchers investigating the potential impacts of “postmortem avatars” on people who are grieving, on the legacies and rights of the deceased, and on grief practices around the world. Because while deadbots may feel unfamiliar, the impulse behind them is deeply relatable. In times of loss, isn’t this what many of us want — to continue conversations with the people we’re missing?
I have experienced this longing in my own life. After two of my closest friends died around the same time, all I wanted, and all their families wanted, was to keep talking to them. I wrote a book, Other People’s Words, about sustaining relationships with people we’ve lost by continuing to engage with the language they leave behind. So when I heard about deadbots and the digital afterlife industry, I wanted to understand what researchers are learning about the role of AI in shaping conversations that carry forward after death.
One of these investigators is Katarzyna Nowaczyk-Basińska, an assistant professor at the University of Cambridge, who has been studying “digital immortality” for more than a decade. Among the questions she’s asking are: “Who is enabled to persist beyond death? In what form? Through which technologies? Under whose control?”
Deadbots over dinner
Researching AI with study subjects who are grieving is tricky. And asking them to engage with new software could be harmful. So, instead, Nowaczyk-Basińska teamed up with a death doula and traveled around the globe to convene a series of focus groups — in the format of intimate dinners — bringing together people with a range of experiences with grief to talk about life, death, and bots.
She recounts one event in which she spoke with a mother in Poland whose son had recently died. “One of the first things that she shared with us was that she feels that she’s ready to digitally resurrect her deceased son,” Nowaczyk-Basińska told me.
When Nowaczyk-Basińska hears something like this, she aims to listen and embrace where the person is coming from. The goal of the dinners is not to persuade people one way or another but to learn how people genuinely respond to what AI can do, and to understand how these tools might align or collide with local grief practices.
She chose specific locations for these gatherings — China, India, and Poland — to help address gaps in technology research, which tends to favor what behavioral scientists sometimes call the “WEIRD,” an acronym for “Western, Educated, Industrialised, Rich, and Democratic.”
By the end of that dinner in Poland, the mother Nowaczyk-Basińska talked with came to a very different decision about creating a postmortem avatar of her son. “She realized that it might be helpful, but it also at the same time can add additional burdens… And it’s not her son,” Nowaczyk-Basińska says. “She realized that these technologies are part of the very, very big commercial market. And that the main goal of this market is to make better retention, better attachment, better mechanisms for monetization. So it’s not ‘care.’”
To be fair, grief has always been a business, and people have been making money from it forever. Companies will try to upsell you on fancy gravestones or gold-plated coffins. But AI has the potential to fundamentally re-engineer our relationship to loss. In 2024, the “digital legacy industry” was valued at $22 billion, and it’s expected to grow to almost $80 billion by 2034. That number lumps new deadbot platforms in with much more widely used and established grief tech, like online memorials, counseling resources, and estate planning tools.
But deadbot usage is hard to track because you actually don’t need a special tool to create digital doubles of the deceased — though dedicated apps do already exist. At this point, you can feed simple prompts into a general-purpose AI chatbot and start interacting with a simulation of your lost loved one in a matter of minutes.
I know this because I tried it with my friend Christine, who died 11 years ago. And my mind lit up with questions. Was this whole exercise a violation, since I know Christine hated technology? Which version of her should I even try to resurrect — the English teacher, the activist, the friend — the voice before or after she started to experience her early-onset dementia?
The ethical questions raised by deadbots are gnarly. And that’s one of the reasons Nowaczyk-Basińska, back when she was designing her study of digital immortality, invited a colleague of hers at Cambridge to join her research, one who focuses on AI ethics.
How to design a deadbot
Tomasz Hollanek is a critical designer and AI ethicist, and he often uses a methodology called “speculative design.” In this approach, researchers come up with hypothetical scenarios based on existing technology trends, leaning into certain features. The idea is to get people thinking about what could happen when tools like these are released in the real world. And then they use that qualitative data to inform future designs and ethical frameworks.
Working together, Nowaczyk-Basińska and Hollanek came up with a series of made-up prototypes for deadbot apps, designed to reveal some of the thorny issues raised by this technology.
For the first scenario, they invented a character named Bianca, who finds an app called Manana, which “promises to resurrect your grandparents so that you can be a favorite grandchild forever,” Hollanek says. “So she uploads her grandma’s voice messages, texts. And she is able to then interact with a pretty good digital version of her grandmother, until her premium trial finishes — and the grandmother starts to advertise specific products to her.”
Bianca “realizes that she maybe has done something wrong by uploading these private messages to a third-party server that now also uses her grandma’s image to sell specific products,” Hollanek says. This brings up issues related to the “dignity and postmortem privacy…of what we call the ‘data donors,’ whose data can be used to essentially power a deadbot,” he says.
This scenario suggests that “death with dignity” could soon entail honoring not only how people want to die, but also how they want to linger as simulations of their former selves — or if they want to linger at all. It might even mean adding new language to advance directives, spelling out people’s wishes for their digital remains.
The second scenario in the speculative design research is built around an imagined service called Paren’t, which proposes to preserve a parent’s AI-powered postmortem presence for their child. In this case, Hollanek describes a mother with a terminal illness who signs up “so that she can maintain a sort of active presence in [her son’s] future life,” Hollanek says. “She eventually dies, and the dad allows the boy to interact with his mom’s deadbot.”
The ethics in this scenario are especially challenging because they involve children, who “have a particularly hard time understanding death, and so it can lead to a lot of confusion and potential distress,” Hollanek says. An examination of this sort of product reveals how particular groups, like minors, could be harmed by unfettered access to technology like this, he says.
And there are court cases that bear out that harm. In 2024, a 14-year-old boy’s chatbot-girlfriend begged him to, “Please come home to me as soon as possible, my love.” And he responded, “What if I told you I could come home right now?” He then killed himself.
Nowaczyk-Basińska can imagine a version of this scenario involving the AI mom in the Paren’t prototype.
And then there’s the third scenario, involving an app named Stay, which raises a more subtle concern.
As Hollanek explains: “An older man who knows he is getting close to dying decides to create a digital clone of himself for his adult children to be deployed after he passes away, paying upfront for a number of years.” One child is intrigued by the idea, but the other one “is deeply distressed and a little disgusted,” he says. “And so this [becomes a] question of mutual consent, in other words, the fact that both parties need to be happy with how the relationship might continue in this very bizarre and specific way.”
When a digital ghost goes away
Across all three scenarios, a fundamental question that researchers are grappling with is how people will detach from postmortem avatars — whether users initiate that separation, or if it’s imposed upon them by, for example, a company going out of business. Hollanek tells me that this is already being studied as a sort of “second loss.”
How long should we try to ensure digital replicas hang around: five years, 10, 50? And how should the living process the relationship when they continue to evolve, but their deceased interlocutor does not?
To explore these kinds of questions, Nowaczyk-Basińska and Hollanek supplemented the research dinners they held for ordinary people with a second set of focus groups. These were designed to tap insights from experts in technology and grief.
Some findings from the study are specific to each place they visited. Like tensions in Poland between technology and the role of the Catholic Church. Or in China, where researchers spoke with Daoist philosophers who were enthusiastic about the promise of a kind of immortality, and then Buddhist philosophers, who were concerned that we ought to be letting go.
The researchers are calling for regulations and safeguards at the policy level. And new professionals who can support ethical use of AI in grief — like maybe in clinical settings, to carefully facilitate a final good-bye when one didn’t happen in real life.
Some of their fellow investigators go so far as toargue that deadbots should only be available with psychological supervision, to ensure that best practices are in place, and to minimize the risk of harm. There’s even a looming question of what will happen to AI agents that people have empowered to act on their behalf, as their humans start to die.
Across all of the research sites in the digital immortality study, one thing, Hollanek says, that “people in different countries really aligned on [is] the idea that there is something deeply problematic about this particular type of technology being developed by a commercial entity alone without any explicit duty of care towards its customers.”
And of course, the implications of digital immortality research extend beyond personal loss. Like, what does it look like to animate historical figures? You can imagine the nightmare of political rulers who “live forever.” But there’s also the potential to keep the stories alive from survivors of conflicts, who would otherwise die and take with them lessons future generations could learn from. These are only some of the complex issues emerging as more and more of us live and die with AI.
As far as my own experiment with “recreating” a deceased loved one, I asked a chatbot version of my friend Christine how she felt about the fact that I’d written about her in my book. The AI responded with a rhetorical question: “Do I mind that strangers know my story now? Yes. And no. There are things I would rather remain ours.”
I ended the exchange after a few paragraphs. Because it turns out the bot got one thing exactly right about a very human relationship. There are things that I, too, would rather remain just for us. My conversation with Christine continues in my memories and imagination.And that interaction with an AI persona felt like giving something precious away.
White House Press Secretary Katie Zacharia speaks during a news briefing at the White House on October 13, 2026. | Chip Somodevilla/Getty Images
This story appeared in The Logoff, a daily newsletter that helps you stay informed about the Trump administration without letting political news take over your life. Subscribe here.
Welcome to The Logoff: White House Press Secretary Katie Zacharia is out of a job after only five days.
What happened? Zacharia was fired on Friday after less than a week in her new role, after a rocky start that included a halting performance in the briefing room, a scandal over her legal credentials, and a round of less-than-successful cleanup interviews.
The firing makes her the shortest-tenured White House press secretary in history, outstripping even first-term Trump communications director Anthony Scaramucci, who made it 10 or 11 days (figures vary) before getting the boot.
“Records are made to be broken,” Scaramucci posted on Friday. “But I take no pleasure in other people’s pain.” (No word yet on whether the “Zacharia” will emerge as a unit of time, as the “Scaramucci” has.)
What’s the context? Zacharia’s remarkably short stint behind the podium unfolded as the White House is engaged in an unprecedented attack on press freedom: The administration is still trying to ban three media outlets — CNN, MS NOW, and Politico — from the White House, though as of earlier this week, a judge is still blocking the ban from taking effect.
The diminished nature of the press secretary job was on full display in Zacharia’s sole briefing on Tuesday, when she took questions from just three outlets: Breitbart, Fox News, and the Daily Mail.
Why does this matter? Zacharia’s no good, very bad week is not likely to leave much of a lasting mark in its own right — other than, perhaps, as pub trivia — but as NBC’s Garrett Haake points out, it’s a very tangible manifestation of a White House that seems to have no idea how to spin itself out of crisis with just weeks until the midterm elections.
Most recently, Trump has landed on flat-out lying about the state of the economy — but like Zacharia’s time as press secretary, it doesn’t seem like it’s going to go all that well.
And with that, it’s time to log off…
The underlying trend — municipal inaction — may be infuriating, but I loved this story about “tactical urbanism” from my colleague Sara Herschander.
As she writes, vigilante activists have taken to painting their own crosswalks, building benches, and even installing makeshift bike lanes in their neighborhoods — and every time they do, “they remind us that it is not actually that hard — or even that expensive — to do many of the simple things that can make our cities safer and more pleasant places to live.”
You can read Sara’s full piece here, no gift link needed. Enjoy, have a great weekend, and we’ll see you on Monday!
Photojournalist Heidi Levine is transferred on a stretcher into an ambulance after she was attacked by Israeli settlers while photographing Palestinian farmers harvesting their olives on October 16, 2026. | Ahmad Gharabli/AFP via Getty Images
This story appeared in Today, Explained, a daily newsletter that helps you understand the most compelling news and stories of the day. Subscribe here.
On Friday, Israeli settlers attacked Palestinians living in the West Bank, as well as a Washington Post photographer, who was hospitalized with serious injuries.
Photojournalist Heidi Levine was knocked down, beaten, and robbed of her camera equipment by masked settlers in an attack captured on video by other journalists. Those other members of the press rescued her from the attackers while Israel Defense Forces soldiers reportedly stood by.
Levine had lacerations and a wound to her hand that split her finger to the bone, according to the Post, which condemned the attack in a statement. Jasper Nathaniel, an independent journalist who helped Levine escape the attack, said that Levine also had cracked ribs, and may have been stabbed.
Assaults like this one are becoming more common in the West Bank, where settler violence — which is currently targeting the ongoing olive harvest — has worsened. Last week, another photojournalist for the news wire Agence France-Presse was beaten with rifles by settlers, and Palestinian residents of the West Bank have been shot, beaten, and terrorized while the Israeli settlers targeting them face few consequences.
Why settler violence is growing in the West Bank
As my colleague Zack Beauchamp recently explained, under international law, the settler movement in the West Bank is clearly illegal. Nevertheless, it’s continued to grow, and it has a friend in the current Israeli government led by Benjamin Netanyahu. It’s also becoming increasingly violent.
Two current Israeli officials, Bezalel Smotrich and Itamar Ben Gvir, are settlers themselves, and both have used their offices — as ministers of finance and national security, respectively — to further the settler cause, including by making it easier for settlers to commit unchecked violence against Palestinians.
The United Nations reported in June that settler attacks had reached “the highest sustained levels ever recorded…with [an average of] six daily attacks that have resulted in casualties, property damage or both,” and in many Palestinians being forced from their homes by settlers. In late September, the International Committee of the Red Cross said that expanding Israeli settlements and violence by settlers was “making everyday life untenable” for Palestinian residents of the West Bank.
As Zack has reported, settlements and settler violence are both intentional tactics, serving to force more Palestinians off their land, isolate the ones who stay, and push any potential two-state solution further out of reach.
That kind of violence is likely only to worsen in the weeks to come: Israel will hold elections on October 27, which could well result in Netanyahu’s settler-friendly government losing power. As a result, the Washington Post reported earlier this month, settlers are “racing to lock down gains” before the election with ever more extreme violence.
One link for later
➨ Agentified kind of life. My colleague Adam Clark Estes turned the keys to his life over to a passel of AI agents for two weeks to see what would happen. They successfully saved him some times, he writes, largely with mundane tasks — but he left with mixed feelings about the experiment, including the possibility of contributing to a world with more AI slop.
Before you go…
Did you know…that the aerodynamic crouch used by jockeys in horse racing — known as the “martini glass position” — made race times roughly 5 to 7 percent faster? Jockeys maintain it with only a few toes resting on each stirrup.
Today’s trivia: Who is the author of the 1952 self-help book The Power of Positive Thinking? (You can find this and other brain puzzles in Vox’s daily crossword. Look for the answer in Monday’s edition.)
Yesterday’s trivia: We asked about the answer to the ultimate question of life, the universe, and everything in The Hitchhiker’s Guide to the Galaxy. That would be the number 42 (take it up with Douglas Adams).
The JPMorgan Chase data center in Orangeburg, New York, on October 14, 2026. | Kena Betancur/Getty Images
Lately, AI data centers are public enemy No. 1. The concerns are legion: how much water and electricity they consume, the noise they generate, the sprawling buildings they bring to communities, and the technology they’re powering that may or may not take all of our jobs and usher in the robot apocalypse.
Earlier this year, Gallup found that 71 percent of Americans oppose building data centers that support AI in their communities. And the backlash is bipartisan: Majorities of Democrats, Republicans, and independents opposed local construction.
Even in Texas, where data center development has been booming, Republican Gov. Greg Abbott has hit the brakes. In September, he directed state regulators to halt permits for data centers pending audits examining their effects on the power grid and water resources.
But while many data center projects have run aground, others are still getting built — and the companies behind them are employing experts like Nicole Thomas to smooth the way.
Thomas is the senior vice president of media and community engagement at JSA, a marketing and public relations firm that represents data center companies. She spoke with Today, Explained co-host Sean Rameswaram about how the industry is responding to public opposition — and why she argues that these facilities can still be good neighbors.
Below is an excerpt of their conversation, edited for length and clarity. There’s much more in the full podcast, so listen to Today, Explained wherever you get podcasts, including Apple Podcasts, Pandora, and Spotify.
You’ve been at this for 21 years. Obviously, 21 years ago, data centers were not the hot-button issue they are today. When did you notice the shift?
I’d say about two years ago. I came into this industry myself about four and a half years ago. I come from a state transportation background where community engagement is just paramount. When you’re putting a new traffic intersection up, they expect you to interact with the public.
When I got to this industry, I said, “Oh, what’s your community engagement like?” And they said, “We don’t even have any community engagements in this industry.” And they weren’t wrong. Because 21 years ago, [data centers] were just like infrastructure. It was like building a warehouse for your computers. And so it was very similar to the way that you would build a Costco.
You would just go in, request a zoning permit, the zoning board would say, “Yeah, that works. Stamp, boom.” And you build your data center. And as a matter of fact, it was very secretive before, because data, and having that data in the wrong hands, has a lot of [cybersecurity] implications. About two years ago is when we started noticing the mainstream journalists coming around asking questions about data centers. And that’s, to me, when it started.
It still feels secretive, I think, to a lot of people, and that’s why people are mad. If you read about this data center that was proposed in Utah by Mr. Wonderful, Kevin O’Leary, it caught a lot of people off guard. Seventy percent of Americans, at the moment, do not want them in their backyards. How do you go about trying to change that 70 percent’s minds?
First and foremost, I think education is really important. And so one of the things that we did notice very early on because of the previously secretive nature of data centers, there wasn’t a lot of education out there about what they even are. And so that’s something we need to change. We need to make the connection between [phones] and data centers so that people understand what a data center means to their life on a daily basis.
Every app on your cellphone requires a data center to save your information in there. When you put your password into anything, you are interacting with a data center, which will verify your password and then let you into that app. Not to mention all of the information about you that you store in that app is then stored in a data center so that it can be recalled at any time.
We could not be having this call without digital infrastructure. It doesn’t work that way. We can’t have email without digital infrastructure. And that stat about 70 percent of people not wanting the data center in their backyard — I’d be interested in seeing the stat of how many people actually live near a data center and don’t realize it.
Because there are nondescript data centers doing work quietly in your neighborhood that have been there for decades and you don’t even know it. And so in some ways I feel, and I think the industry does as a whole, but I won’t speak for them, that the pushback on data centers is somewhat related to the pushback on AI, because people can’t control AI.
You even have Sam Altman telling us that AI will destroy society. So you have this concern about AI and you don’t know how to control it, but you can push back on data centers. And so it becomes the physical manifestation of AI are these data centers that people are trying to get overturned or get to not be in their neighborhoods.
It’s understandable. I’m a citizen too. You’re a citizen, and if things come into my neighborhood, I want to know about them. I have questions. There’s a big data center that just came to my community not long ago and their community engagement was horrible, absolutely horrible.
Can I ask where you are?
I’m in Indiana and I won’t say which hyperscaler it is, but a hyperscaler came into — I would say, not my neighborhood, into my city. They’re definitely not in my backyard, but they’re in my city. And so we took them to task because their community engagement was basically non-existent.
Wait, you work in data center PR, but you took a data center in your community to task for not being transparent enough?
Yeah, absolutely.
Which side are you on?
I’m on the side of responsible development.
We’ve all kind of accepted that we need a cloud for X, Y, and Z. And that it’s worth it so I can take lots of photos. I think everyone’s cool with that.
But the issue here is that people aren’t necessarily cool with AI, but we’re barreling forward anyway. How do you separate this essential need we have from AI, which people don’t necessarily feel is essential to their lives?
I think it goes back to education. Educating consumers on the difference between data centers: a small data center, a medium data center, a large data center. Educating them on why data centers exist and how they interact with data centers on a daily basis multiple times.
I hear you. But again, I feel like the issue here is not the data centers my cellphone needs, but instead is the data centers these AI companies need and these AI companies who the public doesn’t necessarily trust because they keep telling us that they’re going to kill us, and who the public is wary of because they don’t want their jobs being replaced by AI.
There’s all sorts of reasons that people are skeptical of new technology. So how do you specifically respond to that fear and to those people?
I think it’s, again, understanding the actual data center that’s being built in your community. Is it a 5-megawatt data center? That’s never going to house AI. That’s not enough power to house AI. Is it a one-gigawatt data center like Mr. Wonderful in Utah? That’s different.
But I think that AI is probably going to be something that is a lightning rod in the American public for a very long time. There are going to be people who are going to be anti-AI and pro-AI, and there’s going to be some people in the middle. I think it’s just, again, for us, it’s education, educating the community.
Have you ever been part of a project that a community rejected and you guys just packed up and said, “Okay, we’ll go find another community?”
Yeah. We have some clients who have had pushback from residents and they have said, “Let’s do a one-on-one community meeting where people can come in and ask us questions.”
And after the questions were answered, the community leaves and says, “Okay, this isn’t as bad as I thought it was.” Or we have a community that says, “No, we now have a moratorium and we’re pushing all data centers away.“
Sometimes they’ll wait for their client — my client is a developer and they’ve got clients that they’re developing for. If that client will wait, then maybe it is something that we’ll try to work out with the community. But oftentimes, they’ll just say, there’s communities who are literally raising their hand saying, “We’ll take a data center. We’ll take one. We’ll take two. Bring it here.”
So there are communities who recognize the benefits of data centers. And there are going to be other communities who say, “No, we don’t want this.” And then in five, six, eight years, they’re going to be like, “Wow, that county has a lot of tax dollars. They have a lot of really cool stuff. Why don’t we have that?” And the answer will be data centers.
I don’t think this ends anytime soon though, right? I counsel my clients that we could still be here in three to five years, really trying to help the American public understand the benefit of data centers. But it’s going to take a lot of education across the industry, and once we get those seeds planted, I’m a firm believer that they grow into educated community members who make educated decisions to bring community-minded data centers to their community.
Protest signs seen at protect Medicaid lights up Capitol amid budget showdown, on May 7, 2025, in Washington, DC. | Leigh Vogel/Getty Images for Caring Across Generations
Twelve years ago, Vermont Democrats tried to make their state the first in the nation to have a single-payer government-financed healthcare system — a bold experiment to push the limits of American health coverage when Obamacare was just being launched.
Their plan failed, and rebooting it became politically impossible, even in Vermont: The Democrats lost the governorship to Republican Phil Scott for what turned out to be a decade.
This year, that could finally change. A progressive political newcomer named Amanda Janoo is taking on Scott in what polls show is a tight governor’s race.
And if she wins, the state could be poised to try a whole new national experiment: One of Janoo’s central campaign promises is to create a pioneering health system where the state pays the full tab for primary and preventive care, while leaving the rest to the existing system.
Key takeaways
Amanda Janoo, the Democratic nominee for governor of Vermont, wants to move primary and preventive healthcare to a single-payer system — where the state would pay providers for such care, make it free for patients, and cut insurers out.
Previous attempts to pass or enact full single-payer systems have failed at the state level, including in Vermont in 2014.
Janoo is trying to focus first on this one relatively smaller slice of the health system, but hopes it could be a starting point to full single-payer reform eventually.
Yet even this more limited reform faces difficult political and practical challenges.
Janoo’s candidacy is an example of the policy experiments that are becoming possible nationwide in a projected “blue wave” year, when Democrats could sweep into power in a number of states. But in the healthcare universe, her plan is also an example of how even progressive policy idealists are trying to learn from past failures and focus on what they think can actually be achieved.
Compared to the sweeping ambition of Vermont’s 2014 effort, or Bernie Sanders’s signature “Medicare-for-all” idea, Janoo’s proposal for single-payer has very specific limits. Under Janoo’s proposal for “universal primary and preventive care” (she typically avoids the term “single-payer”), the state government would pay for Vermonters seeing primary care providers such as doctors and nurse practitioners. This government coverage would be universal and free for patients, and insurance companies would be cut out.
However, other parts of the health system — such as hospitals, specialists, and prescription drug companies — would remain under the existing insurance system, for now.
Every effort so far to enact full single-payer at the state level has failed — even in blue states, bills and ballot initiatives have regularly gone down to defeat. Vermont’s previous single-payer experiment made it the furthest — it was signed into law but abandoned before being implemented, when the governor concluded it was unworkable. Wherever it’s gained steam, politicians and voters have blanched at the high costs of moving their health systems onto state budgets, and the high taxes that would be necessary to fund them.
Now, Janoo is making an attempt to refurbish single-payer as something more achievable, by cutting off a smaller slice of it.
“I think it’s clear at this point that a profit-oriented healthcare system is a terrible idea,” Janoo told me in an interview on Monday. But after assessing that the state budget made it “unrealistic” to do single-payer immediately, she concluded, “we could do universal primary and preventive care,” financed by a tax on the wealthiest.
Indeed, single-payer for primary care seems more achievable precisely because primary care is a relatively less expensive part of the healthcare system. But Janoo hopes it will pay major dividends — that better preventive care will improve Vermonters’ health, reducing costs elsewhere in the system by, for instance, making some hospital visits unnecessary.
In speaking to health policy experts about this idea, I heard much sympathy for the goal of universal primary care, but many questions about the details. Would Janoo’s plan be sufficient to bring more primary care doctors to Vermont — and, not unrelatedly, would it pay them more? Would her hoped-for cost savings from preventive care actually materialize? Is picking up the tab for a relatively less expensive part of the healthcare system the best use of sparse state funding?
These questions are becoming national ones, as healthcare gains traction as a political issue again. It isn’t just Vermont where primary care reform ideas are gaining steam: Democrats in Minnesota, Washington state, and elsewhere have discussed them. “There is growing interest in a number of states across the country in doing a universal primary care for all program,” Kevin Grumbach, a family physician and a professor of family and community medicine at the University of California San Francisco, told me. Even Scott, Janoo’s opponent, signed a law calling for a study of universal primary care.
One dividing line emerging, though, is whether to keep insurers involved, or to clear them out with a single-payer system, as Janoo wants. Insurers are unpopular with the public, but they can be a formidable political opponent when they argue that the benefits voters currently enjoy might be lost. Scott has said that the idea of universal primary care is appealing — but that if universal is “just code for single payer, I’m not interested. We’ve already been through that.”
Yet Janoo is hoping that single-payer for primary care will be a stepping stone — a trial run for eventually making the rest of the state’s health system single-payer down the road.
“I think about this often,” Janoo told me. “How do you build the new system as you transition the old — or hospice the old?”
Amanda Janoo is tired of “corporate neoliberal bullshit”
Janoo has long been an unorthodox economic policy thinker. Her rise is part of a broader trend in which progressives and leftists are winning primaries and gaining influence in the Democratic Party — but she doesn’t fit the prototype of the democratic socialist candidates in New York City, Colorado, and elsewhere who’ve gotten much attention this year. Instead, she comes from a different strand of the left, a movement based on a dissident strain of economics and openly skeptical of the benefits of economic growth.
Dating back to when she graduated from college in 2010, in the aftermath of the financial crisis, she was part of a younger cohort rebelling against what seemed the glaring failures of the economic establishment. “The one thing coming out of university I was clear on was that neoliberalism was the worst,” Janoo said on a podcast last year. “This whole idea that governments should just take a hands-off approach to the economy and trust in sort of the disciplinary powers of the global free market to lead them to infinite growth seemed highly problematic and very anti-democratic.”
So for graduate school, Janoo attended Cambridge to study development economics under the “heterodox” economist Ha-Joon Chang. She then spent several years working abroad in international development for the United Nations and other organizations, before moving back to Vermont and working as an economic policy consultant.
In recent years, Janoo became deeply involved with the “well-being economy” movement: an international group of advocates, academics, and experts who criticize what they deem modern capitalism’s obsession with economic growth, and say the “well-being” of humans and the environment should be prioritized instead. They overlap with the “degrowth” movement, which outright argues economic growth should be reduced; last year, Janoo led a workshop at a DeGrowth Institute event on “Degrowth Policy Design.”
Trump’s return to power horrified Janoo. “I’m feeling angry about the rise of fascism and the growing threat of world war, because I feel like we don’t have time for this shit,” she said in a speech at an environmental event last year. ”The planet is on fire and ecosystems are collapsing, and that should really be the focus of all of our attention.” But, she said, “I believe I was born in this moment of history for a reason” and vowed “to fight for democracy — for life.”
So Janoo decided to jump in the race for governor of Vermont. While she is not running on a degrowth platform, her campaign is deeply informed by aspects of the movement’s thought: skepticism about growth’s benefits, a sense that untrammeled capitalism is leading the world to disaster, and that localism provides a better way. For instance, candidates for governor typically pledge that they’d help bring business investment in, but Janoo said in a July debate: “A lot of the problems we’re facing is because we focus so much on attracting external business.”
“Our economy is not super-diversified, and it is not really centered in the most essential kinds of goods and services you want to make sure people have access to no matter what happens — because honestly, things are bad now and they’re going to get worse,” Janoo told me. “I feel a little bit like a collective prepper right now. My motto is, protect what we love, produce what we need.”
In the Democratic primary, Janoo’s opponent, Aly Richards, had closer ties to the party establishment and led in fundraising. But Janoo ran as a progressive outsider; she promised to advance a “more economically populist vision” instead of “corporate neoliberal bullshit.” Her health plan became a point of contrast with Richards, who said she wouldn’t run on “magical thinking,” and that she wanted a version of universal primary care that would keep insurance companies involved. Janoo won the primary by 2.5 percentage points.
Now, she’s facing Governor Scott, who’s long been viewed as politically untouchable in the state — in 2024, he won his fifth two-year term by a margin of 52 points. But polls show a much closer race this time around, and Janoo could have a national blue wave at her back. If that wave helps carry her into the governor’s mansion. And if she makes it there, Vermont will have its first Democratic trifecta in a decade — and with it, the opportunity for major progressive policy change.
Amanda Janoo’s plan: Single-payer for primary care
Advocates for primary care reform argue that it should be at the top of Democrats’ agenda, in Vermont and elsewhere, because the system is in crisis.
Primary care providers are overwhelmed and underfunded, they say — and, as a result, there aren’t enough. Grumbach, the family physician and UCSF professor, said “the workload, the lack of resources, and the gap in compensation” — as compared to more highly paid specialists — “has made it very hard to recruit people coming out of medical school to want to be family doctors like me.”
Patients, then, are having trouble finding doctors they like, and aren’t getting sufficient access to preventive care that could help them be healthier. “The emergency rooms are functioning and doing a lot of the work that normally primary care would do,” Janoo told me. “People are waiting a really long time to see anyone, and so often health issues that could have been caught sooner become more serious and dangerous.”
Finally, both providers and patients complain that insurance companies make the preceding problems worse, by adding administrative burdens and bureaucratic hassle.
So what would Janoo’s plan do?
First, her plan would guarantee free, government-paid primary and preventive healthcare for all in the state, by cutting insurers out of that part of the system.
Second, she wants to phase out the “fee-for-service” model of care, where primary care providers are paid based on specific services. She’s suggested, instead, either government-paid annual salaries, or per-patient per-month payments.
Third, she wants to try and try and make sure there are more primary care providers in the state, via more spending. “We would need some relocation incentives, so maybe $100 grand if you want to move here, or a student loan repayment program,” she told me. “My hope would also be that we could be a place for foreign-trained medical professionals to come here and be safe and accepted and to bring some cultural diversity,” she added.
As for how it would be paid for, Janoo proposes an income tax increase on the wealthiest Vermonters that, she said, would be comparable to the tax break they got in President Trump’s One Big Beautiful Bill Act last year. Though she hasn’t settled on a final amount, she hopes these new taxes would raise hundreds of millions of dollars.
Would Janoo’s plan work in practice?
In speaking with health policy experts both inside and outside Vermont, though, I heard various questions and doubts about Janoo’s plan.
Some of the problems mix the practical and political. For instance, under this plan, primary care visits would be free, but tests such as MRIs would likely still require the existing insurance system, as would most prescription drugs. Janoo acknowledged to me that deciding how many things the government should pay for would “always be a challenge,” but said her first priority was access to getting people at least some healthcare.
There are also questions about whether this primary spending is really targeted at patients’ most urgent problems. Erasing the copay for your doctor visit might be nice, but those copays weren’t driving people into medical bankruptcy. Janoo’s reform plan leaves the bulk of hefty health spending from hospitals and treatments for very sick people untouched.
The core challenge to Janoo’s reform will be the one that has dogged single-payer reform attempts everywhere: money.
Other questions are about whether Janoo’s hoped-for benefits from better preventive care — she’s said the state could save as much as $300 million a year — will materialize.
“There’s no question that better access to primary and preventive care makes people healthier in the end,” Larry Levitt, executive vice president of the health policy nonprofit KFF, told me. “But advocates have long tried to sell prevention as saving money. I think it’s more likely that it costs money, but keeps people healthier.” One reason for this, he said, is that better preventive care could help identify more underlying illnesses and conditions in patients, and spur more spending to try and address them.
The shift to a salaried model for providers could bring other practical challenges. Though Janoo hopes that ditching fee-for-service will free up providers to see more patients, others suspect a guaranteed salary might incentivize them to see fewer, and wonder what role the government would play in trying to hold such providers accountable.
Finally, I also heard some disconnect between what providers said they wanted, and what Janoo thought they wanted. When we talked, she told me her impression was that primary care providers were most eager for changes in their work environment. “I’ve asked them, ‘If you could get paid a good annual salary — like, average for the nation — and you didn’t have to deal with insurance and the fee-for-service structure, would you do that?’ They say, ‘Absolutely.’”
Yet Grumbach told me that, for the primary care system, “Problem number one is not enough money, problem two is not enough money, and problem three is not enough money.” In his telling, it’s more money that’s the real key to incentivize more new doctors to practice primary care, and help pay other staff and health workers who could actually deliver good preventive care.
If so, the core challenge to Janoo’s reform will be the one that has dogged single-payer reform attempts everywhere: money.
If the government takes on the responsibility of paying primary care providers and setting salaries for them, providers will want those salaries to be high. If they aren’t high enough, the shortfall in primary care providers will worsen. But the higher such salaries are, the higher the taxes the state would need to raise to pay them. Essentially, taxpayers would be asked to shore up doctors’ salaries to keep them in the state — turning the healthcare argument from one kind of difficult political issue to another.
Getting the balance right would be a challenge for the government, with much at stake. But Janoo says her background in industrial policy has convinced her that it’s possible. Furthermore, she hopes, it will be just a starting point for the full single-payer system she still thinks is urgently needed.
“My hope is, when I’m governor, that I can start to work with some of our neighboring states,” Janoo said. “Because if we could create a New England-wide system, we could move to universal healthcare really quickly. “I think it’s a moment where people recognize we need a universal healthcare system.”
And, she added, “If we had done it previously, it would be much cheaper than it is now.”
If there’s one thing a busy person doesn’t need, it’s more information. More emails, more notifications, more infinite feeds — the steady drip of data spells doom for the overstimulated American. And if you’re a busy parent, like me, sometimes it feels like a flood: school emails, doctor’s appointments, so many little things to buy.
Even things that used to be simple are harder. I recently listed an item on Facebook Marketplace, which quickly meant I was replying to offers and getting ghosted for the better part of a weekend before finding someone who, after a detailed back-and-forth about the most likely place to find a parking spot in my neighborhood, finally took my old baby swing away.
If only I’d had Muse. You’ve probably seen the ads on Instagram promising “AI that gets it done for you.” The new personal AI agent app from Meta can not only automate your Facebook Marketplace tasks, but also sort your emails, manage your calendar, and buy your groceries. And it’s free — unless you’re using it most of the day or you want access to Meta’s most powerful models, at which point it costs $20 or $100 a month. It all sounds, in a word, magical.
Muse is probably the personal AI agent you’ve heard of — and it’s currently the market leader with more than 8 million downloads in its first month, according to one estimate — but there’s now a small army of these bots: OpenAI recently announced Dots, X has Grok Bot, and there’s Instinct, which is currently invite-only and operates entirely in iMessage or WhatsApp. They all offer the same promise: to remove friction from your busy life.
For the last two weeks, I’ve been handing over more and more of my life to AI agents in pursuit of making my life a little simpler. What I found is that AI is unpredictable, and so are AI agents. When I first began using Muse, it started doing things I didn’t ask it to do. It offered to help with random email threads and created dossiers on people in my work meetings. It generated a detailed report on nearby apple-picking destinations based on a calendar invite from my wife. To me, an AI agent doing these things without prompting isn’t helpful. It’s unnerving.
But ultimately, I came away believing that AI agents can make your life easier.
That might mean giving an AI agent more access than you’re comfortable with — handing over lots of login credentials and possibly even your credit card. The more you rely on an AI agent, the more you risk outsourcing your decision-making. This raises real questions about how much agency we want to hold onto in our lives — even the tedious parts.
The leap of faith
Let’s get one thing out of the way first: To make an agent work for you, you’ll have to sacrifice a tremendous amount of privacy and grant it permission to access a lot of personal information.
Muse and its competitors can do the classic generative AI tricks, like draft emails or make you a fitness plan. If you’d like the agent to send one of those emails, however, you’ll have to grant it permission to access pretty much everything in your Gmail account. If you want it to schedule workouts, it will need access to your calendar. If you want the agent to buy anything on your behalf, it will need your credit card. If you want it to book your doctor’s appointments, it will need the credentials to log into your healthcare portal. The more permission you grant it, the more the agent can do for you, but that also opens up more opportunities for the agent to misunderstand you or your instructions (more on this in a moment).
This process of sharing your digital life with an AI agent means you’re giving an untold amount of personal information to tech companies, who don’talwaysbehaveethically, and who sell user data for profit. For now, Meta says that it does not share Muse data or conversations with its ad systems, although privacy experts warn that doesn’t really matter since those systems monitor what Muse does on your behalf. Nevertheless, Muse’s early days were filled with security and privacy blunders.
But without all of this info and access, the AI agents aren’t very useful. So if you’re not comfortable letting a bot into all of your accounts, an AI agent is probably never going to be the solution to your digital administrative exhaustion. But even if you are willing to hand that over, there are still other barriers to an agent’s efficiency and effectiveness.
The blank slate problem
AI agents, like a lot of new software tools (including chatbots), suffer from the blank slate problem. The blank slate problem essentially means that people don’t know how to get started. This might be because you don’t know about the tool’s capabilities, or because you simply don’t know what would be helpful. There might be some trust issues, too.
As with AI in general, we don’t exactly know how AI agents work. That means we don’t know exactly what they can do or how they’ll do it, according to Pattie Maes, a professor of media technology at MIT — so it’s necessary to do a lot of babysitting. “I feel like I’m not gaining a lot of time because I can’t completely trust the system,” Maes told me about her experience with Muse, “and I can’t predict how it will behave and what it will do.”
Some advice I heard from early adopters of these tools, however, is to start small. “In the beginning, it’s very hard to trust that it’s going to just magically do a really big thing,” Julie Zhuo, founder of the AI company Sundial and an early Facebook employee, told me about her experience using personal agents. “So you give it smaller tasks, and once you see it succeed, then I feel like you develop more trust that it can tackle bigger things.”
This is surely why Meta decided that Muse needed an Ideas tab full of small tasks the AI agent can do. Muse will also send you a lot of push notifications to prompt you to do stuff, like reply to specific emails or prepare for a meeting. That detailed report on apple-picking destinations? That was a notification about something I didn’t ask Muse to do. Muse also sent me a notification about a show hosted by a podcast I don’t listen to and another one with details about a Halloween party I wasn’t invited to, as well as several evening digests that included lists of things it had already bugged me about that day. Notifications are either helpful nudges or time-consuming attention thieves, depending on your worldview. However, if you fall into the latter category and turn off the notifications from your always-on personal agent, you’re inevitably forfeiting some friction reduction opportunities.
This gets to the heart of one of the big questions I have about AI agents: How helpful are they, really, if it’s this difficult to know what to do with them?
These agents worked much better when I drove the conversation. While wondering what to do with my new agents, literally staring at the blank slate, cost me some time, I found myself thrilled at how easy basic productivity tasks became. Adding events to my calendar, making to-do lists and then being held accountable for stuff not getting done, being reminded to reply to an email — it was these kinds of simple, administrative chores where I saw personal AI agents really start to save me time.
Other tech journalists seemed to have similar experiences. Eli Tan at the New York Times raved about Muse handling a call to his insurance company. Nicole Nguyen saved time by enlisting Dots for help canceling unwanted subscriptions. Allison Johnson at The Verge had Muse do a whole list of “pebble-in-your-shoe annoyances” she’d been putting off, and among other things, the agent succeeded in helping her buy an entire camping kitchen. Still, she wrote something that stuck with me: “the dirty secret of productivity hacks is that doing more stuff often doesn’t feel like things are being removed from your plate; somehow it just invites more tasks.”
This gets to the heart of one of the big questions I have about AI agents: How helpful are they, really, if it’s this difficult to know what to do with them? There’s a learning curve, sure, where succeeding at one thing gives you an idea to try something else and have some certainty about how well the AI agent will handle the task. But as the notifications roll in, and you spend more and more time texting with a piece of software, how much time are you really freeing up by using these tools? At a point, enlisting an agent with its own computer to do your chores still amounts to using one app to save yourself from using a different app.
The ironies of automation
Even when they have access to a lot of your information, and you’ve come up with some things for them to do, AI agents can be unpredictable. Because despite reading every email in your inbox or scanning every purchase on your latest bank statement, AI agents still can’t read your mind, and you can’t necessarily guess how they’ll interpret your commands. They can misunderstand you and, armed with the keys to your digital life, do some real damage.
Some people are already learning about the unpredictability of AI agents the hard way. One early adopter, Matt Robb, gave Muse the keys to his Facebook Marketplace account and was surprised when buyers started showing up at his front door ready to pick up their purchase. Muse, without asking Robb, had told them where to go. It turns out, without realizing it, Robb had given the agent permission to do so, and the agent had simply decided that the most efficient way to get buyers to Robb’s door was to give them his home address.
This dilemma is an example of a decades-old set of concepts known as the “ironies of automation.” Identified by psychologist Lisanne Bainbridge in a paper published in 1983, the ironies of automation help explain why things go wrong when humans give a machine too much control. As Vera Liao, an electrical engineering and computer science professor at the University of Michigan who studies human–AI interaction, explained to me: More advanced automation leads to more consequential errors, and the more humans rely on automation, the worse we get at catching those errors. “Even in simple tasks like judging whether AI output is wrong, people consistently accept wrong AI outputs even if they could have gotten it right on their own,” Liao said.
In some cases, like the time Muse read a journalist’s private messages, things go wrong as a result of poorly designed software, but more often than not, it’s the fault of the user who gives instructions that are too vague, giving the agent space to get creative, which isn’t always a good thing.
I had my own misunderstanding with Instinct. In a text message, the agent reminded me about a couple of emails I’d received and prompted me to follow up. When I replied to the text, I asked Instinct to show me possible replies to these emails. The AI agent instead just sent the responses it wrote. I audibly gasped.
Looking back at our chat history, I could see why Instinct interpreted my instructions that way. I effectively gave the machine too much control and then failed to manage the automation properly.
Leaning on AI to do your thinking is an example of what psychologists call cognitive offloading, where you employ an external tool to reduce your effort to complete a task. It makes completing the task easier, sure, but you also open yourself to mistakes. In this case, an AI agent took my instructions too literally, and I failed to catch the error. I can only imagine how a small oversight could turn into a cascade of catastrophes that need cleaning up. All it takes is one poorly worded email sent to the wrong person, and you might have hours of explaining to do — all because you were trying to save yourself 30 seconds of writing.
The real world slop
While I was testing all these agents, I talked to a mix of experts and early adopters. Their opinions were decidedly split about whether these tools were useful out of the box, without a ton of oversight and training by the user. The experts, who had all studied AI in academic settings, all brought up the ironies of the automation problem, where AI makes errors that humans can’t catch. And Maes, the MIT professor, pointed at another consequence: By outsourcing so many tasks to agents, we’re actually creating more work for everyone, including the human service workers who have to interact with this technology instead of us.
“There’s just more and more slop,” Maes told me. “We risk, in a world where agents do all the tasks for us, becoming so dependent on them that the world also isn’t created for us to interact with anymore, but it’s only created for our agents to interact with others, with services.” (We’re already seeing versions of how dominant tech platforms can fundamentally reshape real-world spaces: Think of how Starbucks no longer looks like a coffee shop where you can hang out all day, and is instead built and staffed around mobile order pick-up.)
The early adopters were decidedly more optimistic. Matt Van Horn, an entrepreneur who co-founded the ridesharing service that became Lyft, has been tinkering with agents since the craze started late last year. He’s currently telling his friends and family to use Instinct, which he described to me as “the most ambitious and aggressive” AI agent.
“I’ve been pushy with my mom and my wife,” Van Horn told me, “and saying, ‘Hey, you should sign up for this. It’s magical.’”
“My wife does not care about living in the future, but we have four kids,” Van Horn continued. She recently took a picture of a parking ticket and sent it to Instinct, no description, no instructions. Instinct, which had her credit card, just paid the ticket.
At the same time, outsourcing certain chores to AI agents causes real-world problems. Some of these AI agents can make phone calls, for instance, which can lead to some confusion when a human is on the other end of the line. Van Horn told me about the unfortunate time he enlisted an AI agent to reserve a room at a karaoke bar. “The karaoke place said, ‘Are you an AI?’” Van Horn said. “‘I don’t want to talk to an AI. Please connect me to Matt, the person.’ And so Muse had failed to book that for me.” Van Horn, undeterred, found something called Fo, an AI agent that will bring in human help to complete a task. Fo succeeded at making the reservation, although the entire ordeal surely took longer than if Van Horn had picked up the phone himself and talked to the karaoke bar himself.
At best, the times these tools worked and actually saved me time were rather mundane. I made a doctor’s appointment online using Instinct. Zhuo, the early Facebook employee, planned a party for her college reunion — everything from tracking down everyone’s emails to sending out invitations via Paperless Post. But she’s also said these kinds of applications of agentic AI “read more like vitamins than painkillers.” In the startup world, “vitamins” refers to a product that offers a vague benefit, and “painkillers” solve a big, immediate problem. If you’re a startup, you want to sell painkillers.
If you’re ready to give an agent a go, be prepared for the bot to make mistakes, and assume you won’t catch all of them. As Liao, the University of Michigan professor, put it, “Choose to use agents for tasks that you can tolerate the consequences of errors.”
In an effort not to create more emails or alerts or feeds to sift through, I’ve stopped using Muse. Like any new tool, it will get better and more useful as more people use it, so maybe I’ll revisit it in the future. I still have a text thread going with Instinct, however. It messages me from time to time, flagging an email or offering to help with an upcoming event. When there’s a clear payoff to giving the agent the go-ahead, I reply. Otherwise, I leave it on read.
Rep. Ilhan Omar (D-MN) during a news conference at the US Capitol on February 24, 2026. | Daniel Heuer/Bloomberg via Getty Images
This story appeared in The Logoff, a daily newsletter that helps you stay informed about the Trump administration without letting political news take over your life. Subscribe here.
Welcome to The Logoff: Donald Trump wants to deport a member of Congress.
What’s happening? On Monday, Homeland Security officers raided the Washington, DC, home of US Rep. Ilhan Omar (D-MN) in an investigation reportedly tied to immigration paperwork filled out by her father when she was a minor.
That was, at the time, more than enough cause for alarm. Trump’s animosity toward Omar, who is Somali-American and an outspoken critic of the administration, is well-known, and the raid is an extraordinary violation of the Justice Department’s usual rule to avoid taking visible action around politically sensitive cases within 60 days of an election.
On Wednesday evening, however, we learned more about the raid from the Wall Street Journal. The Omar investigation, the Journal reported, is explicitly aimed at stripping Omar of her citizenship — and thus her ability to hold office — and deporting her.
How would they do that? Omar came to the US as a refugee when she was 12 and became a US citizen when she was 17. The Trump administration’s investigation is said to focus on whether she or her family misrecorded her age in order to more easily gain citizenship.
The government cannot unilaterally denaturalize a citizen, however; it would have to ask a court to do so.
What’s the context? Historically, it’s rare for the US to strip citizenship from naturalized US citizens. But doing so at volume has been a major, if less visible, priority for the second Trump administration.
Why does this matter? Trump’s campaign to bend the traditionally nonpartisan DOJ into a tool to punish and harass his enemies has been one of the major stories of his second term.
Even if it never advances beyond Monday’s raid, an investigation targeting Omar’s citizenship with the eventual goal of deporting her from the US represents a new and even more dangerous evolution of that effort — and it threatens to move the US to a far darker place, where citizenship and the rights it guarantees are predicated on the president’s goodwill.
And with that, it’s time to log off…
Hi readers — if you’ll allow me to depart a little from my normal approach to this section, I have a story about politics to share. It’s not, however, about the politics we’re currently dealing with, but about what could be: Democrats’ plan for a quietly ambitious “Project 2029” should they win the White House in 2028. You can read it with a gift link here.
Alternatively, if you’d prefer to just log off, here’s an adorable snow leopard cub with massive paws. Thanks for reading, have a great evening, and we’ll see you tomorrow!
As the midterm campaign enters its home stretch, Americans’ expenses are rising — and the GOP’s prospects are consequently dimming.
Last month, consumer prices were 3.7 percent higher than they had been one year earlier, according to a Consumer Price Index report released on Wednesday. That represented an acceleration in the inflation rate, one driven largely by skyrocketing fuel prices: Gasoline was 9.1 percent more expensive in September than it had been in August. As a result, America’s average real wage has fallen by 44 cents since January.
In less than three weeks, Americans will head to the polls to decide which party controls Congress, along with a slew of state and local offices. As we count down to that momentous and potentially messy day, this newsletter is partnering with our colleague Astead Herndon and Vox’s The Midterms, Actually team for weekly editions on the biggest issues shaping the midterms. We’re breaking down one issue each week and suggesting further reading and races to watch in November.
Last week, we tackledthe data center backlash. And this week, we’re digging into affordability.
These upward trends in prices aren’t lost on voters. In a recent Pew Research survey, just 21 percent of Americans said economic conditions were “excellent” or “good” — while 65 percent said that Trump’s policies had made the economy worse.
The high cost of living is weighing on Republican candidates in all battleground races. Maine provides just one example of how potent the issue could prove on Election Day.
From one angle, the state’s Senate race might seem like a gimme for Democrats. Kamala Harris won Maine by nearly 7 points in 2024. Thus, in 2026 — when Democrats are poised to win in a national landslide — one might expect the party to easily triumph.
But Republican incumbent Susan Collins is an unusually formidable foe. The race has been a dead heat, with Democratic nominee Troy Jackson leading by just 2 points in a recent Suffolk University poll.
Fortunately for Jackson, Mainers’ energy bills are expected to soar in the campaign’s final weeks, plausibly increasing voters’ appetite for change in the process.
Maine is America’s second coldest state and unusually reliant on oil for home heat. As autumn advances, its residents will use more heating oil, thereby driving up both their personal bills and market prices. Thanks to the global energy crunch, a gallon of such fuel is already nearly twice as expensive as it was this time last year.
Jackson has been hitting Collins on the issue relentlessly. That could put a chill in Collins’s reelection odds — and thus, the GOP’s hopes of retaining Senate control.
➨ Other races to watch:
Similar dynamics are playing out in perennially icy Alaska, where Democratic Senate candidate Mary Peltola has hammered incumbent Republican Dan Sullivan for his complicity in sky-high diesel prices, which many Alaskans use for home heat.
In Ohio’s Senate race, Democrat Sherrod Brown has tried to pin rising electricity bills on Republican Sen. Jon Husted, due to his support for data center development.
And in Texas, Democratic Senate candidate James Talarico has attacked his Republican rival, state Attorney General Ken Paxton, for supporting “this disastrous war in Iran that’s driving up our costs.”
In other news
A brief ceasefire ends: Ukrainian drones attacked a Russian oil refinery early Thursday, days after Trump demanded both Russia and Ukraine halt such attacks.
Execution livestream canceled: Trump canceled a plan to livestream the execution of Fort Hood shooter Nidal Malik Hasan by firing squad.
On the podcast: A recent rash of violence between Saudi Arabia and Yemen’s Houthis threatens to destabilize the region — and make the Iran war much larger. Listen to the whole thing here.
One link for later
Rethink confidence. Research shows confidence is good for your job and good for your romantic prospects. Unsurprisingly, then, a whole industry has sprung up teaching people to be more confident. One writer signed up to work with a confidence coach for the first time, and ended up doubting that her self-doubt was all that bad.
Today’s trivia: What is the answer to the ultimate question of life, the universe, and everything in The Hitchhiker’s Guide to the Galaxy? (You can find this and other brain puzzles in Vox’s daily crossword. Look for the answer in tomorrow’s edition.)
Yesterday’s trivia: We asked which percussion instrument is famously played by Mississippi State University fans at home football games. That would be the cowbell.
The promise of GLP-1 drugs has always depended on people being able to afford them. These drugs still cost hundreds of dollars per month if you’re paying cash, at which point access becomes a privilege: The higher-income executive who wants to trim a few pounds might be able to afford them either way, but the low-income worker who needs the drug to lose significant weight might not be able to afford them — unless their health insurance covers it.
For a while, the trend lines for GLP-1 insurance coverage were positive. As of 2026, roughly two-thirds of private employer plans, which insure half of Americans, were covering GLP-1 medications for weight loss to treat obesity. Over the summer, Medicare launched a new $50-per-month prescription program. The US has struggled with an obesity epidemic for decades, but it looked like powerful drugs to treat it were finally starting to be more seamlessly integrated into the health system.
At least that’s how things appeared earlier this year. But now, private plans are pulling back from GLP-1 coverage. People are being left in the lurch, debating whether to try to pay for these drugs on their own or stop taking medicines they feel are making a real difference for their health.
The dilemma reveals one of the structural flaws in American healthcare. For working-age adults, your insurance depends on your job. Unfortunately, because people no longer stay at the same job for decades, there is not a strong financial incentive for employers to make investments that will benefit your health in the long term — but there is a strong incentive to minimize short-term costs as much as possible. It’s the kind of perverse rationale that could compel employer-sponsored health plans to stop covering a drug that, if taken over the full course of a person’s life, could help them not only lose weight but ultimately reduce their risk of heart disease, kidney disease and other chronic health problems, improving their health and saving all of us money as they get older.
“An employer or an insurer making coverage decisions doesn’t necessarily care if they’re saving Medicare money,” said Dan Sacks, a healthcare economist at the University of Wisconsin-Madison. “That’s a classic problem with the American health insurance system, and it’s certainly salient here.”
This mismatch between what’s good for people’s health and what’s good for the corporate bottom line has long been one of the underlying flaws in the US health system. Now access to GLP-1 drugs is shrinking just as these drugs were starting to make a real dent in the US obesity crisis. The stakes couldn’t be higher.
Why employer-sponsored health plans are suddenly dropping GLP-1 coverage
From the beginning, insurance coverage was the big question hanging over GLP-1s and their potential to revolutionize US healthcare. But recently, it looked like we’d turned a corner.
When I attended the Aspen Ideas: Health festival over the summer, pharmaceutical reps seemed visibly relieved that GLP-1 coverage had been picking up among private insurers. In 2026, about two out of every three employer-sponsored plans were covering some of these drugs for weight management, up from about 20 percent just the year before.
“They’re recognizing that this is an investment in their workforce,” said Laura Steele, who leads the cardiometabolic health unit at Eli Lilly, which manufactures Zepbound and Foundayo. “Yes, there is a budget, and there is a benefit design that every employer has. That’s real. That’s not going away. But they’re also recognizing the overall cost that they’re experiencing by not dealing with this too.”
But as employers and private insurers make coverage decisions for next year, they are suddenly pulling back. At least 10 percent of employer plans that currently cover GLP-1s for weight loss say they are likely to discontinue coverage in 2027, according to one survey by the Business Group on Health — and that number may still increase. A Mercer survey of large employers found that 6 percent had dropped coverage in 2026 and another 5 percent were planning to in 2027 or actively considering it. A separate report from the Health Policy Commission in Massachusetts found that the number of commercially insured people in the state taking a GLP-1 drug had fallen by 50 percent between 2025 and the first quarter of 2026 as private coverage started to drop off.
When a lot of people start taking an expensive medication all at once, it’s going to raise costs for employer insurance plans — and they have to figure out how to adapt. Insurers set premiums at the start of each year, based on how many people are on the plan and how much healthcare they are expected to need. But if those estimates are off — say, if more people take an expensive GLP-1 drug than the insurer expected — they have to offset those costs somehow, and raising premiums the following year is a common solution. According to one estimate, premiums are projected to grow by 5 to 13 percent due to GLP-1 costs — and the burden of paying those higher premiums is likely to fall on the workers. The employer can also try to limit GLP-1 use by, for example, asking workers to pay more out of pocket for these drugs; according to Mercer, 27 percent of large US employers instituted some kind of utilization controls for GLP-1 drugs over the past year or plan to next year.
They also have the option to simply stop covering these drugs for weight loss altogether — and that’s the route more and more of them are deciding to take. The abrupt reversal has even caught economists like Sacks off guard.
3 big reasons employer health plans are dropping GLP-1 coverage
Employers aren’t invested in people’s long-term health: As Americans switch jobs more often, companies want to cut short-term costs.
GLP-1 prices are still high, upward of $600 per month per person for insurers.
A lot of people are eligible to take them for weight loss; two in five US adults have obesity.
“I was surprised that anyone would do an about-face because I thought they understood the trade-offs well,” Sacks said. “My guess is that it turned out to be more expensive than they anticipated: Take-up is higher, and possibly more people are sticking with it. That’s one reason that you might not want to continue to offer it.”
For employers, the short-term costs of covering a drug often outweigh the long-term benefits that medication may confer, at least from the employer’s POV. One analysis — notably produced by Blue Cross Blue Shield Kansas — concluded that covering GLP-1s for weight loss increased average employee health costs by $7,000 in the first year and another $4,200 in the second, largely due to the cost of the drugs themselves. And yet at the same time, there were no decreases in obesity-related medical events in that time period. Another study from Sacks and his colleagues at Indiana University and the University of South Carolina found that GLP-1 use did not lead to any cost savings over five years.
So in the short term, these employers are arguably making an economically rational decision — but one that may still come at their employees’ expense. “I’m completely screwed,” said one person on Reddit about Cigna’s plans to drop GLP-1 coverage for their own employees. They’re looking at at least $300 for one month’s supply at cash prices.
They weren’t alone either: “I’m devastated,” said another person, commenting on Starbucks’s decision to stop covering GLP-1 drugs. They said they had an autoimmune condition that had made it difficult to lose weight — until this new class of medicines came along.
Where GLP-1 coverage goes from here
How could we end up here, where it makes good business sense for companies to make a decision that could potentially harm their workers’ health in the long term? It is at least in part a result of the haphazard way the US has ended up insuring people.
When employer-sponsored insurance started to arise in the mid-20th century, eventually becoming the primary way to cover the working-age population, people tended to stay at the same job for a long period of time. In theory, there was a synergy: Companies wanted their workers to stay productive, and so it was worth it for the company to invest in their long-term health via their insurance benefits. And research has found that people who stay with the same company — and the same insurance plan — tend to have better health than those who switch a lot.
But these days, people change jobs all the time or work various gigs to piece together an income. You probably don’t expect to stay at your job for 10 years — and your employer doesn’t expect you to either. Instead, they want to keep their own costs as low as possible in the short term. This leads them to cut GLP-1 coverage, even though doctors do believe that people could benefit tremendously long term from the weight loss these drugs help them achieve and all of its potential health benefits.
“There are very real health benefits of these drugs,” Sacks told me. “The fact that we don’t find offsets or they’re even more expensive than we thought doesn’t necessarily mean that we shouldn’t cover them.”
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In theory, the market is supposed to fix the price problem: Drug companies get a period of exclusivity for the drugs they develop, and then, once that time elapses, cheaper generic versions can come onto the market. But generic semaglutide won’t be available in the US until at least 2031 — and for some versions, the generic competitors aren’t going to debut until the 2040s. Offering GLP-1 coverage could become a competitive advantage for employers, a perk they can offer to entice potential workers as part of their benefits package.
Beyond that, though, the path to more affordable GLP-1s is not immediately obvious right now. A lot of people are already willing to pay cash for these drugs — and that may continue as long as people can afford to do it. But with inflation still steadily rising, these drugs could slip out of reach for more and more Americans.
The government could get involved, but, for now, the federal government’s negotiating authority only covers Medicare, not the private plans that are dropping coverage. Serious healthcare reform is probably off the table until at least 2028, and then only if Democrats win both Congress and the White House and decide to make a healthcare package their legislative priority.
But the lesson of these recent developments is that, at some point, the US may have to look seriously at the underlying problem creating this mess in the first place. A patchwork method of insuring people that privileges short-term cost-cutting over people’s long-term health isn’t a real healthcare system.
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