About this episode: Two health policy experts could not disagree more about the Affordable Care Act. Yet they're working together to tackle what they see as a root cause of unaffordability. In this episode: A 1954 change to federal tax code made employer-provided health benefits tax-free, incentivizing employers to cover workers' health insurance—but this policy is one explanation for high healthcare costs for Americans today. Guests: Michael F. Cannon, JM, MA, is the director of health policy studies at the Cato Institute. Elizabeth Fowler, PhD, JD, is a distinguished scholar in Health Policy and Management at the Johns Hopkins Bloomberg School of Public Health. Host: Dr. Josh Sharfstein is distinguished professor of the practice in Health Policy and Management, a pediatrician, and former secretary of Maryland's Health Department. He served as the Baltimore City Commissioner of Health from 2005 to 2009. Show links and related content: This policy is at the root of unaffordable health care—Washington Post The New Reality Facing Medicare, Medicaid, and the ACA—Public Health On Call (August 2025) Transcript information: Looking for episode transcripts? Open our podcast on the Apple Podcasts app (desktop or mobile) or the Spotify mobile app to access an auto-generated transcript of any episode. Closed captioning is also available for every episode on our YouTube channel. Contact us: Have a question about something you heard? Looking for a transcript? Want to suggest a topic or guest? Contact us via email or visit our website. Follow us: @‌PublicHealthPod on Bluesky @‌PublicHealthPod on Instagram @‌JohnsHopkinsSPH on Facebook @‌PublicHealthOnCall on YouTube Here's our RSS feed Note: These podcasts are a conversation between the participants, and do not represent the position of Johns Hopkins University.