The health care debate is coming to a head in Washington, where the moment of truth has arrived for Republicans who have vowed for seven years to “repeal and replace” Obamacare the first chance they get. On Beacon Hill, state leaders are wrestling with how to restrain Medicaid costs without cutting people off coverage.

No one understands these issues as well as John McDonough, who joined Bruce Mohl and me for this week’s Codcast. McDonough is a professor at the Harvard Chan School of Public Health, but his policy studies today are informed by decades he spent as a policy practitioner.