Birth of Red Pill, Death of Medicaid

Back in 1999, Neo was offered a choice between the blue pill and the red pill, between ignorance and enlightenment. The red pill was a signifier of escaping the mainstream, being a free thinker, accepting harsh truths about the reality we are forced to endure everyday.

Now in 2025, Bryan is offered a choice between the NPR podcast and a red pill podcast, between ignorance and enlightenment. The red pill podcast is a signifier of escaping feminist groupthink, being a truly masculine man, and accepting harsh truths about the evil that women perpetuate through the pursuit of their autonomy.

The Red Pill ideology, which prioritizes male superiority and anti-feminism, thrives on Reddit but has infected almost all social media platforms as of present day. Back in 2016, the community on Reddit consisted of mostly white men who were in their early thirties and claimed their views align with President Donald Trump. [6] However, research shows that red pill content is now consumed by men of far younger ages, including adolescents as young as eighteen and men in their early twenties. [1] Reasons for enjoying red pill content amongst young men include the lack of sugarcoating in these online forums, the utilization of biology and facts to back up arguments, and an abundance of advice to increase sexual success and masculinity. [1] Sexual success and masculinity are bonded by the common denominator of testosterone, the primary sexual hormone in biological males. From extensive online observation, a significant aspect of the red pill approach to heightening masculinity involves resistance training and a diet very reminiscent of the ketogenic diet.

Select evidence shows that a ketogenic diet is correlated with an increase in total testosterone amongst male participants who followed the diet for a few weeks. [3,12] However, other studies have demonstrated that a ketogenic diet is associated with a decrease in free testosterone (FT), [9] which is different from total testosterone in that FT is not bound to proteins and is available for use when building muscle. [5] Conflicting evidence makes it difficult to deem ketogenic diets as a concrete method of increasing testosterone as desired by followers of The Red Pill ideology. However, a medical correlation that stays pretty much uncontested is that meat consumption is associated with increased low-density lipoprotein (LDL) cholesterol in the blood, which is a gateway to high-risk or even fatal heart disease. [7]

How is Medicaid involved with Bryan and his red pill podcast? A great number of nonelderly Medicaid beneficiaries have a chronic condition, with high cholesterol being the second most abundant condition. [8] Much of red pill content focuses on the apparent female need for “alpha men,” who have masculine builds and immense wealth. [1] This stirs a great deal of anger within the community, which indicates that perhaps most consumers of The Red Pill ideology are not able to meet what they believe are the needs of a woman, which includes an overflowing wallet. Essentially, the dietary advice that floats around from one online red pill forum to the next feeds into a future situation that may require a red pill consumer to require coverage from Medicaid. From a public health perspective, this brings up the question of whether The Red Pill ideology is luring men into self-destructive cycles that have repercussions beyond the weakening of their self-esteem. Have middle-class men been convinced to adopt lifestyles that are advertised through social media to increase their masculinity but in reality lead them down a path of needing medical coverage for chronic heart disease?

Bad news: This medical coverage may have become increasingly difficult to access. While the White House states that there are no cuts to Medicaid, [4] the impact of The One Big Beautiful Bill includes increased out-of-pocket payments for Medicaid beneficiaries, an increased difficulty in keeping Medicaid due to tighter enrollment deadlines and the loss of auto-enrollment systems, and the curtailing of provider taxes which ultimately decreases funding for rural community care. [10] The red pill health cycle may have escalated from self-destructive to potentially fatal.

If it truly is a cycle, then the passing of The One Big Beautiful Bill must circle back to red pill content. Keeping in mind the aforementioned increase in young male consumption of red pill content, a bulk of which is prevalent on Reddit, let us consider the demographic statistics of young voters in the 2024 U.S. presidential election. Men aged 18–29 voted “decisively for Trump” according to the Survey Center on American Life, with approximately 55% of young male voters claiming to be in support of Trump. [2] Clearly, a conservative lean was present amongst young voters who participated in the last presidential election, and the roots of this ideological skew can be attributed partially to increased conservative media consumption. In fact, two groups that received a majority of their political news from social media during the last election cycle were those who voted red and young voters aged 19–29. [11] Furthermore, young men were more likely to receive their news from TikTok, X, and Reddit, while young women mostly remained on TikTok. [11]

Let us visualize a potential cascade of correlation: Red pill content prevails on Reddit, which is a major news source for young men in the U.S. From here, two branch points occur. Reddit as a news source leads to the adoption of red pill approved dietary guidelines, which often promote ketogenic diets and increased meat consumption in efforts to increase testosterone. It also leads to the conservative lean amongst young male voters in the last presidential election. Ketogenic diets lead to increased LDL levels in the blood and subsequent risk of heart disease, and the conservative lean leads to the enabling of the government to pass a bill that jeopardizes Medicaid for future generations. These two converge when increased cardiovascular risk amongst middle-class men requires a need for Medicaid assistance and/or rural healthcare, which are depleted under the new legislation.

These are potential correlations, but further research in the intersection of politics, media, and health outcomes may cement this cascade as a legitimate pathway for destructive health behaviors, which would then assist future medical professionals in reversing or preventing such behaviors from coming to fruition amongst young male patients. Our current media sphere is closely linked to our current sociopolitical condition, and both are impacting the health obstacles patients are facing and how doctors must respond to them. Understanding the root cause of medical behaviors is essential for effective treatment and prevention, but also for a more empathetic approach to healthcare that is lacking in the current system. The frustration that comes from not understanding why someone would adopt extreme diets from a young age negatively impacts the patient’s experience with their physician and the physician’s ability to provide productive advice for sustainable lifestyle changes. Physicians closely follow their medical training and recent medical research to make patient care decisions, both of which currently lack the inclusion of media studies and political communication. Red pill content and Medicaid is just one example of how political media consumption (PMC) could be a potential social determinant of health (SDoH) that was omitted in previous discussions about the non-medical factors that impact American health outcomes. The reality is that there is no blue pill or red pill, but instead an atorvastatin pill, one meant to lower your cholesterol and perhaps no longer covered by Medicaid in the years to come.

Esha Brahmbhatt is the Chief Executive Officer of Cabin Fever Magazine. She discusses the intersection of media/communications and health in the United States.

References

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8. Saunders, H., Burns, A., & Rudowitz, R. (2025). 5 Key Facts About Medicaid Coverage for Adults with Chronic Conditions. Kaiser Family Foundation. https://www.kff.org/medicaid/issue-brief/5-key-facts-about-medicaid-coverage-for-adults-with-chronic-conditions/#:~:text=Counts%20of%20diagnosed%20chronic%20conditions,90K
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