Director Matt Nadel developed the Oscar-shortlisted documentary short "Cashing Out" after learning about his father's investment in viatical settlements during the Covid-19 pandemic's early stages.
Viatical settlements involved buying life insurance policies from individuals with terminal illnesses, such as those with HIV/AIDS, for a portion of the policy's value in cash. This practice provided funds for various needs, including medical care, housing, or personal experiences, for policyholders in their final months. Nadel's father had invested in these settlements, a practice that Nadel later connected to his own upbringing.
The film explores the history of viatical settlements during the AIDS crisis. Scott Page, a key figure in the documentary, utilized an early viatical settlement for his partner, Greg, who had AIDS, to provide financial security. Page subsequently became a broker for other men with AIDS, noting that many lacked family support.
Initially, banks and credit unions were hesitant to participate, leading private investors to form the primary network for purchasing these policies. Investors assessed a policyholder's health status, such as T-cell count and life expectancy, to estimate the time until payout.
The documentary also highlights disparities in access to viatical settlements. DeeDee Chamblee, an advocate, notes that Black trans women living with AIDS, who often lacked employment with life insurance benefits, typically could not access such settlements.
By the late 1990s, advancements in antiretroviral therapy extended the lives of HIV-positive individuals. This development impacted viatical investors, who found themselves paying premiums for longer than anticipated, as payouts were delayed.
Nadel's film posits that while viatical settlements offered assistance to some, their existence underscores deficiencies in the US healthcare and social safety net, particularly regarding access to care. Nadel states the film's thesis is that the system "helped a lot of people, but I’m disgusted that it had to exist." The film draws parallels to contemporary healthcare precarity in the US. Nadel chose to include his father's story in the documentary after subjects like Page and Chamblee shared their experiences openly.