On a walk with his father in 2020, Matt Nadel learned an earth-shattering truth about his upbringing. A few years later, he turned that truth into the short film “Cashing Out.”
During the early days of the AIDS crisis, before life-saving medications and therapies came into play, thousands of people turned to a new industry for a little relief before they died: viatical settlements, or the practice of people with terminal illnesses selling their life insurance policies to a third party. The sick person gets money to make the rest of their life more comfortable, and when they die, the owner of their policy collects the payout.
On that walk with his father, Nadel learned that his father was one of the investors who bought life insurance policies during the AIDS crisis. He started researching viatical settlements, trying to make sense of an undeniably morbid practice, but one that also helped so many people in an impossibly dire situation. Out of his research came “Cashing Out,” which examines what type of system allows for something like viatical settlements to exist, focusing on the intertwining perspectives of Scott Page, the broker of one of the first sales of a life insurance policy for a person with AIDS (that person was his partner); Sean Strub, who sold his life insurance policy and then lived to tell the tale; and Dee Dee Chamblee, a Black trans woman who navigated the AIDS epidemic in Atlanta without a life insurance policy to sell.
The short played at last year’s Out on Film festival, and was recently shortlisted for the Best Documentary Short category for this year’s Academy Awards. I recently interviewed Nadel about his personal connection to the subject matter and how he approached making the documentary. This interview has been edited for length and clarity.
Before we dive into “Cashing Out,” I know you are an investigative journalist. How did you come to that?
Matt Nadel: I came to journalism through documentary, actually. I’ll tell you a long story quickly, which is that I was actually a child actor. I grew up in Florida, and I was in little commercials and indie films. I had a non speaking role on a TV show. I was always so fascinated with what the crew was doing, what was happening on the other side of the camera. So I pursued film first.
When I was in high school, I started getting really interested in politics. You know, I lived in Florida, and I saw over the course of my young life how Florida had changed so much politically. It went from really being this swing state to being solidly red. There were all these things that were interesting to me, so I always wanted to put these passions together — my love for movies and a desire to interrogate political questions. Documentary was such a natural way to do that. It was in college that I came across a few stories that I was really interested in, but that just didn’t feel visual in nature. That’s when I started reporting in print as well, because those were stories I wanted to tell. I would say I’m an investigative storyteller, whether I’m telling a story in print or on film.
When you start a documentary, and I know you’ve made a few now, when you find the subject, what is your first step in starting to investigate something? What is your process?
Nadel: I mean, it’s very content specific, obviously. It’s interesting, I’m not somebody who really believes that there is such a thing as objectivity, and we all bring our own biases to the table. There’s no such thing as an objective story. That being said, my first step is to try and do as much listening as I can and not [impose] whatever predetermined beliefs I have onto the subject matter, because oftentimes there are nuances that the general public does not appreciate that are happening in the conversation that are the basis for good reporting. I don’t want to paint with a really broad brush when there are probably fine details that need to be captured.
With “Cashing Out” specifically, that was a bit of a different beast, because my entrée to the story was a personal one, which is not always the truth for other stories I tell. On that project, for example, my first step was just to try and dig into the archive. I was reading old gay newspapers, and looking at the op-eds, and how were people talking about this at the moment — digging up old cable news footage and “The Phil Donahue Show,” and also AIDS community television, to see how the was the general public, and also how was the affected population talking about this? Not me in 2025, crossing my arms and making a world determination about this, but trying to get a sense of, what was the shape of the conversation in the moment that it was happening? Then I started trying to meet people who had survived and who would have interesting insights to share at this point.
The cable news footage was so interesting, just because along with everything else, I thought it was a good example of how media language all becomes unified — the word “ghoulish” kept coming up.
Nadel: It’s so true. I have to say with that, I was really surprised, because yes, I understand that the industry is ghoulish, and I’m not surprised that they reported on that. But we have to remember that the media was doing a pretty lackluster job reporting on the ways that the government was neglecting people with HIV. There were all these government programs that were failing to protect people, and the media was not doing the kind of reporting it needed to do on that. Instead, it was taking the low hanging fruit of this crazy industry — which yes, totally. But that industry exists because people are trying to find a way to survive a context of neglect and abandonment and austerity that you weren’t reporting on.
Moving to your personal connection to this, which is obviously your dad, I’m curious what that was like? How did you find out about this? Did he just tell you, had you already heard about it?
Nadel: No, I had no idea. It was in 2020, interestingly, at the beginning of our most recent pandemic. I was back home in Florida on a walk with my dad one day. This was around the time that there was conversation about a vaccine, but we didn’t have one yet for COVID. I just said to him, sort of offhand — Look, I obviously want there to be a vaccine, but I can’t help but feel sort of uncomfortable that there are some executives at these pharmaceutical companies that are going to make a ton of money off of this pandemic that has killed and bankrupted and devastated so many people. And my dad was like [in an aggressive tone], “What do you mean by that?” I was like,”Whoa! What?” That is so not his vibe — I was like, “Whoa! What do YOU mean by that? What’s going on?” And he was like, “I think I have to tell you about something.”
That’s when he explained — before you were born in the early 1990s, I had this business, and this is what it consisted of. He was kind of defensive of it off the bat … It sort of set me on this path where I was like, look, I need to figure out what to make of this, not just as your son, but as a gay man. I live and stand on the shoulders of the activists of that era who fought for the health advances and the advances in recognition that mean that I can live a free and healthy life now. So, if you’re telling me I have benefitted from their deaths in some way, that’s something that I really need to take seriously and try and reckon with. Making the film was my process of trying to do that. It didn’t even start out as, I’m gonna make a film. I started doing the research just to try and figure this out for myself. Then as I started meeting people, I understood a film was sort of taking shape under my nose, and I just needed to start rolling a camera.
I think you’ve been pretty vocal and the film is fairly clear, I think, about how your opinion on viatical settlements evolved over the course of making this. I’m curious, how did your thoughts about the American healthcare system writ large evolve, because I think that’s the more poignant thing here.
Nadel: I didn’t realize going into it how much this was a story about the American healthcare system. I guess I would broaden that slightly to say, the American social safety net. I went in really, again, with this personal quest to figure out what to make of this moral and financial inheritance of mine. It was through the conversations with — I interviewed many people beyond those included in the film, almost two dozen people. As I was talking to them, and especially when I met Dee Dee [Chamblee], who’s in the film, it became clear to me that the disgust that people sort of instinctively feel toward this industry, I think it’s valid, but a bit misplaced. That disgust is really for the systems that created the conditions and the need for this industry to exist. That’s the sort of journey I went on in making it. I realized, I’m losing the forest for the trees here. I don’t want to get mad at this group of marginalized people who are doing whatever they can and grasping at whatever tool to survive. I feel angry at the systems that profit off of their suffering and do nothing to help them.
I think the American psyche has this fear of socialism ingrained in it, and this idea that when we provide for our people, there’s something un-American about that. But the lines that we draw between what is and isn’t socialism are really arbitrary. We have a completely socialized education system. We can agree children have the right to go to school, and you don’t see anybody really decrying that as un-American or overly socialist. I think that if you’re given a prognosis of six months or 12 months to live, you shouldn’t be worrying about how you’re going to pay your rent. I just think we can do better than that as a country.
The journey there reminded me a lot of a documentary from, I think it was last year, called “Life After.” That’s more centered on the right-to-die argument, specifically in Canada. But there’s an argument that comes out of that movie — when you’re given the choice between no one to take care of you, expensive healthcare, no money, losing your job, and dying, that’s not really a choice.
Nadel: When you make life so hard, is it really a free choice to die if the choice to live is inherently a choice to be neglected? I had never really thought of that link between those films, but you’re totally right. The way healthcare is delivered in this country, it’s a catch-22. To get sick and get care, you need health insurance. To get health insurance, you need a job. To have a job, you need to be well enough to work. So you have to be well enough to get sick. It’s just so broken, you know? It makes the system much more expensive, also, because then people wait to go to the doctor until they’re in emergency situations because they don’t have coverage, and it’s a huge stress on the system. It’s a classic example of how the bootstraps ethos of America gets in the way of both the human dignity that I think we all understand and want people to have, especially as they’re dying, and of prudent policy.
You mentioned that you interviewed a lot more people than we see on screen. How did you decide who you actually wanted to include in the film? Scott feels like a given, a little bit.
Nadel: There’s a challenge in telling this story, which is that it’s a story about an industry, which is a sort of amorphous, not very sympathetic thing. What I was looking for were stories that made my heart sing in some way, because I knew this film would stimulate my brain and the brains of my viewers. But film is an emotional art form, and I could see that this was a highly — even though this is an economic history — personal history for so many people. So that was really the metric for me. I needed people who, through their personal stories, we could tell the story of the industry, and also these personal stories were going to make people lean in. Scott was such a given for that, given the fact that his intersection with this industry is a love story. I think people respond and open their hearts to love stories, and that’s one of the ways that we have been able to communicate AIDS history well over the course of the generations, is to tie it in with, this is an illness that oftentimes couples got and had to navigate together.
With Sean, I was really interested in the question of how does a person feel after they’re told they’re going to die, they sell their policy on that premise, and then they live? He was such an amazing living answer to that question, because what he chose to do with his money was not just some fun vacation. He really invested it back into his community by starting the magazine Poz. It cannot be overstated how important Poz was in that moment. It was really the only source of good, reliable, non-stigmatized information about HIV and AIDS. Which, if you lived in New York, or L.A., or San Francisco, maybe you could get [information] from other places. But if you lived in Kansas or Florida or Georgia, you could get this in the mail, and you could feel like you were a part of a community of people dealing with this, and like you weren’t alone. He was told he had two years to live, and that’s how he said he wanted to spend them, making people feel less alone. I mean, I tear up even thinking about that impulse. And [Poz] it’s still in existence today.
That’s amazing — I mean, magazine culture is bad.
Nadel: I know! It’s really amazing! Again, it made my heart sing to think about how he transformed something so terrible as a fatal prognosis into a way of pouring investment back into his own community, and then that he got to live to see the fruits of that, and see how many people it helped, and see the tides of the epidemic turn.
Dee Dee is a legend. She, first of all, needed and needs her flowers, so I was really excited to be able to feature her in the film, so that people would know who she is. It’s shocking to me that they don’t. She’s the first black trans woman ever honored at the White House. She was the answer to the biggest picture questions that I came to in making the film — what did people without life insurance do to navigate this moment, and what kinds of changes do we need to make to our society so that this basic form of dignity is available to all people, not just people whose lives are deemed valuable by a life insurance industry or by a capitalist system? What really made it clear to me that she needed to be in the movie was she told me that she remembered this industry very clearly, because she remembered the dream that she had of what she would do if she had money like that — go to the beach, and she would just sort of live out her dying days there until it was over. That fantasy struck me as so morbid. Her fantasy was just to go die somewhere else, but even that was inaccessible to her. So she had to, as she says in the film, get herself up from out of her grave and dust herself off and fight, and fight for the black trans community that she saw was being hit so hard by the epidemic, but was not being recognized. Again, that thing of, you’re told you have very little time to live, and she chose to spend it fighting so that people like her could get access to the same level of dignity and even joy that disproportionately white gay men were getting through the vatical settlement industry.
You’re in this film, partly because your father is part of this, but you’re also in the interviews with all three of those subjects together. I was curious, have you ever done something like that before?
Nadel: No, I’ve never been in a film of mine before. Actually, since “Cashing Out,” I have been, but it was the first one that I did. It was sort of scary — it gave me a whole new level of respect for the people who are in my films and the incredible vulnerability of putting their story in my hands, and trusting that I will do them justice. It’s brave, really, and I’ve always known that. But I appreciated it on a new level, because I’m in control of the edit — I’m in control of how I look in every frame, how my story unfolds — and even I’m afraid of how the audience is going to see me. Imagine if I didn’t have any of that control.
Did you have any trouble — I’m thinking specifically about your dad — getting anyone to participate? Did he have any reservations about that?
Nadel: No. I mean, I think he felt like, if participating in the film was going to help [me] process this, then great. He’s a really good dad. I think he also — this was a period of his life that was really impactful, but then he basically didn’t revisit [it] for 20 years, almost. I think he actually welcomed the opportunity at this very different season in his life to pick these stories back up and re-examine what this meant.
I did see, through the process of making the film with him, a sort of softening happen with him, specifically politically. He’s a real sort of pull-yourself-up-by-your-bootstraps kind of guy, and he’s always been a very free market kind of thinker. In the film, he says, after my time in this industry, I can’t help but think that you shouldn’t have to sell your life insurance policy in order to live. That seems obvious, but that is not obvious for him. I think a year before making the film, I don’t know if he would have said that. So, I think he welcomed the opportunity to look back and try to make meaning of a period of his life where he was exposed to a pretty crazy amount of death. He was in his 20s and 30s, and he sort of just moved on. So I think it was a good moment for him to say, what do I make of that?
Yeah, that was kind of crazy.
Nadel: Exactly, and how should that influence my politics and the way I am in the world?
This might be a little heady, but I was watching a TikTok about something else you do, which is making short documentaries for people applying for clemency. Something you said really stuck with me: “I don’t think people’s freedom should depend on elaborate filmmaking.” This is something I’ve been thinking about a lot lately. I feel like every documentary I watch is about something terrible in the world, and I’m so thankful for the people making those documentaries, but at the same time as more of them get made, for me personally it becomes a, when does this ever stop, sort of feeling. I wonder if you struggle with that as the person on the other side of things?
Nadel: First of all, I want every film that I make, even about difficult topics, to include moments of laughter and release. I think “Cashing Out” has that. I think that there are different ways to make films about difficult subjects. There is a version of things where it’s kind of a fire hose to your face of, this is so bad. And the primary emotion they want to evoke from you is disgust or horror. Then I think there’s a type of film that treads a bit more carefully. It’s saying, look — yes, this is hard, but I’m not trying to make you emotionally shut down, or respond to this as if it were a horror movie. I’m asking you to think and consider things.
I think filmmakers have a tendency to underestimate our audiences. I think people want to think. I think people want to understand these problems and not just have them shown. We don’t want to be fire-hosed to our face of stories about the worst things in the world. But we do want to understand why those things are happening. I think that a big part of the issue you’re talking about it, as filmmakers, I think it’s our responsibility to not just capitalize on people’s pre-existing disgust or horror. But if we’re asking people to feel something hard — if we’re asking viewers to go there — there needs to be a purpose. What are we asking them to think about in a new way? How are we advancing their understanding of this thing so it’s worth the pain? That’s part of the reason I chose to make “Cashing Out” a short, at 40 minutes, rather than a feature. This is heavy. This is a lot. I don’t need to puff it up to make it a feature. Forty minutes is actually enough, and a person is generous if they are willing to give 40 minutes to think and rethink about this.
I think a lot of it comes down to the intention of the filmmaker in bringing up these stories. You see films that are about really sad things that do it well, and you leave them feeling sad, but also feeling a deeper sense of understanding. I think that is the difference.
Yeah. You know, sometimes I come out of these things feeling helpless, which is not a great feeling. And the feeling I am always searching for is, what can I do? Or how does this affect my life moving forward?
Nadel: Totally. I also think there is a political usefulness for the powers that be of that feeling of helplessness. But I hope with “Cashing Out” that people understand the resonance. I never expected that “Cashing Out” would be as timely a film as it has become, but just in the last week, because of the expiration of Obamacare tax credits, tens of millions of people see their health care premiums go way up, meaning they’re either going to be bankrupting themselves to pay for health care, or they’re going to be having to go down to a lower level of coverage or lose their health care altogether.
Yes, we need to go into the streets. We need to march. We need to fight to get our protections back, and to make sure we’re taken care of by our government. But what are we supposed to do in the meantime? I think my film, my hope is, that it offers an instruction manual from queer history of how we can band together and find creative ways to survive while we’re waiting to see the fruits of our advocacy.