As a young gay man, Matt Nadel was discomfited to learn in 2020 that his father, Phil Nadel, had invested in the viatical settlements industry in the early years of the AIDS crisis. “He shared that he’d made a good bit of money off of the life insurance policies of gay men who died of AIDS. That’s what funded my childhood,” Nadel says.
Nadel, 26, initially delved into the morally ambiguous history of viatical settlements to figure out his own story. Starting in the late 1980s, thousands of people with AIDS sold their life insurance policies to investors for quick cash, until the advent of effective antiretrovirals for HIV and AIDS ended the controversial industry a decade later. Was it a way for investors to profit off the deaths of people stricken with an incurable and then-fatal illness – or did it provide people with AIDS the cash they needed to afford care and live out their last days with some joy and dignity?
As Nadel trawled through print and video news archives and interviewed survivors, he realized this moment in American AIDS history needed to be told. “I wanted to dig into the huge moral questions that this history presents—about healthcare, equity, and the cost of dignity under capitalism—and see what light they might shine on our present,” he says.
That culminated in Cashing Out, a critically acclaimed documentary short released by The New Yorker Documentary in September. Nadel says a soundbite in the film from GMHC’s then-policy director, Ruth Finkelstein, crystalizes what is still at stake: “That in this country, we accept the fact that when a person becomes chronically or terminally ill, they will be pauperized is a scandal,” she told CNN in 1992.
Cashing Out follows three individual stories to explore the experiences of people who participated in viatical settlements – and those who couldn’t. Life-settlements broker Scott Page arranged one of the first viatical deals to ease his late partner Greg’s final days, while Sean Strub sold his life insurance policy for $400,000 to start POZ Magazine for people living with HIV and AIDS. Black trans activist Dee Dee Chamblee didn’t have that option after her 1987 AIDS diagnosis.
“If you were Black and trans, you went to jail … you can’t even get a job at McDonalds,” Chamblee says in the film – much less a middle-class job with life insurance. Even so, she survived and thrived, founding La Gender in 2001 to support transgender women of color in Atlanta, which prompted President Barack Obama to invite her to the White House as a Champion of Change.
To support Cashing Out, GMHC hosted an advance screening and intergenerational talkback on September 3 at the Tribeca Screening Room. Nadel has also partnered with the National AIDS Memorial for a national film tour. “We want to bring this film to universities and schools, so young people can connect with this history and become its guardians,” he says.
We talked to Nadel to find out how a chance conversation with his father impelled him to make Cashing Out – and the warning it holds for the present moment.
The conversation has been edited for length and clarity.
GMHC: When your father told you that he’d invested in viatical settlements, what was your initial response?
Matt Nadel: He wanted me to know that it was beneficial for people, because they needed the money. I was open to that possibility, but as a gay man it was too personal. I needed to do my own research. I started reading all the archival articles I could find about viaticals, then sought out TV news footage, and I realized it was a subject of genuine debate. There was moral ambiguity, where people, even at the time, were disagreeing vociferously.
This story is also a reflection of the central paradox of American capitalism – there’s a lot of beauty, growth and abundance, but it’s always at the expense of other people not having enough.
When you asked your father to participate in the documentary, did he have any reservations?
We have different politics, but he has always been incredibly supportive of me, both as a gay man and a filmmaker. This was an opportunity for him to support me as both, which overcame any reluctance to put himself on display in the film.
I think it had really escaped him that this was something that would interest me. I suspect it was an unconscious defense mechanism – because if I had been born a couple of decades earlier, it could have been me. When I made that connection for him, I think he appreciated that I was trying to make meaning and learn the painful lessons from this part of LGBTQ+ history to which he was a peripheral witness.
How did you find the film’s subjects, Scott Page, Sean Strub, and Dee Dee Chamblee?
I came to Scott and Sean first, to understand how the viatical industry affected people with AIDS. I found Sean through some of the print reporting from my early research, and I found Scott in the Donahue episode that’s in the film. Phil Donahue referenced Scott’s business as a gay-owned viatical firm. It turned out that there was a really beautiful and heartbreaking love story there.
My process of making the film, from archival research to interviews, mirrored my process of digesting this information about my family, which brought me to the bigger question: What did people with AIDS who didn’t have a life insurance policy do to live with dignity? The people I talked to couldn’t answer that question.
When I spoke to Dee Dee, I was really moved by her fantasy of going to the beach and living out her last days with viatical settlement money. Being deprived of that impelled her to start La Gender and become a local activist for transgender people of color. She picked herself up out of her grave and became the first Black trans woman to be invited to the White House. I realized she could help illuminate the bigger picture revealed by this particular episode in queer history.
The viatical industry is a striking reflection of America, in that it offered a lot of benefit to a lot of people who were in desperate need – but it has this dark underbelly, which is the very fact that it needed to exist. When the government abandons us and steps away from public health – as it did during the early years of the AIDS crisis and right now – private industry will creep in. That can be good for some people, but it also intensifies inequities for others
Now that you’ve made the film, what’s your take on the viatical settlements industry? Was it exploitative or beneficial?
After four years of processing this historically and personally, I view the viatical settlement industry as a net good, in the context of government abandonment and neglect of people with HIV and AIDs. I’ve been really moved and proud to hear from long-term survivors that the film portrays this painful era accurately and does justice to the difficult choices that people had to make.
That said, it was an appalling tragedy that it had to exist. Americans should not have to die of preventable deaths. Wherever you come down on the moral value of this industry as an historical phenomenon, I hope we can agree that it’s better left in the past.
How did you connect with GMHC for the advance screening of Cashing Out?
A mutual friend introduced me to GMHC’s CEO, Jon Mallow, who has an incredible background in documentary film. Jon watched the film and immediately saw the resonances with GMHC’s own history. When it was founded as Gay Men’s Health Crisis in 1982, doctors and nurses did not even want to touch people with AIDS, so taking care of them was a radical act.
He suggested we bring the film out into the world together. The screening with GMHC was followed by powerful intergenerational conversations between people who lived through this era and younger queer folks. It is helping to get the word out to communities that need to see it – which is one of the most important things we can do.
I’m grateful to be in coalition with GMHC. I hope my film makes clear how pressing and urgent and alive HIV and AIDS history is. I really appreciate GMHC’s commitment to bringing that history into the present and continuing the spirit of care and advocacy it was founded on, at a time when no one else would.
You’ve partnered with the National AIDS Memorial to disseminate the film to young people. In this particular moment, why is it so important to pass down queer history to the next generation?
Part of my goal was to make the film an accessible way for my generation to learn this history that schools don’t tend to teach. I wish I had learned about AIDS history at my Florida public high school. Instead, I’ve had to piece together for myself the story of our community and the political projects that we inherit. It’s been a meaningful and grounding process for me. Queer people have been here figuring out how to survive and thrive for a very long time.
The AIDS crisis showed people the limits of assimilation as a political tactic for LGBTQ+ and other marginalized people. The institutional lack of response at that time was a politically convenient way to express disdain for who we are and the way we have sex with people. I’m glad it radicalized people. I think our movement could use another infusion of that radical spirit now.
This specific story is important to share right now as a strong warning call. HIV is no longer a medical epidemic. It’s a social epidemic. It’s an epidemic of will. I hope the film jolts some people into action over threats of federal cuts to HIV prevention and treatment programs. I hope the stories of pain, resilience, and love in the film can transcend our political divisions – and we can all come together around this critical issue.
Watch Cashing Out here.
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