Christine Mai-Duc, Author at �鶹Ů�� Health News

‘Kind of Morbid’: Health Premiums Threaten Their Nest Egg. A Terminal Diagnosis May Spare It.

Christine Mai-Duc — Thu, 26 Feb 2026 10:00:00 +0000

COLUSA, Calif. — Early on, Jean Franklin got some career advice she followed religiously: “Pay yourself first.” So she did, socking away hundreds of thousands of dollars in retirement savings by the time she became a stay-at-home mom at age 41.

She and her husband, Charles, a former high school teacher who goes by Chaz, planned to retire comfortably in the three-bedroom house where they raised their kids about 60 miles northwest of Sacramento.

But early last year, the 63-year-old became unsteady on her feet. One morning in May, she woke up with slurred speech and landed in the hospital, then rapidly lost the ability to move the right side of her body.

In August, as doctors continued to puzzle over a possible diagnosis, the couple received a notice saying that on Jan. 1 their combined health care premium payments through the state insurance exchange would shoot up from $540 a month to $3,899 a month. The reason: Federal enhanced premium subsidies expiring at the end of last year would no longer offset their payment.

They immediately canceled a monthlong cruise they’d been planning with friends and looked through their retirement accounts.

“Now, instead of thinking about where we can go in our retirement, we’re asking the question, ‘Are we still going to be able to stay where we are because of the health care costs?’” said Chaz, who retired in 2021 at age 59.

Then they received more bad news. In October, at the age of 63, Jean was diagnosed with ALS, a debilitating disease that will eventually leave her unable to speak, swallow, or breathe on her own. But Jean’s condition allowed her to enroll in Medicare, the federal health insurance program that covers adults 65 and older and people with disabilities. The diagnosis saved them roughly $1,600 a month in premiums — little comfort as Jean lost her ability to walk, bathe, and dress herself.

Jean was diagnosed with ALS around the time she and Chaz were told their monthly health insurance premium payments would increase sevenfold. The diagnosis, which allowed her to enroll in Medicare, saved the couple roughly $1,600 a month. (Christine Mai-Duc/�鶹Ů�� Health News)

Charlie Franklin helps his mother, Jean, out of her wheelchair. (Christine Mai-Duc/�鶹Ů�� Health News)

“It’s kind of morbid that, because of my diagnosis, I got put on Medicare right away, so at least we don’t have to pay that out-of-pocket,” Jean said, sitting in a wheelchair in her living room, a quilt draped over her legs to guard against the intense chills she now often gets. “We’re not going to get buried under this.”

Yet the premiums for Chaz’s plan and her Medicare remain a significant strain on their finances. The $2,300 a month they now owe, which includes roughly $342 in premium payments for Jean’s Medicare supplemental insurance, is higher than their monthly mortgage and eats up more than a quarter of their budget.

The Franklins are among the across the nation facing greater financial pressure after Congress chose not to extend 2021 enhanced federal subsidies. That assistance helped more than double enrollment in Obamacare plans to over 24 million.

The Congressional Budget Office estimated in 2024 that, without an extension of the tax credits, the number of uninsured Americans would climb by 2.2 million this year alone. , nationwide enrollment in ACA plans was down about 1.2 million year over year, though experts say it could be months before the full effects of rising premiums are known, as people miss payments and lose coverage.

The groups hit hardest will be , , and people living in high-cost states, said , a senior research fellow at the Center on Health Insurance Reforms at Georgetown University. The Franklins are all three.

A Retired Couple Faced a Huge Health Premium Increase. Her Terminal Diagnosis Saved Them Money.
Jean Franklin, 63, and Chaz Franklin, 64, of Colusa, California
Chaz and Jean Franklin thought they’d saved enough to retire comfortably. But when they found out the premium payment for their “silver” Affordable Care Act plan would soon rise from $540 a month to $3,899, they had to reevaluate. A couple of months later, Jean was diagnosed with ALS, a debilitating neurodegenerative illness that qualified her for Medicare. Her premium payment dropped to $342 a month. The couple still pays a combined $2,300 a month in premiums, more than a quarter of their budget. “It’s the terrible irony that because my wife got a disorder, I’m saving money, and a lot of it,” Chaz said.

“They fell off what we call a subsidy cliff,” Pogue said. “It’s very, very shocking, the amount that a person would have to absorb.”

That’s because the expanded tax credits made the biggest difference for people nearing retirement age who sat just above thresholds, Pogue said. People such as the Franklins, who likely wouldn’t have qualified for financial help before expanded credits were implemented, are now losing that support at a time when insurers have responded to the uncertainty by dramatically raising rates.

Roughly half of people who were expected to lose eligibility for premium tax credits were ages 50 to 64, according to an , a health information nonprofit that includes �鶹Ů�� Health News.

Republicans who opposed the extension have said the premium assistance went directly to insurance companies rather than consumers, incentivizing fraud and wasteful coverage. They also say the enhanced subsidies, which had no upper income limit for eligibility, were far too generous in capping premium payments at 8.5% of income, no matter how much an enrollee made.

“Most Americans would agree that taxpayers should not be subsidizing the health insurance of someone making $250,000,” U.S. Rep. , a California Republican who an extension in January, wrote in an . “I cannot accept the simple extension of a program that will line the pockets of insurers and is riddled with fraud at the expense of the American taxpayer.”

Patient advocates say the premium increases and expiration of subsidies have forced people into difficult choices. “The young people who are healthy are the first to say, I’m going to roll the dice” and forgo coverage, said , executive vice president of policy and programs at the National Patient Advocate Foundation. “Those who are remaining in the system — because they have no choice — are holding off care, they’re holding off their meds, they’re going without necessary food.”

While the Franklins are getting by, they have relied on their sons to pay for a motorized recliner to assist with lifting Jean and a handicap van to transport her. Chaz, who broke a tooth a year ago, delayed fixing it because a crown would cost him $1,000.

This year, the couple will draw $36,000 more than they had anticipated from their retirement savings, most of it to cover Chaz’s insurance premiums.

“I have a nest egg,” Chaz said. “But there’s a lot of people around here who don’t.”

For a while, he was outraged.

“I wish Congress would get off their butts and solve this issue,” said Chaz, who is a registered Republican but blames both sides of the aisle. “You’re so busy bickering over stupid crap and it’s both parties pointing fingers and blaming. Where was this discussion two years ago?”

Now, Chaz said, he’s focused on making Jean, his wife of 27 years, as comfortable as possible.

Before she got sick, they did practically everything together — hiking, traveling, tai chi, amateur photography, and bug-hunting. One of her favorite specimens was the rain beetle, a fuzzy scarab-like insect that can’t feed as an adult, relying solely on fat stores from its larval stages.

In the mornings, Chaz and their sons, Charlie and Louis, take turns lifting Jean, dressing her, and helping her use the bathroom. It’ll be fodder for the counselor, she jokes to her sons, when they inevitably need therapy later in life.

Chaz practices tai chi three times a week in the auditorium at Colusa City Hall. The exercise helps him deal with the financial and emotional stress of his wife’s illness and their soaring health care expenses. (Christine Mai-Duc/�鶹Ů�� Health News)

Jean laughs with her sons, Louis (right) and Charlie, and Charlie’s girlfriend, Masha Billingsley. Charlie and Louis have helped their mother get dressed and get in and out of her wheelchair since she was diagnosed with ALS last year. (Christine Mai-Duc/�鶹Ů�� Health News)

Most days, Jean’s outdoor adventures rarely extend beyond being wheeled to her back patio, where she loves to watch their backyard chickens bobble around. Chaz’s stubbornness makes him a great patient advocate. Charlie always seems to know exactly when she needs a big hug, and Louis tells jokes that can still make her snort with laughter.

“I don’t know what I would do without my boys making me laugh,” she said.

In December, Chaz will turn 65, old enough to qualify for Medicare himself. “After this year — knock on wood — we should be OK,” Jean said, before pausing and shooting her husband a wry smile.

“Well, you’re gonna be OK.”

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Newsom��Tries��To��Thread Needle��on Immigrant Health as��Ambitions Turn National

Christine Mai-Duc — Fri, 06 Feb 2026 19:30:00 +0000

As Gov. Gavin Newsom spars with President Donald Trump and courts national attention for a potential presidential bid, at home he’s catching flak from the left and the right on health care.

The��California��Democrat��came into office promising to fight for��“,”��and he came close to achieving it. Really close. But as it turns out,��that’s��easier said than done when��you’re��juggling��,��,��and��shrinking federal support.��

Now he’s walking the fine line between keeping his and being tarred as a reckless state executive who has stretched California’s spending .

After years of political infighting, Newsom and the Democratic-controlled legislature in 2024 broadened California’s Medicaid program, Medi-Cal, to regardless of immigration status.

Now, he’s rolling back those expansions in the name of “fiscal prudence.”

This year, California froze Medi-Cal enrollment for most adults without legal status, just two years after . On July 1, immigrants not eligible for federal Medicaid — both legal residents and those without authorization — will lose access to state dental coverage. Next year, they’ll have to start paying monthly premiums.

Last month, Newsom proposed letting roughly 200,000 legal immigrants — asylees, refugees, and others — get cut off from Medi-Cal after Sept. 30, when the federal government will stop paying for them.

Advocates are livid.

Progressives��say��Newsom’s political ambitions��—��and perceived need to distance himself from the��polarized��topic of immigrant health care��—��go against��his early��pledges.��

“You’re clouded by what Arkansas is going to think, or Tennessee is going to think, when what California thinks is something completely different,” said California state Sen. Caroline Menjivar, chair of the budget subcommittee on health and human services.

Meanwhile, Republicans and fiscal hawks have painted Newsom as a Democrat prioritizing use of limited state funds on free health care for noncitizens. And Newsom has taken hits from the Trump administration accusing California of “” to use federal funds for immigrant health services.

He’s not the only governor grappling with this dilemma. And all 50 states, which are currently required to provide health coverage to refugees, asylees, and others, will have to decide whether to backfill that coverage for some 1.4 million legal immigrants starting Oct. 1, when of the One Big Beautiful Bill Act kicks in and leaves states without federal reimbursement for their care.

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Newsom Walks Thin Line on Immigrant Health as He Eyes Presidential Bid

Christine Mai-Duc — Thu, 05 Feb 2026 10:00:00 +0000

California Gov. Gavin Newsom, who is eyeing a presidential bid, has incensed both Democrats and Republicans over immigrant health care in his home state, underscoring the delicate political path ahead.

For a second year, the Democrat has asked state lawmakers to roll back coverage for some immigrants in the face of federal Medicaid spending cuts and a roughly that if the artificial intelligence bubble bursts. Newsom has proposed that the state not step in when, starting in October, the federal government stops providing health coverage to an estimated 200,000 legal residents — comprising .

Progressive legislators and activists said the cost-saving measures are a departure from Newsom’s , while Republicans continue to skewer Newsom for using public funds to cover any noncitizens.

Newsom’s latest move would save an estimated $786 million this fiscal year and $1.1 billion annually in future years in a proposed budget of $349 billion, according to the Department of Finance.

State Sen. Caroline Menjivar, one of two Senate Democrats who voted against Newsom’s immigrant health cuts last year, said she worried the governor’s political ambition could be getting in the way of doing what’s best for Californians.

“You’re clouded by what Arkansas is going to think, or Tennessee is going to think, when what California thinks is something completely different,” said Menjivar, who said previous criticism got her from a key budget subcommittee. “That’s my perspective on what’s happening here.”

Meanwhile, Republican state Sen. Tony Strickland criticized Newsom for glossing over the state’s , which state officials say could balloon to $27 billion the following year. And he slammed Newsom for continuing to cover California residents in the U.S. without authorization. “He just wants to reinvent himself,” Strickland said.

It’s a political tightrope that will continue to grow thinner as federal support shrinks amid ever-rising health care expenses, said Guian McKee, a co-chair of the Health Care Policy Project at the University of Virginia’s Miller Center of Public Affairs.

“It’s not just threading one needle but threading three or four of them right in a row,” McKee said. Should Newsom run, McKee added, the priorities of Democratic primary voters — who largely mirror blue states like California — look very different from those in a far more divided general electorate.

Americans are deeply divided on whether the government should provide health coverage to immigrants without legal status. In a last year, a slim majority — 54% — were against a provision that would have penalized states that use their own funds to pay for immigrant health care, with wide variation by party. The provision was left out of the final version of the bill passed by Congress and signed by President Donald Trump.

Even in California, support for the idea has waned amid ongoing budget problems. In a by the Public Policy Institute of California, 41% of adults in the state said they supported providing health coverage to immigrants who lack legal status, a sharp drop from the 55% .

, Vice President JD Vance, , and congressional Republicans have repeatedly accused California and other Democratic states of using taxpayer funds on immigrant health care, a red-meat issue for their GOP base. Centers for Medicare & Medicaid Services Administrator Mehmet Oz has of “” to receive more federal funds, freeing up state coffers for its Medicaid program, known as Medi-Cal, which has enrolled roughly 1.6 million immigrants without legal status.

“If you are a taxpayer in Texas or Florida, your tax dollars could’ve been used to fund the care of illegal immigrants in California,” he said in October.

California state officials have denied the charges, noting that only state funds are used to pay for general health services for those without legal status because the law prohibits using federal funds. Instead, Newsom has made it a “” that California has opened up coverage to immigrants, which his administration has noted and helps them avoid costly emergency room care often covered at taxpayer expense.

“No administration has done more to expand full coverage under Medicaid than this administration for our diverse communities, documented and undocumented,” Newsom told reporters in January. “People have built careers out of criticizing my advocacy.”

Newsom warns the federal government’s “carnival of chaos” passed Trump’s One Big Beautiful Bill Act, which he said puts 1.8 million Californians at risk of losing their health coverage with the implementation of work requirements, other eligibility rules, and limits to federal funding to states.

Nationally, 10 million people could lose coverage by 2034, according to the Congressional Budget Office. higher numbers of uninsured patients — particularly those who are relatively healthy — could concentrate coverage among sicker patients, potentially increasing premium costs and hospital prices overall.

Immigrant advocates say it’s especially callous to leave residents who may have fled violence or survived trafficking or abuse without access to health care. Federal rules currently require state Medicaid programs to cover “qualified noncitizens” including asylees and refugees, according to Tanya Broder of the National Immigration Law Center. But the Republican tax-and-spending law ends the coverage, affecting legal immigrants nationwide.

With many state governors yet to release budget proposals, it’s unclear how they might handle the funding gaps, Broder said.

For instance, Colorado state officials estimate roughly 7,000 legal immigrants could lose coverage due to the law’s changes. And Washington state officials refugees, asylees, and other lawfully present immigrants will lose Medicaid.

Both states, like California, expanded full coverage to all income-eligible residents regardless of immigration status. Their elected officials are now in the awkward position of explaining why some legal immigrants may lose their health care coverage while those without legal status could keep theirs.

Last year, spiraling health care costs and state budget constraints prompted the Democratic governors of , potential presidential contenders JB Pritzker and Tim Walz, to pause or end coverage of immigrants without legal status.

California lawmakers last year voted to eliminate dental coverage and freeze new enrollment for immigrants without legal status and, starting next year, will charge monthly premiums to those who remain. Even so, the state is slated to spend $13.8 billion from its general fund on immigrants not covered by the federal government, according to Department of Finance spokesperson H.D. Palmer.

At a press conference in San Francisco in January, Newsom defended those moves, saying they were necessary for “fiscal prudence.” He sidestepped questions about coverage for asylees and refugees and downplayed the significance of his proposal, saying he could revise it when he gets a chance to update his budget in May.

Kiran Savage-Sangwan, executive director of the California Pan-Ethnic Health Network, pointed out that California passed a law in the 1990s requiring the state to cover when federal Medicaid dollars won’t. This includes green-card holders who haven’t yet met the five-year waiting period for enrolling in Medicaid.

Calling the governor’s proposal “arbitrary and cruel,” Savage-Sangwan criticized his choice to prioritize rainy day fund deposits over maintaining coverage and said blaming the federal government was misleading.

It’s also a major departure from what she had hoped California could achieve on Newsom’s first day in office seven years ago, when he declared his support for single-payer health care and proposed extending health insurance subsidies to middle-class Californians.

“I absolutely did have hope, and we celebrated advances that the governor led,” Savage-Sangwan said. “Which makes me all the more disappointed.”

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On the Hook for Uninsured Residents, Counties Now Wonder How They’ll Pay

Christine Mai-Duc — Tue, 06 Jan 2026 10:00:00 +0000

In 2013, before the Affordable Care Act helped millions get health insurance, California’s Placer County provided limited health care to some 3,400 uninsured residents who couldn’t afford to see a doctor.

For several years, that number has been zero in the predominantly white, largely rural county stretching from Sacramento’s eastern suburbs to the shores of Lake Tahoe.

The trend could be short-lived.

County health officials there and across the country are bracing for an newly uninsured patients over the next decade in the wake of Republicans’ One Big Beautiful Bill Act. The act, which President Donald Trump signed into law this past summer, is also expected to reduce Medicaid spending by over that period.

“This is the moment where a lot of hard decisions have to be made about who gets care and who doesn’t,” said Nadereh Pourat, director of the Health Economics and Evaluation Research Program at UCLA. “The number of people who are going to lose coverage is large, and a lot of the systems that were in place to provide care to those individuals have either gone away or diminished.”

It’s an especially thorny challenge for states and New Mexico where counties are legally required to help their poorest residents through what are known as indigent care programs. Under Obamacare, both states were to include more low-income residents, alleviating counties of patient loads and redirecting much of their funding for the patchwork of local programs that provided bare-bones services.

Placer County, which estimates that 16,000 residents could lose health care coverage by 2028, quit operating its own clinics nearly a decade ago.

“Most of the infrastructure that we had to meet those needs is gone,” said Rob Oldham, Placer County’s director of health and human services. “This is a much bigger problem than it was a decade ago and much more costly.”

In December, county officials that provides care to mostly small, rural counties, citing an expected rise in the number of uninsured residents.

New Mexico’s second-most-populous county, Doña Ana, added dental care for seniors and behavioral health benefits after many of its poorest residents qualified for Medicaid. Now, federal cuts could force the county to reconsider, said Jamie Michael, Doña Ana’s health and human services director.

“At some point we’re going to have to look at either allocating more money or reducing the benefits,” Michael said.

Straining State Budgets

Some states, such as Idaho and Colorado, abandoned laws that required counties to be providers of last resort for their residents. In other states, uninsured patients often delay care or receive it at hospital emergency rooms or community clinics. Those clinics are often supported by a mix of federal, state, and local funds, according to the National Association of Community Health Centers.

Even in states like Texas, which opted not to expand its Medicaid program and continued to rely on counties to care for many of its uninsured, rising health care costs are straining local budgets.

“As we have more growth, more people coming in, it’s harder and harder to fund things that are required by the state legislature, and this isn’t one we can decrease,” said Windy Johnson, program manager with the Texas Indigent Health Care Association. “It is a fiscal issue.”

California lawmakers face a nearly in the 2026-27 fiscal year, according to the latest estimates by the state’s nonpartisan Legislative Analyst’s Office. Gov. Gavin Newsom, who has acknowledged he is , has rebuffed to significantly raise taxes on the ultra-wealthy. Despite blasting the bill passed by Republicans in Congress as a that guts health care programs, in 2025 the Democrat rolled back state Medi-Cal benefits for seniors and for immigrants without legal status after rising costs forced the program to borrow $4.4 billion from the state’s general fund.

H.D. Palmer, a spokesperson for the state’s Department of Finance, said that the Newsom administration is still refining its fiscal projections and that it would be “premature” to discuss potential budget solutions.

Newsom will unveil his initial budget proposal in January. State officials have said California a year in federal funding for Medi-Cal under the new law, as much as 15% of the state program’s entire budget.

“Local governments don’t really have much capacity to raise revenue,” said Scott Graves, a director at the independent California Budget & Policy Center with a focus on state budgets. “State leaders, if they choose to prioritize it, need to decide where they’re going to find the funding that would be needed to help those who are going to lose health care as a result of these federal funding and policy cuts.”

Reviving county-based programs in the near term would require “considerable fiscal restructuring” through the state budget, the Legislative Analyst’s Office said in .

No Easy Fixes

It’s not clear how many people are currently enrolled in California’s county indigent programs, because the state doesn’t track enrollment and utilization. But enrollment in county health safety net programs dropped dramatically in the first full year of ACA implementation, going from about 858,000 people statewide in 2013 to roughly 176,000 by the end of 2014, at the time by Health Access California.

“We’re going to need state investment,” said Michelle Gibbons, executive director of the County Health Executives Association of California. “After the Affordable Care Act and as folks got coverage, we didn’t imagine a moment like this where potentially that progress would be unwound and folks would be falling back into indigent care.”

In November, voters in affluent Santa Clara County approved a sales tax increase, in part to backfill the loss of federal funds. But even in the home of Silicon Valley, where the median household income is about 1.7 times the , that is expected to of the $1 billion a year the county stands to lose.

Health advocates fear that, absent major state investments, Californians could see a return to the previous , with local governments choosing whom and what they cover and for how long.

In many cases, indigent programs didn’t include specialty care, behavioral health, or regular access to primary care. Counties can also exclude people or income. Before the ACA, many uninsured people who needed care didn’t get it, which could lead to them winding up in ERs with untreated health conditions or even dying, said Kiran Savage-Sangwan, executive director of the California Pan-Ethnic Health Network.

Rachel Linn Gish, interim deputy director of Health Access California, a consumer advocacy group, said that “it created a very unequal, maldistributed program throughout the state.”

“Many of us,” she said. “including counties, are reeling trying to figure out: What are those downstream impacts?”

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After Chiding Democrats on Transgender Politics, Newsom Vetoes a Key Health Measure

Christine Mai-Duc — Fri, 17 Oct 2025 09:00:00 +0000

California Gov. Gavin Newsom this week signed a for transgender patients amid continuing threats by the Trump administration.

But there was one glaring omission that LGBTQ+ advocates and political strategists say is part of an increasingly complex dance the Democrat faces as he curates a more centrist profile for a potential presidential bid.

Newsom that would have required insurers to cover, and pharmacists to dispense, 12 months of hormone therapy at one time to transgender patients and others. The proposal was a for trans rights leaders, who said it was crucial to preserve care as gender-affirming services under White House pressure.

Political experts say highlights how charged trans care has become and, in particular, for Newsom, who as San Francisco mayor engaged in civil disobedience by allowing gay couples to marry . The veto, along with his lukewarm response to anti-trans rhetoric, they argue, is part of an alarming pattern that could damage his credibility with key voters in his base.

“Even if there were no political motivations whatsoever under Newsom’s decision, there are certainly political ramifications of which he is very aware,” said Dan Schnur, a former GOP political strategist who is now a politics lecturer at the University of California-Berkeley. “He is smart enough to know that this is an issue that’s going to anger his base, but in return, may make him more acceptable to large numbers of swing voters.”

Earlier this year on Newsom’s podcast, the governor told the late conservative activist Charlie Kirk that trans athletes competing in women’s sports was “,” triggering a backlash among his party’s base and LGBTQ+ leaders. And he has as a “major problem for the Democratic Party,” saying Donald Trump’s were “devastating” for his party in 2024.

Still, in a conversation with YouTube streamer ConnorEatsPants this month, Newsom “as a guy who’s literally put my political life on the line for the community for decades, has been a champion and a leader.”

“He doesn’t want to face the criticism as someone who, I’m sure, is trying to line himself up for the presidency, when the current anti-trans rhetoric is so loud,” said Ariela Cuellar, a spokesperson for the California LGBTQ Health and Human Services Network.

Caroline Menjivar, the state senator who introduced the measure, described her bill as “the most tangible and effective” measure this year to help trans people at a time when they are being singled out for what she described as “targeted discrimination.” In a legislature in which Democrats hold supermajorities in both houses, lawmakers sent the bill to Newsom on a party-line vote. Earlier this year, Washington to enact a state law extending hormone therapy coverage to a 12-month supply.

In a on the California bill, Newsom cited its potential to drive up health care costs, impacts that an found would be negligible.

“At a time when individuals are facing double-digit rate increases in their health care premiums across the nation, we must take great care to not enact policies that further drive up the cost of health care, no matter how well-intended,” Newsom wrote.

, federal agencies have been to gender-affirming care for children, which Trump has referred to as “chemical and surgical mutilation,” and from or of institutions that provide it.

In recent months, , , and have reduced or eliminated gender-affirming care for patients under 19, a sign of the chilling effect Trump’s executive orders have had on health care, even in one of the nation’s most progressive states.

California wide coverage of gender-affirming health care, including hormone therapy, but pharmacists can currently dispense only a 90-day supply. Menjivar’s bill would have allowed 12-month supplies, modeled after that allowed women to receive an annual supply of birth control.

Luke Healy, who at an April hearing that he was “a 24-year-old detransitioner” and no longer believed he was a woman, criticized the attempt to increase coverage of services he thought were “irreversibly harmful” to him.

“I believe that bills like this are forcing doctors to turn healthy bodies into perpetual medical problems in the name of an ideology,” Healy testified.

The California Association of Health Plans opposed the bill over provisions that would limit the use of certain practices such as prior authorization and step therapy, which require insurer approval before care is provided and force patients and doctors to try other therapies first.

“These safeguards are essential for applying evidence-based prescribing standards and responsibly managing costs — ensuring patients receive appropriate care while keeping premiums in check,” said spokesperson Mary Ellen Grant.

An analysis by the California Health Benefits Review Program, which independently reviews bills relating to health insurance, concluded that annual premium increases resulting from the bill’s implementation would be negligible and that “no long-term impacts on utilization or cost” were expected.

Shannon Minter, legal director for the National Center for LGBTQ Rights, said Newsom’s economic argument was “not plausible.” Although he said he considers Newsom a strong ally of the transgender community, Minter noted he was “deeply disappointed” to see the governor’s veto. “I understand he’s trying to respond to this political moment, and I wish he would respond to it by modeling language and policies that can genuinely bring people along.”

Newsom’s press office declined to comment further.

Following the podcast interview with Kirk, Cuellar said, advocacy groups backing SB 418 grew concerned about a potential veto and made a point to highlight voices of other patients who would benefit, including menopausal women and cancer patients. It was a starkly different strategy than what they might have done before Trump took office.

“Had we run this bill in 2022-2023, the messaging would have been totally different,” said another proponent who requested anonymity because they were not authorized to speak publicly on the issue. “We could have been very loud and proud. In 2023, we might have gotten a signing ceremony.”

Advocates for trans rights were so wary of the current political climate that some also felt the need to steer clear of promoting a separate bill that would have expanded coverage of hormone therapy and other treatments for menopause and perimenopause. , authored by Assembly member Rebecca Bauer-Kahan, who has spoken movingly about her struggles with health care for perimenopause, .

In the meantime, said Jovan Wolf, a trans man and military veteran, patients like him will be left to suffer.

Wolf, who had taken testosterone for more than 15 years, tried to restart hormone therapy in March, following a two-year hiatus in which he contemplated having children.

Doctors at the Department of Veterans Affairs told him it was too late. Days earlier, the Trump administration it would phase out hormone therapy and other treatments for gender dysphoria.

“Having estrogen pumping through my body, it’s just not a good feeling for me, physically, mentally. And when I’m on testosterone, I feel balanced,” said Wolf, who eventually received care elsewhere. “It should be my decision and my decision only.”

This article was produced by �鶹Ů�� Health News, which publishes , an editorially independent service of the .��

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University of California Researchers, Patients Wary of Trump Cuts Even as Some Dollars Flow Again

Christine Mai-Duc — Thu, 09 Oct 2025 09:00:00 +0000

In August, an 80-year-old woman walked into the emergency room at Ronald Reagan UCLA Medical Center. She was lucid but experiencing a stroke. Within minutes, doctors asked for permission to pull out the stroke-causing clot before any more brain damage could occur.

She hesitated. The procedure was part of a clinical trial, and she’d heard about a federal freeze on . She wanted to know: Would this study be at risk, potentially affecting her care?

Those worries put unnecessary pressure on a patient facing the loss of roughly 2 million nerve cells every minute that treatment was delayed, said , a neurologist and longtime stroke researcher.

“To then have to worry about what’s happening with the funding from the federal government is a needless increase in the stress patients are going through,” Saver said.

Patients and researchers such as Saver have found themselves caught in the middle as the Trump administration has accused major universities of , pulling research funds in an attempt to .

Scientists who have spent their lives developing treatments for lung cancer, brain tumors, and Alzheimer’s disease say scientific funding should not be politicized — and warn that patients waiting for lifesaving treatments stand to lose the most. They also worry that funding cuts mired in legal challenges could discourage would-be scientists from entering the field, reducing the chances for medical breakthroughs.

“I would have thought that stroke and Alzheimer’s disease and all these conditions affect Democrats and Republicans alike and would be supported by everyone,” Saver said. “The reasons for the suspension don’t seem to tie into the work we’re doing.”

In July, the National Institutes of Health, the National Science Foundation, and the Energy Department in medical and science research grants to UCLA after the Justice Department said the university had of Jewish students during pro-Palestinian protests. The Trump administration that would require UCLA to pay a $1.2 billion fine and overhaul campus policies on admissions, hiring, and gender-affirming health care to reinstate the grants.

Yet the federal government plays a crucial role in funding lifesaving research that industry has little incentive to back. Saver said treatment discoveries made in the past 15 years have been “transformative” for stroke care. To keep eight clinical trials afloat, Saver said, he and other neurology department faculty members sought outside funding and agreed to salary cuts. But they were close to running out before federal funds were restored.

In the ER, doctors told the stroke patient not to worry. Given the need to study her particular symptoms, they tapped a pot of private donations to cover the procedure. She enrolled and was treated.

Gov. Gavin Newsom, a Democrat who has been challenging President Donald Trump more directly as he builds a national profile, has likened the president’s demands .

And Newsom last week state funding from any California university that Trump put forth that prioritizes federal research funds to institutions that adhere to the administration’s definitions of gender, limit international students, and change admissions policies, among other stipulations. “California will not bankroll schools that sell out their students, professors, researchers, and surrender academic freedom,” Newsom said in a statement.

In September, U.S. District Judge Rita Lin of the Northern District of California ordered frozen NIH grants in the state to flow again, folding UCLA researchers into a lawsuit initially brought by researchers from the University of California-Berkeley and UC-San Francisco in June after federal agencies slashed hundreds of millions in grants to UC campuses.

Some private academic institutions have reclaimed their funding by agreeing to pay hefty fines and changing campus policies, including , which agreed to pay $200 million, and , which settled for $50 million. Meanwhile, last month that the administration’s cancellation of some $2.6 billion in grants to Harvard was illegal.

Still, researchers worry the relief is temporary. Even with the district court’s restoration, the case brought by UC researchers is still pending and could ultimately be decided in Trump’s favor. The White House has the ruling to restore Harvard’s funding, while of the school’s finances.

“We haven’t seen everything play out yet. Lots of scientists and researchers and people who run labs are circumspect, knowing that the near future could be a bit bumpy,” said Jessica Levinson, a constitutional law professor at Loyola Law School. “They should feel like this is a win, but it’s possible that it’s a short-lived one.”

Officials at the U.S. Department of Health and Human Services did not respond to questions about potential harm done to studies while the funds were frozen, or criticisms that they are wrongly politicizing money for potentially lifesaving research.

In a statement about the administration’s campaign targeting antisemitism, HHS spokesperson Andrew Nixon said that “we will not fund institutions that promote antisemitism. We will use every tool we have to ensure institutions follow the law.”

HHS spokesperson Emily Hilliard said in a follow-up statement that the department is “steadfast in its commitment to advancing groundbreaking biomedical research” and that it continues to “invest strategically in research that tackles today’s urgent challenges.”

Most of the UCLA funding freezes affected foundational science that doesn’t directly involve patients but has the potential to vastly improve treatment. David Shackelford, a researcher exploring novel ways to stunt the growth of therapy-resistant lung cancer, said he was nearing a potential breakthrough for treating the disease, which kills 9 in 10 patients within five years of a diagnosis.

“I’m not used to my science being politicized,” Shackelford said. “It’s cancer. We should never even be having this discussion.”

As court battles play out, Democratic state legislators are on next year’s ballot dedicating state funds to continue advances in cancer, stroke, and infectious disease research, among other scientific research. But state bond money, if approved by voters, wouldn’t come close to replacing federal grants, which traditionally finance the lion’s share of biomedical research.

In 2024 alone, for example, roughly flowed to California, with $3.8 billion of that going to universities. And the proposed bond would be broad, one-time funding that could pay for other study areas, such as climate change research, marine ecosystems, or wildfire prevention.

the possibility of even bigger federal cuts to the state’s second-largest employer would have ripple effects across California’s economy.

While other universities have sued the Trump administration, UC leaders have instead engaged in “good faith dialogue” with the Justice Department in hopes of negotiating a settlement, Milliken said.

S. Thomas Carmichael, a neurologist at UCLA, said about 55 grants totaling $23 million from the NIH, including studies of migraines, epilepsy, and autism, were frozen in his department at the David Geffen School of Medicine. As bad as funding cuts are, he warned of the Trump administration’s ability to attack a school’s accreditation, to limit visas for international students, or to launch investigations.

“It’s essentially a complete and total power mismatch to take the federal government on,” Carmichael said. “If you simply give no ground, yield nothing, you won’t win.”

Separately, in mid-September, a group of UC labor unions and faculty associations filed suit against the federal government, claiming the threat to research funds amounted to “financial coercion” to adopt campus policies that would restrict free speech. A hearing in that case is scheduled for December.

Brenda L., a UCLA patient, said she was devastated when a scan in 2021 led to her stage 4 lung cancer diagnosis at age 70. After 18 months on Tagrisso, a drug considered the gold standard for treating this particular cancer, her tumors started growing again. (Brenda declined to provide her full name because she hasn’t disclosed her diagnosis to some family members.)

“I was just feeling like, well, that’s the end of me,” said Brenda, who’s now 75 and lives in Bakersfield. She joined a clinical trial and has been taking another experimental drug alongside Tagrisso for two years. The combination has all but stopped the cancer’s progression.

“I’m the lucky one,” said Brenda, whose current trial has not been impacted. “Other patients, they should have that same chance.”

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Kennedy’s Take on Vaccine Science Fractures Cohesive National Public Health Strategies

Stephanie Armour — Fri, 19 Sep 2025 09:00:00 +0000

Health and Human Services Secretary Robert F. Kennedy Jr. has had a busy few months. He fired the director of the Centers for Disease Control and Prevention, purged the agency’s vaccine advisory committee, and included among the group’s new members appointees who espouse anti-vaccine views.

The leadership upheavals, which he says will restore trust in federal health agencies, have shaken the confidence many states have in the CDC and led to the fracturing of a national, cohesive immunization policy that’s endured for .

States and medical societies that long worked in concert with the CDC are breaking with federal recommendations, saying they no longer have faith in them amid the turmoil and Kennedy’s criticism of vaccines. Roughly seven months after Kennedy’s nomination was confirmed, they’re rushing to draft or release their own vaccine recommendations, while new groups are forming to issue immunization guidance and advice.

How the new system will work is still being hammered out. Vaccine recommendations from states, medical societies, and other groups are likely to diverge, creating dueling guidance and requirements. Schoolchildren in New York may still generally need immunizations, for example, while others in places such as Florida may not need many vaccines.

There are potential financial ramifications too, because historically, private insurers, Medicaid, and Medicare have generally covered only vaccines recommended by the federal government. If the CDC and its advisory group, which began Sept. 18 in Atlanta, stop recommending certain vaccines, hundreds of millions of people could wind up paying for shots that previously cost them nothing. Some states are already taking steps to prevent that from happening, which means where people live could determine if they will face costs.

“You’re seeing a proliferation of recommendations, and the recommendations by everybody are different from the CDC,” said , a University of Minnesota epidemiologist who launched an ad hoc group that provides vaccine guidance. “States and medical societies are basing their recommendations on science. The recommendations out of CDC are magic, smoke, and mirrors.”

Kennedy has defended changes at the CDC and the revamping of the vaccine committee as necessary, saying previous advisory panel members had and agency leadership botched its pandemic response.

The CDC is “the most corrupt agency at HHS, and maybe the government,” Kennedy said at a . Susan Monarez, the ousted CDC director, testified Sept. 17 at another Senate hearing about how Kennedy told her to preapprove vaccine recommendations from the advisory panel or be fired.

Kennedy has said HHS also plans to investigate vaccine injuries he says are . The CDC investigates injuries that are reported by providers or patients, but Kennedy has said he wants to recast the entire program. The Food and Drug Administration is already who died following covid-19 vaccination.

HHS didn’t return an email seeking comment.

The actions by states, medical societies, and other groups reflect a mounting lack of confidence in federal leadership, public health leaders say, and the break from the CDC is happening at a rapid clip.

The Democratic governors of California, Hawaii, Oregon, and Washington — fashioning themselves as the West Coast Health Alliance — are coordinating to develop vaccine recommendations that won’t necessarily follow those from the CDC. The governors said in a that the CDC shake-up has “impaired the agency’s capacity to prepare the nation for respiratory virus season and other public health challenges” and this week for vaccination against viruses such as covid, influenza, and respiratory syncytial virus.

A group of northeastern states are exploring a similar collaborative.

“The worst thing that could happen is that we have 50 different recommendations for the covid vaccine. That will destroy public health,” said Massachusetts Public Health Commissioner Robbie Goldstein, who has been involved with the effort. He’s also spoken with leaders of the West Coast alliance. “I’m really hopeful that we do come together in larger and larger collaboratives with the same recommendations or very similar recommendations,” he said while speaking to a group of reporters this month.

And medical societies such as the American Academy of Pediatrics are releasing covid vaccine recommendations for the first time from the CDC’s guidance.

Some states are seizing on the split to ensure access to shots. Massachusetts is to cover vaccines recommended by the state health department rather than paying only for those suggested by the CDC, making it the first state to guarantee such continued coverage. AHIP, a trade group representing insurers, that health plans will cover immunizations, including updated formulations of covid and flu vaccines, that were recommended by the CDC panel as of Sept. 1 with no cost sharing through the end of 2026.

Pennsylvania is to give covid vaccines even if they’re not recommended by the federal agency. Instead, they can follow recommendations from the pediatric academy and other medical groups.

Florida, meanwhile, plans to for schoolchildren to get immunizations against chickenpox, meningitis, hepatitis B, and some other diseases. State lawmakers would need to take action to end mandates for all vaccines.

Joseph Ladapo, the state’s surgeon general, said in a that any vaccine requirement is wrong and “drips with disdain and slavery.”

Some doctors criticize the decision as a dangerous step backward.

“This is a terrifying decision that puts our children’s lives at risk,” said , former acting director of the CDC, in an emailed statement.

The first school vaccine mandate was rolled out in the , for smallpox. While all states have vaccine requirements for schoolchildren, immunization rates for kindergarten students declined while cases of vaccine-preventable in 2024 and 2025.

Rochelle Walensky, the Biden administration’s first CDC director, warned of the “polarization” of state-by-state approaches. “It’s like your head is in the oven and your feet are in the freezer and, on average, we’re at 95% vaccination. That doesn’t work in measles — every place has to be at 95% vaccination.” She was referring to the proportion of a population that needs to be vaccinated to provide herd immunity.

Kennedy’s actions have thrust vaccines center stage and made him fodder for comedy. The Marsh Family, a British musical group, on Sept. 7 of Paul Simon’s “Me and Julio Down by the Schoolyard,” with the chorus, “We’ll see measles and polio down in the schoolyard.”

HBO comedian said the CDC could be known by the title “Disease” during a recent episode of his show. And Stephen Colbert used his monologue on “The Late Show with Stephen Colbert” to weigh in on the revamped vaccine advisory group, calling its new members the “.”

President Donald Trump has defended Kennedy, telling reporters “he means very well,” even as Trump said on Sept. 5 that “you have some vaccines that are so amazing.” Trump has repeatedly expressed pride in Operation Warp Speed, a government initiative during Trump’s previous administration that rapidly developed covid vaccines. But he’s also promoted a discredited theory linking vaccines and autism.

The White House did not respond to a request for comment.

The Trump administration already narrowed recommendations for the covid vaccine despite no new safety risks with the shots, although medical societies are continuing to recommend them for most people. The gulf is expected to widen as the agency’s advisory group reviews on a number of pediatric vaccines.

Other groups are also trying to provide vaccine and public health guidance, driven in part by concerns that Kennedy and other federal health leaders will make policy decisions and statements not grounded in science. Kennedy has promoted claims that aluminum, used in many vaccines, is , despite a lack of evidence for the claims. A , in fact, found aluminum was not linked to chronic disease, but Kennedy said the study’s supplemental data indicated it caused harm. The journal that published the study .

Current and former CDC and HHS staffers, along with public health academics and retired health officials, have formed the National Public Health Coalition, a nonprofit to endorse recommendations and provide guidance on policy issues. They plan to partner with state and local health departments.

“A real benefit of the National Public Health Coalition is we are made up of current and former CDC and HHS folks, people who have deep knowledge of what government programs for public health look like, and what improvements are needed,” said Abigail Tighe, the group’s executive director.

Another new group is , which bills itself as a volunteer-led effort to raise awareness about vaccines. And the was launched in April by the University of Minnesota’s infectious disease center, to review evidence for medical societies on the safety and effectiveness of vaccines.

“We’re going to continue to help wherever we can to address misinformation,” said Osterholm, the center’s leader.

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In the Fallout From Trump’s Health Funding Cuts, States Face Tough Budget Decisions

Stephanie Armour — Tue, 09 Sep 2025 09:00:00 +0000

In 2024, the Texas State Guard participated in Operation Border Health, a five-day free health clinic in Texas. The annual event was canceled this year after the Trump administration announced a plan to strip more than $550 million in federal public health and pandemic emergency funds from Texas. (Texas State Guard/)

Patients begin lining up before dawn at , an annual five-day health clinic in Texas’ Rio Grande Valley. Many residents in this predominantly spanning the Mexican border lack insurance, making the health fair a major source of free medical care in South Texas for more than 25 years.

Until this year. The Trump administration’s plan to strip in federal public health and pandemic funds from Texas helped prompt just before its scheduled July 21 start.

“Some people come every year and rely on it,” said Hidalgo County Health and Human Services Director Dairen Sarmiento Rangel. “Some people even camp out outside of Border Health so they can be the first in line to receive services. This event is very important to our community.”

States and local governments have made painful program cuts in the wake of major reductions in federal health funding that have already taken effect. Now, they’re sizing up the financial hits to come — some not until late next year or beyond — from the “,” the tax and spending law congressional Republicans passed in July that enacts much of President Donald Trump’s domestic agenda.

Texas, for instance, expects to see its federal Medicaid funds reduced by as much as over 10 years due to new barriers for enrollment, such as more frequent eligibility checks, according to a July analysis by �鶹Ů��.

Taken together, the reductions amount to a seismic shift in how state health programs are provided and paid for. The administration is, in effect, pushing a significant amount of health costs to states. That will force their leaders to make difficult choices, as many state budgets are already strained by declining tax revenues, a slowdown in federal pandemic spending, and economic uncertainty.

Revenue forecasters have lowered expectations for the coming year, according to a .

“It’s almost inevitable that states will enact a number of cuts to health services because of the fiscal pressure,” said Wesley Tharpe, senior adviser for state tax policy at the left-leaning .

Some are proactively trying to stanch the impact.

Hawaii lawmakers are looking to aid nonprofits that are already contending with federal funding cuts. They’re in grants to health, social service, and other nonprofits hit by federal funding cuts. To get the money, nonprofits must show a termination or drop in funding, or that they have otherwise been harmed by the cuts.

“It is not fair that organizations dedicated to supporting the people of Hawaii are being forced to scale back due to federal funding cuts,” Democratic Gov. Josh Green .

Other states are scaling back projects to contend with cuts. Delaware Gov. Matt Meyer, a Democrat, received notice in March that the Trump administration was in public health funding from the state. The next month, state legislative leaders halted a planned project to upgrade and expand the Capitol complex as a result.

“We recognized that the reckless federal cuts to the social safety nets of thousands of Delawareans called for us to hold back resources to protect our most vulnerable,” said , president pro tempore of the Delaware Senate.

In New Mexico, the state with the , a bipartisan group of lawmakers voted to create a trust fund to boost funding for the program. About 10% of the more than covered by Medicaid and the related Children’s Health Insurance Program could lose their health coverage under the federal spending law, based on .

Some state leaders are warning constituents that the worst may be yet to come.

At an Aug. 18 event at a hospital in the South Bronx section of New York City, New York Gov. Kathy Hochul, a Democrat, stood on stage among health care workers in white coats to skewer Trump’s new law.

“What Republicans in Washington have done through the ‘Big Ugliest Bill’ I’ve ever seen is literally screwing New Yorkers,” she said. The state’s health system is bracing for in annual cuts.

And in California, lawmakers weighed the impact of the coming cuts from the federal law at a general assembly , where some Democratic legislators said state efforts to protect reproductive health services and other programs were in jeopardy.

“We’ve been bracing for this reality: President Trump’s so-called ‘Big, Beautiful Bill’ is now law,” Democratic lawmaker Gregg Hart said at the hearing, calling it a “direct assault on California’s core programs and our values.”

“Sadly, the reality is, the state does not have the capacity to backfill all of these draconian federal funding cuts in the current budget,” Hart said. “We cannot simply write a check and make this go away.”

President Donald Trump is joined by Republican lawmakers as he signs his tax and spending bill into law on July 4. (Samuel Corum/Getty Images)

The sweeping budget law, which passed without any Democratic support, will reduce federal spending on Medicaid by about over the next decade, based on estimates from the . The spending reductions largely come from the imposition of a on people who’ve obtained Medicaid under the Affordable Care Act’s expansion, as well as other new barriers to coverage.

The law will mean more than 7.5 million people will lose Medicaid coverage and become uninsured, according to the Congressional Budget Office, while extending tax cuts for wealthy people who, Democrats say, don’t need them. Republicans and Trump have said the spending package and its accompanying program cuts were necessary to prevent fraud and waste, and to sustain Medicaid, a state-federal program for people with disabilities and lower incomes.

“The One Big Beautiful Bill removes illegal aliens, enforces work requirements, and protects Medicaid for the truly vulnerable,” the White House said in a .

The Medicaid cuts won’t begin until after the midterm elections in November 2026, but other cuts have already hit.

The Trump administration has sought to claw back earmarked to states because of the pandemic, spurring a with a coalition of Democratic-led states. It also in for mental health services in schools, and halted grants from the National Institutes of Health that provided money to more than 90 public universities.

HHS press secretary Emily Hilliard said the agency is prioritizing investments that advance Trump’s mandate to confront chronic disease. She defended some of the cuts and said, erroneously, that the spending law doesn’t cut Medicaid.

“The covid-19 pandemic is over, and HHS will no longer waste billions of taxpayer dollars responding to a crisis that Americans moved on from years ago,” she said.

State leaders say the pandemic funding the administration wants returned was earmarked for other public health measures, such as tracking emerging diseases, outbreak responses, and staffing. State attorneys general in May won a against the administration.

“What we’re seeing now is states anticipating big cuts in Medicaid coming, but they’re also dealing with a whole variety of federal cutbacks in public health programs that are smaller but still quite meaningful,” said , executive vice president for health policy at �鶹Ů��, a health information nonprofit that includes �鶹Ů�� Health News.

Part of the challenge for states is simply understanding the changes.

“I think it’s fair to say there is concern, confusion, and uncertainty,” said Kathryn Costanza, a Medicaid expert at the National Conference of State Legislatures.

States are struggling to sort it all out, forming that are , suing to try to block the cuts, and reallocating funding.

In Colorado, lawmakers to let state Medicaid dollars pay for non-abortion care at Planned Parenthood of America clinics after Trump’s law banned federal funding for such care. Whether the ban holds up in court .

The Louisiana Legislature to state universities to make up for cuts to federal research funding, much of which goes to health-related research.

And in South Dakota, the state’s largest food bank has to make up for funding cuts to the U.S. Department of Agriculture.

States must balance their budgets every year, so cuts put many services at risk if state lawmakers are unwilling to raise taxes. The work will begin in earnest in January, when many states begin new legislative sessions.

And the tough choices are likely to continue. Congressional House Republicans are considering legislation that could , including by slashing the generous cost sharing the federal government provides for 20 million adults who enrolled in Medicaid under the ACA’s Medicaid expansion.

Some states will roll back their Medicaid expansions and cut more health programs as a result.

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Planned Parenthood Bets on Redistricting To Push Back Against GOP Funding Cuts

Christine Mai-Duc — Wed, 20 Aug 2025 09:00:00 +0000

Abortion rights groups are backing California Democrats in the escalating battle to redraw congressional maps, warning that Republicans are rigging seats on the heels of deeply unpopular cuts to safety net health programs and restrictions on reproductive care.

And they worry there’s more to come, including a .

“You take away our freedoms, we’ll take away your seats,” said Jodi Hicks, CEO of Planned Parenthood Affiliates of California, during Gov. Gavin Newsom’s pitch to adopt Democratic-leaning maps to offset President Donald Trump’s attempt to bolster GOP seats in Texas.

“We can’t sit idly by while the Trump administration, while their backers in Congress, pursue every avenue to strip blue states of their autonomy.”

California legislators this week are debating the new congressional maps, drawn by Newsom allies, which would temporarily replace those drawn by the state’s independent redistricting commission. If they’re approved, voters would have the final say in a November special election.

The mobilization comes as Planned Parenthood, one of the nation’s leading reproductive rights groups, tries to prevent further political and funding losses. Since the Supreme Court overturned Roe v. Wade in 2022, , including Texas, have implemented laws banning abortion almost entirely. And Republicans passed Trump’s tax-and-spending bill with massive cuts to Medicaid, which keeps safety net providers like Planned Parenthood afloat.

The Trump administration also recently barred the organization and its affiliates from receiving reimbursement for nonabortion services such as cancer screenings and birth control, though a federal judge has temporarily pending a legal challenge.

John Seago, president of Texas Right to Life, said the anti-abortion group is not taking a position on either state’s redistricting proposals. But, he said, Democrats’ rhetoric about protecting democracy rings hollow when blue states like California pass “” that protect patients seeking abortions and their health care providers from facing consequences and make it more difficult for states like Texas to enforce their laws.

Hicks, whose group represents about 1 in 5 Planned Parenthood clinics nationwide, promised to “go all in” on Newsom’s ballot measure. She declined to say how much money the organization would spend on the campaign.

She added that she wouldn’t be surprised to see more health care groups — many of which opposed the recent Medicaid cuts — jump into electoral politics following the passage of Trump’s signature law. “Health care organizations that, maybe, don’t get involved in those particular races are looking at things differently,” she said.

So far, health industry support has been limited to abortion rights advocates. Reproductive Freedom for All, the national abortion rights group formerly known as NARAL, also lauded Newsom for “holding Republicans accountable for trying to steal votes.”

Planned Parenthood Texas Votes, the advocacy arm of the state’s affiliates, has urged supporters to testify at special session meetings and to “stop the redistricting power grab.” And the national Planned Parenthood Action Fund encouraged leaders in Democratic states to use “all tools in their power to push back, level the national playing field, and stop the slide into authoritarianism.”

Hicks and her group are no strangers to — even against Newsom. Last year, she and other health leaders led a $56 million campaign to pass a revised state health care tax in November over the governor’s concerns.

Newsom, who is trying to build a national profile ahead of a , said the effort would “neutralize” Republican gerrymandering in Texas to pad their party’s fragile five-seat advantage in the U.S. House. The party in the White House has generally lost congressional seats in the midterm elections, and political analysts say the trend appears likely to continue in 2026.

Newsom also called on lawmakers in to follow suit if GOP states move ahead with redistricting plans. Leaders in Florida, Illinois, Indiana, Missouri, New York, and Ohio have suggested they could explore similar actions, creating a potential cascade that political experts have said could sow chaos in next year’s midterm elections and set a dangerous precedent.

California Republican Party chair Corrin Rankin, whose party stands to lose five of the nine House seats it currently holds, a “calculated power grab that dismantles the very safeguards voters put in place” when they reform in 2010.

Democratic leaders have cast the move as necessary to combat an existential threat to democracy. And they have criticized Republicans for trying to make an end run around voter anger toward their policies, particularly around health care. Nearly half of adults think the Republican-passed tax-and-spending law will hurt them, according to a . More than half believe abortion should be legal, at least under some circumstances, per a Gallup poll in May.

The Republican-passed megabill is projected to slash Medicaid, the federal health care program that covers low-income Americans, by nearly $1 trillion over 10 years. And the Trump administration has cut funding to the Centers for Disease Control and Prevention and the National Institutes of Health, including clawing back medical and scientific research funds from universities.

“They know that voters will hold them accountable for the cuts they rammed through Congress that will strip health care away from millions of people,” said Democratic state lawmaker Sabrina Cervantes, chair of the Senate Elections and Constitutional Amendments Committee. “Because they know they cannot win fair elections, they are changing the rules in the middle of the game.”

Republican incumbents who could be redistricted into oblivion are crying foul.

“Mid-Decade redistricting is wrong, no matter where it’s being done,” Rep. Doug LaMalfa wrote on the social platform X. Last week, the seven-term Republican endured a hostile town hall in his rural Northern California district, defending his vote for the new law by saying it “doesn’t cut a single dollar from people who qualify” for Medi-Cal, the state’s Medicaid program.

If approved by voters, proponents said, California’s 52 new House districts would also bolster vulnerable congressional Democrats and be in effect for the 2026, 2028, and 2030 elections. The map would not go into effect unless another state approved its own gerrymandering effort. After the 2030 census, the state commission would regain control of the process.

Paul Mitchell, a redistricting expert who helped draft the Democrats’ map, said his team used the commission’s district boundaries as a starting point and, for more than half the districts, moved fewer than 10% of voters.

“This is not a Twitter hack job,” said Mitchell, a Democrat who is married to Hicks and has long supported the independent commission’s work. “I want to get back to nonpartisan redistricting, but right now we’re in a crisis.”

show voters oppose partisan redistricting. And still overwhelmingly support the state’s independent redistricting system, said veteran GOP strategist Rob Stutzman, who added that passing such complicated ballot language in an off-year election would be no easy feat.

“You’re asking voters to make an unprincipled decision. You’re asking them to rig an election because allegedly Texas is rigging an election,” Stutzman said. “‘No’ votes are so much easier when it’s confusing, and this is extremely confusing.”

Dave Wasserman, senior editor and elections analyst for the Cook Political Report, said Texas and California have the potential to set off a “redistricting apocalypse” that will have major implications in the fight to control Congress.

“If Democrats fail to pass a ballot initiative to offset Texas, then Republicans would go from having a very narrow chance to hold the House to, perhaps, an even chance,” he said. But, he added, public opinion on health care cuts remains the biggest obstacle in the party’s path.

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‘A Fear Pandemic’: Immigration Raids Push Patients Into Telehealth

Christine Mai-Duc — Thu, 14 Aug 2025 09:00:00 +0000

has seen his patients through the federal of the 1990s, a sitting governor’s call to , and the highly publicized and family separation policies of President Donald Trump’s first term.

But in his 40 years as a pediatrician in Southern California serving those too poor to afford care, including many immigrant families, Sweidan said he’s never seen a drop-off in patient visits like this.

“They are scared to come to the offices. They’re getting sicker and sicker,” said Sweidan, who specializes in neonatology and runs five clinics in Los Angeles and Orange counties. “And when they are near collapsing, they go to the ER because they have no choice.”

In the last two months, he has sent young children to the emergency room because their parents worked up the courage to call his office only after several days of high fever. He said he attended to a 14-year-old boy in the ER who was on the verge of a diabetic coma because he’d run out of insulin, his parents too frightened to venture out for a refill.

Sweidan had stopped offering telehealth visits after the covid-19 pandemic, but he and other health care providers have brought them back as ramped-up immigration enforcement drives patients without legal status — and even their U.S. citizen children — deeper into the shadows.

Patients in need of care are increasingly scared to seek it after Trump rescinded a that barred immigration officials from conducting operations in “sensitive” areas such as schools, hospitals, and churches. Clinics and health plans have taken a page out of their covid playbooks, revamping tested strategies to care for patients scared to leave the house.

Sara Rosenbaum, professor emerita of health law and policy at George Washington University, said she’s heard from clinic administrators and industry colleagues who have experienced a substantial drop in in-person visits among immigrant patients.

“I don’t think there’s a community health center in the country that is not feeling this,” Rosenbaum said.

At St. John’s Community Health clinics in the Los Angeles area, which serve an estimated 30,000 patients without legal status annually, virtual visits have skyrocketed from roughly 8% of appointments to about 25%, said Jim Mangia, president and chief executive officer. The organization is also registering some patients for , a service funded by private donors, and has how to .

“People are not picking up their medicine,” Mangia said. “They’re not seeing the doctor.”

Mangia said that, in the past eight weeks, federal agents have attempted to gain access to patients at a St. John’s mobile clinic in Downey and pointed a gun at an employee during a raid at MacArthur Park. Last month, Immigration and Customs Enforcement contractors sat in waiting for a patient and federal prosecutors charged they say interfered with immigration officers’ attempts to arrest someone at an Ontario facility.

C.S., an immigrant from Huntington Park without legal status, said she signed up for St. John’s home visit services in July because she fears going outside. The 71-year-old woman, who asked to be identified only by her initials for fear of deportation, said she has missed blood work and other lab tests this year. Too afraid to take the bus, she skipped a recent appointment with a specialist for her arthritic hands. She is also prediabetic and struggles with leg pain after a car hit her a few years ago.

“I feel so worried because if I don’t get the care I need, it can get much worse,” she said in Spanish, speaking about her health issues through an interpreter. A doctor at the clinic gave her a number to call in case she wants to schedule an appointment by phone.

Officials at the federal Department of Health and Human Services did not respond to questions from �鶹Ů�� Health News seeking comment about the impact of the raids on patients.

There’s no indication the Trump administration intends to shift its strategy. Federal officials have a judge’s order temporarily restricting how they conduct raids in Southern California after immigrant advocates filed a lawsuit accusing ICE of deploying unconstitutional tactics. The 9th U.S. Circuit Court of Appeals on Aug. 1 , leaving the restraining order in place.

In July, Los Angeles County supervisors to explore expanding virtual appointment options after the county’s director of health services noted a “huge increase” in phone and video visits. Meanwhile, state lawmakers in California are that would restrict immigration agents’ access to places such as schools and health care facilities — Colorado’s governor, Democrat Jared Polis, into law in May.

Sweidan serves those too poor to afford health care, including many immigrant families. He recently noticed patients delaying and forgoing health visits. “They are scared to come to the offices,” he says. “They’re getting sicker and sicker.” (Jeff Gritchen/Orange County Register/SCNG)

Immigrants and their families will likely end up using more costly care in emergency rooms as a last resort. And recently passed are expected to further stress ERs and hospitals, said Nicole Lamoureux, president of the National Association of Free & Charitable Clinics.

“Not only are clinics trying to reach people who are retreating from care before they end up with more severe conditions, but the health care safety net is going to be strained due to an influx in patient demand,” Lamoureux said.

Mitesh Popat, CEO of Venice Family Clinic, nearly 90% of whose patients are at or below the federal poverty line, said staff call patients before appointments to ask if they plan to come in person and to offer telehealth as an option if they are nervous. They also call if a patient doesn’t show five minutes into their appointment and offer immediate telehealth service as an alternative. The clinic has seen a roughly 5% rise in telehealth visits over the past month, Popat said.

In the Salinas Valley, an area with a large concentration of Spanish-speaking farmworkers, Clinica de Salud del Valle de Salinas began promoting telehealth services with Spanish radio ads in January. The clinics also trained people how to use Zoom and other digital platforms at health fairs and community meetings.

CalOptima Health, which covers nearly 1 in 3 residents of Orange County and is the biggest Medi-Cal benefits administrator in the area, sent more than a quarter-million text messages to patients in July encouraging them to use telehealth rather than forgo care, said Chief Executive Officer Michael Hunn. The insurer has also set up a for patients seeking care by phone or home delivery of medication.

“The Latino community is facing a fear pandemic. They’re quarantining just the way we all had to during the covid-19 pandemic,” said Seciah Aquino, executive director of the Latino Coalition for a Healthy California, an advocacy group that promotes health access for immigrants and Latinos.

But substituting telehealth isn’t a long-term solution, said Isabel Becerra, chief executive officer of the Coalition of Orange County Community Health Centers, whose members reported increases in telehealth visits as high as 40% in the past month.

“As a stopgap, it’s very effective,” said Becerra, whose group represents 20 clinics in Southern California. “Telehealth can only take you so far. What about when you need lab work? You can’t look at a cavity through a screen.”

Telehealth also brings a host of other challenges, including technical hiccups with translation services and limited computer proficiency or internet access among patients, she said.

And it’s not just immigrants living in the country unlawfully who are scared to seek out care. In southeast Los Angeles County, V.M., a 59-year-old naturalized citizen, relies on her roommate to pick up her groceries and prescriptions. She asked that only her initials be used to share her story and those of her family and friends out of fear they could be targeted.

When she does venture out — to church or for her monthly appointment at a rheumatology clinic — she carries her passport and looks askance at any cars with tinted windows.

“I feel paranoid,” said V.M., who came to the U.S. more than 40 years ago and is a patient of Venice Family Clinic. “Sometimes I feel scared. Sometimes I feel angry. Sometimes I feel sad.”

She now sees her therapist virtually for her depression, which began 10 years ago when rheumatoid arthritis forced her to stop working. She worries about her older brother, who has high blood pressure and has stopped going to the doctor, and about a friend from the rheumatology clinic, who ices swollen hands and feet because she’s missed four months of appointments in a row.

“Somebody has to wake up or people are going to start falling apart outside on the streets and they’re going to die,” she said.

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