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"content": "\u003cp>Dozens of nurses rallied outside \u003ca href=\"https://www.kqed.org/news/tag/kaiser\">Kaiser\u003c/a> San Francisco on Monday to advocate for a San Francisco nurse who is set to lose her job — after the federal government did not process her temporary legal status in time.\u003c/p>\n\u003cp>The surgical nurse, who has lived in the U.S. for most of her life and will remain anonymous due to safety concerns, immigrated from the Philippines when she was two years old. As an employee of Kaiser Permanente San Francisco Medical Center on Geary Boulevard, the nurse filed her DACA, or Deferred Action for Childhood Arrivals, renewal application on Dec.1 — exactly 135 days before her status was set to expire on April 15. Despite applying well within the recommended window, she said she has not heard back.\u003c/p>\n\u003cp>When her status lapsed, Kaiser placed her on 30 days of unpaid leave. That window closes on May 14. In response to her inquiries, Kaiser wrote that “It is your responsibility to keep your work authorization current,” according to \u003ca href=\"https://missionlocal.org/2026/05/kaiser-nurse-daca-renewal-delay-san-francisco/\">\u003cem>Mission Local\u003c/em>\u003c/a>, which first reported her case.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>In a statement, Kaiser said the organization was evaluating potential solutions. \u003c/p>\n\u003cp>“We have been working directly with our employee to support her through this as best we can. We have been working with the union as well, and appreciate their advocacy on behalf of our employee. We are currently evaluating what potential solutions are available,” a spokesperson said in a statement. \u003c/p>\n\u003cp>Outside of Kaiser on Monday, dozens of nurses chanted: “Defend DACA now,” calling on the hospital to extend the nurse’s unpaid leave. In a statement read aloud by fellow nurses at the rally, the soon-to-be-terminated nurse wrote: “I feel devastated and torn to pieces to be in a position where the fault lies with the innocent.”\u003c/p>\n\u003cp>“So, I ask Kaiser to extend my leave, because I want to thrive, too,” it said.\u003c/p>\n\u003cp>Hers is not an isolated case. According to the Migration Policy Institute, an estimated 500,000 immigrants currently hold DACA status, and many have been caught in a surge of federal processing delays — a trend that advocates told KQED accelerated this year.\u003c/p>\n\u003cfigure id=\"attachment_12083226\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12083226\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/05/260511-KAISERDACA00122_TV-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1334\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/05/260511-KAISERDACA00122_TV-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/05/260511-KAISERDACA00122_TV-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/05/260511-KAISERDACA00122_TV-KQED-1536x1025.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Diana Alfaro, a registered nurse, rallies against Kaiser’s plans to terminate a DACA recipient registered nurse outside of Kaiser Permanente on Geary Street in San Francisco on May 11, 2026. \u003ccite>(Tâm Vũ/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The East Bay Sanctuary Covenant, which serves more than 1,000 active DACA clients, said that over half of renewal requests filed since November 2025 remain pending.\u003c/p>\n\u003cp>Lisa Hoffman, the organization’s co-executive director, said delays of 150 days or more are now common.\u003c/p>\n\u003cp>“This is just the latest attack,” Hoffman said. “It feels like DACA is being chipped away at piece by piece every day.”\u003c/p>\n\u003cp>Sydney Simpson, a registered nurse at Kaiser San Francisco, said the hospital’s decision is both morally and practically wrong.[aside postID=news_12082440 hero='https://cdn.kqed.org/wp-content/uploads/sites/10/2024/04/240408-FCIDublin-018-BL_qut-1020x680.jpg']“To replace a nurse with her level of expertise is extremely painful for the organization — it’s expensive, it hurts our morale as nurses and it hurts patient quality of care,” Simpson said. “It seems like a really easy decision, but for whatever reason, they are holding their ground.”\u003c/p>\n\u003cp>Nurses pointed to a stark contrast with the University of California health system. Maureen Dugan, a UCSF registered nurse, said at Monday’s rally that the UC’s union contract explicitly protects DACA nurses from termination during renewal delays — and guarantees recall rights if they are temporarily let go.\u003c/p>\n\u003cp>“UC is committed to supporting DACA staff,” Dugan said. “We won that language in our last contract negotiations.”\u003c/p>\n\u003cp>Last week, a coalition of Bay Area immigrant rights groups — including Justice Action Center, East Bay Sanctuary Covenant, the Immigration Institute of the Bay Area and Cornell Law School’s Path2Papers — filed a Freedom of Information Act request, demanding the Trump administration release data on how it is processing DACA renewals and what, if any, policy changes are driving the delays.\u003c/p>\n\u003cp>Advocates say DACA recipients are now making major life decisions — about their jobs, their housing, their families — without knowing when or whether their renewals will come through.\u003c/p>\n\u003cp>Vanessa Rivas-Bernardy, a staff attorney at Justice Action Center, said the delays reflect a program under sustained administrative pressure.\u003c/p>\n\u003cfigure id=\"attachment_12083229\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12083229\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/05/260511-KAISERDACA00360_TV-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/05/260511-KAISERDACA00360_TV-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/05/260511-KAISERDACA00360_TV-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/05/260511-KAISERDACA00360_TV-KQED-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Supervisor Connie Chan rallies against Kaiser’s plans to terminate a DACA recipient registered nurse outside of Kaiser Permanente on Geary Street in San Francisco on May 11, 2026. \u003ccite>(Tâm Vũ/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“DACA recipients have been living in two-year increments — all their decisions, their whole lives are in these two-year chunks,” Rivas-Bernardy said. “This is just an exacerbation of that uncertainty and risk, but it’s been completely ramping up in recent months in a way we really haven’t seen before.”\u003c/p>\n\u003cp>If the government does not respond to the FOIA request within 20 calendar days, Rivas-Bernardy said the coalition is prepared to file a federal lawsuit to compel disclosure.\u003c/p>\n\u003cp>San Francisco Supervisor Connie Chan attended Monday’s rally and called on Kaiser to change course.\u003c/p>\n\u003cp>“Our nurses — DACA or otherwise — should not be punished for the Trump administration’s incompetence,” Chan said.\u003c/p>\n\u003cp>In her written statement, the nurse said she is still holding on to hope.\u003c/p>\n\u003cp>“I know I am worthy, good enough, an exceptional nurse and member of this society,” she wrote. “I am a DACA recipient — a dreamer.”\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>“To replace a nurse with her level of expertise is extremely painful for the organization — it’s expensive, it hurts our morale as nurses and it hurts patient quality of care,” Simpson said. “It seems like a really easy decision, but for whatever reason, they are holding their ground.”\u003c/p>\n\u003cp>Nurses pointed to a stark contrast with the University of California health system. Maureen Dugan, a UCSF registered nurse, said at Monday’s rally that the UC’s union contract explicitly protects DACA nurses from termination during renewal delays — and guarantees recall rights if they are temporarily let go.\u003c/p>\n\u003cp>“UC is committed to supporting DACA staff,” Dugan said. “We won that language in our last contract negotiations.”\u003c/p>\n\u003cp>Last week, a coalition of Bay Area immigrant rights groups — including Justice Action Center, East Bay Sanctuary Covenant, the Immigration Institute of the Bay Area and Cornell Law School’s Path2Papers — filed a Freedom of Information Act request, demanding the Trump administration release data on how it is processing DACA renewals and what, if any, policy changes are driving the delays.\u003c/p>\n\u003cp>Advocates say DACA recipients are now making major life decisions — about their jobs, their housing, their families — without knowing when or whether their renewals will come through.\u003c/p>\n\u003cp>Vanessa Rivas-Bernardy, a staff attorney at Justice Action Center, said the delays reflect a program under sustained administrative pressure.\u003c/p>\n\u003cfigure id=\"attachment_12083229\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12083229\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/05/260511-KAISERDACA00360_TV-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/05/260511-KAISERDACA00360_TV-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/05/260511-KAISERDACA00360_TV-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/05/260511-KAISERDACA00360_TV-KQED-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Supervisor Connie Chan rallies against Kaiser’s plans to terminate a DACA recipient registered nurse outside of Kaiser Permanente on Geary Street in San Francisco on May 11, 2026. \u003ccite>(Tâm Vũ/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“DACA recipients have been living in two-year increments — all their decisions, their whole lives are in these two-year chunks,” Rivas-Bernardy said. “This is just an exacerbation of that uncertainty and risk, but it’s been completely ramping up in recent months in a way we really haven’t seen before.”\u003c/p>\n\u003cp>If the government does not respond to the FOIA request within 20 calendar days, Rivas-Bernardy said the coalition is prepared to file a federal lawsuit to compel disclosure.\u003c/p>\n\u003cp>San Francisco Supervisor Connie Chan attended Monday’s rally and called on Kaiser to change course.\u003c/p>\n\u003cp>“Our nurses — DACA or otherwise — should not be punished for the Trump administration’s incompetence,” Chan said.\u003c/p>\n\u003cp>In her written statement, the nurse said she is still holding on to hope.\u003c/p>\n\u003cp>“I know I am worthy, good enough, an exceptional nurse and member of this society,” she wrote. “I am a DACA recipient — a dreamer.”\u003c/p>\n\u003cp>\u003c/p>\n\u003c/div>\u003c/p>",
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"content": "\u003cp>\u003ca href=\"https://www.kqed.org/news/tag/santa-clara-county\">Santa Clara County\u003c/a> is proposing cutting several hundred positions and shuttering health clinics to help close a $787 million budget deficit, as it confronts sea changes in funding from both the federal and state governments.\u003c/p>\n\u003cp>“This is our fourth year in a row of budget reductions and the magnitude of the gap that we had to close this year is one of the largest that the county has faced in decades,” County Executive James Williams said of the $14.7 billion budget proposal.\u003c/p>\n\u003cp>He called it an “extraordinarily difficult budget to bring forward,” not just because of the challenges of bridging the gap, but because of residents’ increasing reliance on the county, complicated by the likelihood of further losses of federal revenue in coming years.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“And all of that in a context where there is so much need in the community and the context where we know that there are tremendous pressures on safety net services for the most vulnerable families,” Williams said.\u003c/p>\n\u003cp>The county’s top brass recommended cutting 655 positions across its organization, with the brunt of that expected to be felt in the county’s large hospital system and its behavioral health departments.\u003c/p>\n\u003cp>The county said about 265 of those positions are currently filled, or roughly 40%, but Williams said he is hoping to avoid any layoffs.\u003c/p>\n\u003cfigure id=\"attachment_12080199\" class=\"wp-caption aligncenter\" style=\"max-width: 1980px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12080199\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/04/GettyImages-1679222216.jpg\" alt=\"\" width=\"1980\" height=\"1320\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/04/GettyImages-1679222216.jpg 1980w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/04/GettyImages-1679222216-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/04/GettyImages-1679222216-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 1980px) 100vw, 1980px\">\u003cfigcaption class=\"wp-caption-text\">Santa Clara County Government Center in San Jose, California, on June 10, 2023. \u003ccite>(JHVEPhoto via Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“We will be attempting very vigorously to place all those individuals into other vacant positions across the county,” he said. What exactly happens to those employees would be based on what positions are offered to them, their labor contracts and their personal needs, Williams said.\u003c/p>\n\u003cp>County Supervisor Susan Ellenberg lauded those efforts given the county’s total workforce size of roughly 22,000 people, and hopes the county can support every worker.\u003c/p>\n\u003cp>“It’s rather extraordinary… to be able to find enough places to make budget cuts, look for increased revenue and be able to consolidate and increase efficiencies with such a relatively small number of employees being impacted,” she said. “Of course, for any single employee, that makes all the difference in the world…but we have been very successful in leveraging positions that are either vacant now or we know have upcoming retirements or other planned separations from the county.”[aside postID=news_12074467 hero='https://cdn.kqed.org/wp-content/uploads/sites/10/2024/09/SFLicensePlateReader-1020x675.jpg']The county is facing significant cuts to federal Medicaid and food assistance funding stemming from President Donald Trump’s H.R. 1 bill, which is expected to amount to more than $1 billion in annual revenue losses for Santa Clara County in the coming years.\u003c/p>\n\u003cp>The state has also this year shifted the requirements and funding model for mental health and behavioral health programs after the passage of Proposition 1 by voters in 2024, which Williams said “has really turned the fiscal world in behavioral health upside down.”\u003c/p>\n\u003cp>On top of federal and state funding challenges, the county, like many other organizations and households, has also seen rising costs for labor, goods, services and utilities, while property tax revenue has not kept pace.\u003c/p>\n\u003cp>The biggest way the county is coping with the cuts is through the emergency injection of $337 million expected to be provided by a new sales tax approved by 57% of voters last year, called Measure A. The measure increases sales tax across the county by five-eighths of a cent for every one dollar spent, and is in place for five years.\u003c/p>\n\u003cp>Williams and his staff recommended putting all of the Measure A money for the current budget year into Santa Clara Valley Healthcare, the county’s public hospital and clinic system, to help lessen the blow from Medicaid cuts enacted by Trump and the Republican-controlled Congress.\u003c/p>\n\u003cfigure id=\"attachment_12058486\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12058486\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/10/250924-ELECTION-SJ-MEASURE-A_00662_TV-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/10/250924-ELECTION-SJ-MEASURE-A_00662_TV-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/10/250924-ELECTION-SJ-MEASURE-A_00662_TV-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/10/250924-ELECTION-SJ-MEASURE-A_00662_TV-KQED-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Santa Clara Valley Medical Center stands on 751 South Bascom Avenue in San José on Sept. 29, 2025. \u003ccite>(Tâm Vũ/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>County supervisors also previously approved nearly $200 million in budget cuts in February during the mid-year budget review, including cutting roughly 365 positions that were largely vacant and focused on the county’s healthcare system.\u003c/p>\n\u003cp>While planning for 655 cuts, the county is simultaneously considering adding 191 positions, especially in areas that are growing but aren’t reliant on federal funds, like parks and libraries, for a net cut of 464 positions, Williams said.\u003c/p>\n\u003cp>Two county-run behavioral health clinics are expected to be closed, but Williams said the services will be transitioned to other facilities or community organizations that provide services for the county already.\u003c/p>\n\u003cp>Ellenberg said the idea of consolidating clinics on its face doesn’t worry her too much, so long as people who need those services aren’t challenged to find them elsewhere nearby.\u003c/p>\n\u003cp>But she added that in general, the on-the-ground impacts from broad budget recommendations to alter contracts and leases and reduce positions is where she will focus as supervisors go through budget workshops and reviews next week.\u003c/p>\n\u003cp>“There are many aspects of it that are not yet clear to me, particularly around impact… I need to understand how that impacts particular populations, especially the very high-need and vulnerable residents that the county serves,” Ellenberg said.\u003c/p>\n\u003cfigure id=\"attachment_12044070\" class=\"wp-caption aligncenter\" style=\"max-width: 1999px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12044070\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/06/250612-SCCVERMONT-JG-4_qed.jpg\" alt=\"\" width=\"1999\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/06/250612-SCCVERMONT-JG-4_qed.jpg 1999w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/06/250612-SCCVERMONT-JG-4_qed-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/06/250612-SCCVERMONT-JG-4_qed-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 1999px) 100vw, 1999px\">\u003cfigcaption class=\"wp-caption-text\">Santa Clara County Supervisor Susan Ellenberg, speaks during an event celebrating the opening of Vermont House, a new residential treatment facility in San José for people leaving jail with mental health needs. \u003ccite>(Joseph Geha/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Williams said the county has been aiming to preserve or expand services for those in most need across the county. He pointed to plans for new “satellite clinics in high-need communities,” as well as the planned opening of the county’s behavioral health pavilion on the campus of Santa Clara Valley Medical Center later this year.\u003c/p>\n\u003cp>The pavilion will include the first child and adolescent inpatient psychiatric unit in the South Bay, Williams said, and will be staffed by transferring positions from elsewhere in the county.\u003c/p>\n\u003cp>“We’re continuing to expand in critical areas and areas with significant community demand where there’s significant need. We haven’t taken our eye off the ball,” he said.\u003c/p>\n\u003cp>Williams said the county has “moved mountains” to preserve critical services in the face of unprecedented cuts, and said voters have stepped up at an important time. But he called directly on the governor and legislature to help counties across the state.\u003c/p>\n\u003cp>“We need to see a forceful, clear and unequivocal response at the state level to what’s happening with H.R. 1,” he said. “There’s no way our county or any other can do this alone.”\u003c/p>\n\u003cp>The county’s Board of Supervisors will hold three consecutive budget workshops May 11-13, and will hold three more sessions to adopt a final budget in mid-June.\u003c/p>\n\u003cp>The county is not the only government facing down budget deficits, as South Bay cities look for ways to close their gaps while maintaining critical services.\u003c/p>\n\u003cfigure id=\"attachment_11998675\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11998675\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/240802-VTAFEDFUND-JG-1.jpg\" alt=\"The mayor of San Jose stands behind a podium. A poster breaking down the project budget is displayed next to the speaker.\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/240802-VTAFEDFUND-JG-1.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/240802-VTAFEDFUND-JG-1-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/240802-VTAFEDFUND-JG-1-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/240802-VTAFEDFUND-JG-1-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/240802-VTAFEDFUND-JG-1-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">San José Mayor Matt Mahan speaks during a gathering in Santa Clara on Aug. 2, 2024, to announce a nearly $5.1 billion funding commitment from federal transit officials toward the VTA BART Silicon Valley Phase II extension project. \u003ccite>(Joseph Geha/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>San José, whose Mayor Matt Mahan heavily touted his work to spend more of the city’s affordable housing funds on more than 1,000 new interim shelter spaces for people who are homeless last year, is now working to cut $50 million out of its budget.\u003c/p>\n\u003cp>The city’s current proposal from City Manager Jennifer Maguire would cut support for interim housing operations by $1.25 million in the coming budget year and significantly reduce it by $14.2 million in the budget for 2027-2028, officials said this week.\u003c/p>\n\u003cp>Williams said the coming years for Santa Clara County could be even more difficult, and he is concerned about changes to the “social compact” in the country.\u003c/p>\n\u003cp>“We’re one United States, and there are deep interrelationships between federal, state and local governments that all operate together to help take care of communities across the country,” Williams said. “We’re witnessing a complete reordering of that fabric, not just fiscally, but in terms of policy and the politics of this whole country.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003ca href=\"https://www.kqed.org/news/tag/santa-clara-county\">Santa Clara County\u003c/a> is proposing cutting several hundred positions and shuttering health clinics to help close a $787 million budget deficit, as it confronts sea changes in funding from both the federal and state governments.\u003c/p>\n\u003cp>“This is our fourth year in a row of budget reductions and the magnitude of the gap that we had to close this year is one of the largest that the county has faced in decades,” County Executive James Williams said of the $14.7 billion budget proposal.\u003c/p>\n\u003cp>He called it an “extraordinarily difficult budget to bring forward,” not just because of the challenges of bridging the gap, but because of residents’ increasing reliance on the county, complicated by the likelihood of further losses of federal revenue in coming years.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“And all of that in a context where there is so much need in the community and the context where we know that there are tremendous pressures on safety net services for the most vulnerable families,” Williams said.\u003c/p>\n\u003cp>The county’s top brass recommended cutting 655 positions across its organization, with the brunt of that expected to be felt in the county’s large hospital system and its behavioral health departments.\u003c/p>\n\u003cp>The county said about 265 of those positions are currently filled, or roughly 40%, but Williams said he is hoping to avoid any layoffs.\u003c/p>\n\u003cfigure id=\"attachment_12080199\" class=\"wp-caption aligncenter\" style=\"max-width: 1980px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12080199\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/04/GettyImages-1679222216.jpg\" alt=\"\" width=\"1980\" height=\"1320\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/04/GettyImages-1679222216.jpg 1980w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/04/GettyImages-1679222216-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/04/GettyImages-1679222216-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 1980px) 100vw, 1980px\">\u003cfigcaption class=\"wp-caption-text\">Santa Clara County Government Center in San Jose, California, on June 10, 2023. \u003ccite>(JHVEPhoto via Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“We will be attempting very vigorously to place all those individuals into other vacant positions across the county,” he said. What exactly happens to those employees would be based on what positions are offered to them, their labor contracts and their personal needs, Williams said.\u003c/p>\n\u003cp>County Supervisor Susan Ellenberg lauded those efforts given the county’s total workforce size of roughly 22,000 people, and hopes the county can support every worker.\u003c/p>\n\u003cp>“It’s rather extraordinary… to be able to find enough places to make budget cuts, look for increased revenue and be able to consolidate and increase efficiencies with such a relatively small number of employees being impacted,” she said. “Of course, for any single employee, that makes all the difference in the world…but we have been very successful in leveraging positions that are either vacant now or we know have upcoming retirements or other planned separations from the county.”\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>The county is facing significant cuts to federal Medicaid and food assistance funding stemming from President Donald Trump’s H.R. 1 bill, which is expected to amount to more than $1 billion in annual revenue losses for Santa Clara County in the coming years.\u003c/p>\n\u003cp>The state has also this year shifted the requirements and funding model for mental health and behavioral health programs after the passage of Proposition 1 by voters in 2024, which Williams said “has really turned the fiscal world in behavioral health upside down.”\u003c/p>\n\u003cp>On top of federal and state funding challenges, the county, like many other organizations and households, has also seen rising costs for labor, goods, services and utilities, while property tax revenue has not kept pace.\u003c/p>\n\u003cp>The biggest way the county is coping with the cuts is through the emergency injection of $337 million expected to be provided by a new sales tax approved by 57% of voters last year, called Measure A. The measure increases sales tax across the county by five-eighths of a cent for every one dollar spent, and is in place for five years.\u003c/p>\n\u003cp>Williams and his staff recommended putting all of the Measure A money for the current budget year into Santa Clara Valley Healthcare, the county’s public hospital and clinic system, to help lessen the blow from Medicaid cuts enacted by Trump and the Republican-controlled Congress.\u003c/p>\n\u003cfigure id=\"attachment_12058486\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12058486\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/10/250924-ELECTION-SJ-MEASURE-A_00662_TV-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/10/250924-ELECTION-SJ-MEASURE-A_00662_TV-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/10/250924-ELECTION-SJ-MEASURE-A_00662_TV-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/10/250924-ELECTION-SJ-MEASURE-A_00662_TV-KQED-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Santa Clara Valley Medical Center stands on 751 South Bascom Avenue in San José on Sept. 29, 2025. \u003ccite>(Tâm Vũ/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>County supervisors also previously approved nearly $200 million in budget cuts in February during the mid-year budget review, including cutting roughly 365 positions that were largely vacant and focused on the county’s healthcare system.\u003c/p>\n\u003cp>While planning for 655 cuts, the county is simultaneously considering adding 191 positions, especially in areas that are growing but aren’t reliant on federal funds, like parks and libraries, for a net cut of 464 positions, Williams said.\u003c/p>\n\u003cp>Two county-run behavioral health clinics are expected to be closed, but Williams said the services will be transitioned to other facilities or community organizations that provide services for the county already.\u003c/p>\n\u003cp>Ellenberg said the idea of consolidating clinics on its face doesn’t worry her too much, so long as people who need those services aren’t challenged to find them elsewhere nearby.\u003c/p>\n\u003cp>But she added that in general, the on-the-ground impacts from broad budget recommendations to alter contracts and leases and reduce positions is where she will focus as supervisors go through budget workshops and reviews next week.\u003c/p>\n\u003cp>“There are many aspects of it that are not yet clear to me, particularly around impact… I need to understand how that impacts particular populations, especially the very high-need and vulnerable residents that the county serves,” Ellenberg said.\u003c/p>\n\u003cfigure id=\"attachment_12044070\" class=\"wp-caption aligncenter\" style=\"max-width: 1999px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12044070\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/06/250612-SCCVERMONT-JG-4_qed.jpg\" alt=\"\" width=\"1999\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/06/250612-SCCVERMONT-JG-4_qed.jpg 1999w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/06/250612-SCCVERMONT-JG-4_qed-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/06/250612-SCCVERMONT-JG-4_qed-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 1999px) 100vw, 1999px\">\u003cfigcaption class=\"wp-caption-text\">Santa Clara County Supervisor Susan Ellenberg, speaks during an event celebrating the opening of Vermont House, a new residential treatment facility in San José for people leaving jail with mental health needs. \u003ccite>(Joseph Geha/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Williams said the county has been aiming to preserve or expand services for those in most need across the county. He pointed to plans for new “satellite clinics in high-need communities,” as well as the planned opening of the county’s behavioral health pavilion on the campus of Santa Clara Valley Medical Center later this year.\u003c/p>\n\u003cp>The pavilion will include the first child and adolescent inpatient psychiatric unit in the South Bay, Williams said, and will be staffed by transferring positions from elsewhere in the county.\u003c/p>\n\u003cp>“We’re continuing to expand in critical areas and areas with significant community demand where there’s significant need. We haven’t taken our eye off the ball,” he said.\u003c/p>\n\u003cp>Williams said the county has “moved mountains” to preserve critical services in the face of unprecedented cuts, and said voters have stepped up at an important time. But he called directly on the governor and legislature to help counties across the state.\u003c/p>\n\u003cp>“We need to see a forceful, clear and unequivocal response at the state level to what’s happening with H.R. 1,” he said. “There’s no way our county or any other can do this alone.”\u003c/p>\n\u003cp>The county’s Board of Supervisors will hold three consecutive budget workshops May 11-13, and will hold three more sessions to adopt a final budget in mid-June.\u003c/p>\n\u003cp>The county is not the only government facing down budget deficits, as South Bay cities look for ways to close their gaps while maintaining critical services.\u003c/p>\n\u003cfigure id=\"attachment_11998675\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11998675\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/240802-VTAFEDFUND-JG-1.jpg\" alt=\"The mayor of San Jose stands behind a podium. A poster breaking down the project budget is displayed next to the speaker.\" width=\"1920\" height=\"1280\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/240802-VTAFEDFUND-JG-1.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/240802-VTAFEDFUND-JG-1-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/240802-VTAFEDFUND-JG-1-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/240802-VTAFEDFUND-JG-1-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2024/08/240802-VTAFEDFUND-JG-1-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">San José Mayor Matt Mahan speaks during a gathering in Santa Clara on Aug. 2, 2024, to announce a nearly $5.1 billion funding commitment from federal transit officials toward the VTA BART Silicon Valley Phase II extension project. \u003ccite>(Joseph Geha/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>San José, whose Mayor Matt Mahan heavily touted his work to spend more of the city’s affordable housing funds on more than 1,000 new interim shelter spaces for people who are homeless last year, is now working to cut $50 million out of its budget.\u003c/p>\n\u003cp>The city’s current proposal from City Manager Jennifer Maguire would cut support for interim housing operations by $1.25 million in the coming budget year and significantly reduce it by $14.2 million in the budget for 2027-2028, officials said this week.\u003c/p>\n\u003cp>Williams said the coming years for Santa Clara County could be even more difficult, and he is concerned about changes to the “social compact” in the country.\u003c/p>\n\u003cp>“We’re one United States, and there are deep interrelationships between federal, state and local governments that all operate together to help take care of communities across the country,” Williams said. “We’re witnessing a complete reordering of that fabric, not just fiscally, but in terms of policy and the politics of this whole country.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"slug": "after-the-one-big-beautiful-bill-free-clinics-are-stepping-up",
"title": "After the One Big Beautiful Bill, Free Clinics Are Stepping Up",
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"headTitle": "After the One Big Beautiful Bill, Free Clinics Are Stepping Up | KQED",
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"content": "\u003cp>\u003cem>This story is part of \u003c/em>\u003ca href=\"https://www.kqed.org/affordability\">\u003cem>How We Get By\u003c/em>\u003c/a>\u003cem>, a KQED series exploring how people are coping with rising costs in the Bay Area and California. Find the \u003c/em>\u003ca href=\"https://www.kqed.org/affordability\">\u003cem>full series here\u003c/em>\u003c/a>\u003cem>. \u003c/em>\u003c/p>\n\u003cp>For Marisol, it’s not strange to feel aches and pains all over her body when she comes home after work. She picks and packages fruit for farms in \u003ca href=\"https://www.kqed.org/news/tag/contra-costa-county\">Contra Costa County\u003c/a>. Even when temperatures rise over 100 degrees Fahrenheit, she’s out in the field collecting cherries, peaches, nectarines and apricots.\u003c/p>\n\u003cp>She knows it takes a toll on her body. “Sometimes you’re so exhausted that it feels like there’s something wrong with your body, and you don’t know if you’re actually sick or just tired,” she said in Spanish.\u003c/p>\n\u003cp>As an undocumented immigrant without employer-provided health insurance, actually finding out if she’s sick is a luxury. KQED is withholding her full name because publishing it could expose her to potential immigration enforcement. “I either pay my rent or I go to the doctor,” she said.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>But in the summer of 2023 — when she began to feel several bumps on her breasts — she decided her health could no longer wait. She went to the one place she knew she could get care at no cost: \u003ca href=\"https://www.hijasdelcampo.org/\">Hijas del Campo\u003c/a>.\u003c/p>\n\u003cp>Every Tuesday afternoon, the Contra Costa County Department of Public Health parks \u003ca href=\"https://www.cchealth.org/get-care/for-people-without-health-coverage/health-care-for-the-homeless\">a mobile clinic\u003c/a> outside the nonprofit’s Brentwood offices. The clinic offers limited free care to residents like Marisol who qualify. It’s one of dozens of free clinics across the Bay Area that serve low-income and undocumented immigrants who don’t have access to healthcare.\u003c/p>\n\u003cfigure id=\"attachment_12078942\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-12078942 size-full\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/04/033126Free-Clinics-Brentwood_GH_016_qed.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/04/033126Free-Clinics-Brentwood_GH_016_qed.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/04/033126Free-Clinics-Brentwood_GH_016_qed-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/04/033126Free-Clinics-Brentwood_GH_016_qed-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Marisol, a farmworker in Brentwood, sits outside the Hijas del Campo offices, an organization that connects agricultural workers and their families to free health services, food assistance and legal support on March 31, 2026, in Brentwood, California. \u003ccite>(Gustavo Hernandez/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Free clinics across California are bracing for a surge of uninsured patients as provisions in President Donald Trump’s “\u003ca href=\"https://www.kqed.org/news/12073880/tax-credits-trump-2026-refund-tips-child-tax-credit-car-loan-interest-documents\">One Big Beautiful Bill\u003c/a>” take effect, eliminating federal subsidies for some Affordable Care Act plans and tightening Medicaid eligibility rules.\u003c/p>\n\u003cp>About 160,000 Californians have already \u003ca href=\"https://www.ppic.org/blog/many-californians-are-paying-more-for-health-insurance-from-covered-california/\">lost federal subsidies\u003c/a> that made their premiums cheaper and in the coming years, state officials \u003ca href=\"https://lao.ca.gov/reports/2026/5180/Changing_Landscape_Affects_Californias_Health_Care_System_050426.pdf\">estimate\u003c/a> that the number of Californians without health insurance — currently around 2 million — could double by 2030, leaving safety-net clinics to absorb the growing demand for care.\u003c/p>\n\u003cp>The White House has \u003ca href=\"https://www.whitehouse.gov/releases/2025/06/myth-vs-fact-the-one-big-beautiful-bill/\">defended\u003c/a> the OBBB, arguing that these changes will help eliminate “waste, fraud, and abuse” from the nation’s healthcare system. But doctors and volunteers who staff free clinics are already seeing people who have lost coverage and warn that a growing uninsured population could negatively impact care for all patients.\u003c/p>\n\u003ch2>How free care works\u003c/h2>\n\u003cp>Free clinics have existed for decades across the Bay Area, offering primary care to those without health insurance. Many serve suburban and rural communities far from the medical infrastructure of the region’s larger cities. But even in San Francisco, free clinics serve thousands each year.\u003c/p>\n\u003cp>The \u003ca href=\"https://www.clinicbythebay.org/\">Clinic by the Bay\u003c/a> — located in San Francisco’s Excelsior District, one of the most \u003ca href=\"https://www.sfchronicle.com/sf/article/demographic-map-san-francisco-21310100.php\">ethnically diverse neighborhoods\u003c/a> in the city — sees many patients who are experiencing a transition that left them uninsured, often a layoff, aging out of their parents’ insurance or migrating to the United States.\u003c/p>\n\u003cfigure id=\"attachment_12079790\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12079790\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/04/030526_FREECLINICS-_GH_017-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/04/030526_FREECLINICS-_GH_017-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/04/030526_FREECLINICS-_GH_017-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/04/030526_FREECLINICS-_GH_017-KQED-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Katelyn McMeekin-Jackson, executive director of Clinic by the Bay, poses for a portrait inside the clinic in San Francisco on March 5, 2026. \u003ccite>(Gustavo Hernandez/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“And there’s people who are working but cannot afford their healthcare premiums, so they have decided to go without health insurance,” said Katelyn McMeekin-Jackson, executive director of Clinic by the Bay. She knows many patients by their first name, greeting them warmly when they come through the front door.\u003c/p>\n\u003cp>There are only a few requirements to get care there, McMeekin-Jackson said. A new patient must share a copy of an ID, proof of income and confirm they do not have health insurance.\u003c/p>\n\u003cp>More than 200 volunteers — many of them retired doctors, resident physicians and medical students — help the clinic offer primary and ongoing care for those living with chronic conditions, like diabetes.\u003c/p>\n\u003cfigure id=\"attachment_12079789\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12079789\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/04/030526_FREECLINICS-_GH_016-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/04/030526_FREECLINICS-_GH_016-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/04/030526_FREECLINICS-_GH_016-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/04/030526_FREECLINICS-_GH_016-KQED-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Volunteer Melissa Castillo, left, and executive director Katelyn McMeekin-Jackson walk through a hallway inside Clinic by the Bay in San Francisco on March 5, 2026. \u003ccite>(Gustavo Hernandez/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>When a patient needs a service that’s not available in-house, staff work with the clinic’s extended network of physicians who are willing to donate their time. Companies like LabCorp also provide a limited number of free screenings, and skilled nursing homes regularly donate surplus medication.\u003c/p>\n\u003cp>“A big part of the puzzle is figuring out how we can get around the limitations to get free care,” McMeekin-Jackson said, adding that over the past year, volunteer numbers increased by about 30% to keep pace with the growing number of patients.\u003c/p>\n\u003cp>“We’re anticipating that patient numbers will grow as premiums increase,” she said. “And there are Medi-Cal changes projected in the future.”\u003c/p>\n\u003ch2>Finding the limits\u003c/h2>\n\u003cp>As Congress raced to finalize the details of the OBBB last summer, lawmakers \u003ca href=\"https://www.wsj.com/politics/policy/trump-wsj-poll-tax-bill-support-ee51c67e\">sought to balance\u003c/a> the price tag of other Trump policy priorities — reshaping the \u003ca href=\"https://www.kqed.org/news/12073880/tax-credits-trump-2026-refund-tips-child-tax-credit-car-loan-interest-documents\">nation’s tax system\u003c/a> and supercharging immigration enforcement — by freeing up funding elsewhere.\u003c/p>\n\u003cp>Republicans moved to end the subsidies that lowered the costs of healthcare premiums for millions of people nationwide who bought their plan through an Affordable Care Act marketplace, which includes Covered California.\u003c/p>\n\u003cfigure id=\"attachment_12079787\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12079787\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/04/022726_FREE-CLINICS-_GH_037-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/04/022726_FREE-CLINICS-_GH_037-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/04/022726_FREE-CLINICS-_GH_037-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/04/022726_FREE-CLINICS-_GH_037-KQED-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">The Jewish Community Free Clinic building is seen on March 2, 2026, in Santa Rosa. The clinic provides free healthcare services to uninsured patients. \u003ccite>(Gustavo Hernandez/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>In 2024, the federal government spent nearly $14 billion \u003ca href=\"https://www.kff.org/medicaid/what-does-the-federal-government-spend-on-health-care/#Appendix-Table-3\">on subsidies\u003c/a>, which helped millions of Americans \u003ca href=\"https://www.pewresearch.org/short-reads/2026/01/22/what-the-data-says-about-affordable-care-act-health-insurance-exchanges/\">enroll in a plan\u003c/a>. According to the \u003ca href=\"https://www.kff.org/affordable-care-act/inflation-reduction-act-health-insurance-subsidies-what-is-their-impact-and-what-would-happen-if-they-expire/#:~:text=The%20enhanced%20subsidies%20in%20the%20Inflation%20Reduction%20Act%20reduce%20net%20premium%20costs%20by%2044%25%2C%20on%20average%2C%20for%20enrollees%20receiving%20premium%20tax%20credits%2C%20though%20the%20amount%20of%20savings%20varies%20by%20person.\">Kaiser Family Foundation\u003c/a>, a San Francisco-based public health research nonprofit, the subsidies lowered the annual premium payment in 2024 from about $1,600 to $900 — a difference of about 44%.\u003c/p>\n\u003cp>On Jan. 1, the majority of Covered California enrollees saw their \u003ca href=\"https://www.ppic.org/blog/many-californians-are-paying-more-for-health-insurance-from-covered-california/\">premiums rise\u003c/a> as the federal government pulled back subsidies. But people making above 400% of the federal poverty level — roughly $62,000 for a single person — began paying the full monthly premium for their health insurance. In the Bay Area, some residents \u003ca href=\"https://www.kqed.org/forum/2010101912612/how-are-you-coping-with-increased-health-insurance-premiums\">have shared\u003c/a> that their premiums have gone up by over 150%.\u003c/p>\n\u003cp>“We’re getting a lot of calls from people who lost their plan because they couldn’t pay these outrageous new premiums,” said Donna Waldman, the executive director of the Santa Rosa-based \u003ca href=\"https://www.jewishfreeclinic.org/\">Jewish Community Free Clinic\u003c/a>.\u003c/p>\n\u003cfigure id=\"attachment_12079785\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12079785\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/04/022726_FREE-CLINICS-_GH_027-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/04/022726_FREE-CLINICS-_GH_027-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/04/022726_FREE-CLINICS-_GH_027-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/04/022726_FREE-CLINICS-_GH_027-KQED-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Donna Waldman, executive director and one of the founders of the Jewish Community Free Clinic, listens during a conversation inside the clinic on March 2, 2026, in Santa Rosa. \u003ccite>(Gustavo Hernandez/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Waldman, along with a handful of doctors and nurses, started the clinic in 2001. The majority of patients are immigrant farmworkers who power Sonoma County’s multimillion-dollar wine industry. Many are seeing a doctor for the first time in years and are coming in for a one-time check-in — a situation that the clinic is well-equipped for, Waldman said.\u003c/p>\n\u003cp>“We are not set up to do chronic disease maintenance,” she said. “Our system’s not set up to have you come back every three or four months to get your blood pressure checked — that’s not our type of practice.”\u003c/p>\n\u003cp>Higher premiums are not just forcing people to drop their plan, but also discouraging those who could qualify for a Covered California plan from signing up.\u003c/p>\n\u003cfigure id=\"attachment_12079786\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12079786\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/04/022726_FREE-CLINICS-_GH_029-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/04/022726_FREE-CLINICS-_GH_029-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/04/022726_FREE-CLINICS-_GH_029-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/04/022726_FREE-CLINICS-_GH_029-KQED-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Rivka Vaughan, who works at the front desk and assists with grant writing, sits in the waiting area of the Jewish Community Free Clinic on March 2, 2026, in Santa Rosa. \u003ccite>(Gustavo Hernandez/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>In Sonoma County, new enrollment this year \u003ca href=\"https://www.pressdemocrat.com/2026/02/28/new-affordable-care-act-enrollment-declines-by-33-in-north-bay/\">decreased by 33%\u003c/a>, with officials reporting a \u003ca href=\"https://www.coveredca.com/newsroom/news-releases/2026/02/26/as-enhanced-federal-subsidies-expire-covered-california-ends-open-enrollment-with-state-subsidies-keeping-renewals-steady-for-now-and-new-signups-down/#:~:text=California%20allocated%20%24190%20million%20from,of%20the%20federal%20poverty%20level.\">similar drop statewide\u003c/a>. And according to \u003ca href=\"https://lao.ca.gov/reports/2026/5180/Changing_Landscape_Affects_Californias_Health_Care_System_050426.pdf\">some researchers\u003c/a>, the first people to drop their Covered California plans are usually younger, healthier individuals who use fewer benefits. Those enrollees help lower the costs of care for everyone else. But with fewer healthier people in the marketplace, premiums could rise even higher.\u003c/p>\n\u003cp>When folks call in after dropping their plan, Waldman said the clinic can see them in the meantime, but they also work with the patient to see if they qualify for care at a \u003ca href=\"https://findahealthcenter.hrsa.gov/\">federally qualified health center\u003c/a> — which serve patients on a sliding fee scale, but are subject to income limits and \u003ca href=\"https://www.hhs.gov/press-room/prwora-hhs-bans-illegal-aliens-accessing-taxpayer-funded-programs.html\">potential immigration rules\u003c/a> from the Trump administration.\u003c/p>\n\u003cp>“We have nothing to lose monetarily from the federal government,” Waldman said. “Free clinics play a really important role in the resiliency of the community right now because we are independent organizations.”\u003c/p>\n\u003ch2>‘Influenza doesn’t know if you have insurance or not’\u003c/h2>\n\u003cp>The OBBB’s next big shock to healthcare is expected at the end of this year. By Dec. 31, states must implement stricter eligibility requirements for patients enrolled in Medicaid — known as Medi-Cal in California, which provides free or low-cost care to roughly 15 million lower-income residents.\u003c/p>\n\u003cp>In 2010, the Obama administration expanded Medicaid eligibility to include adults aged 19-64 with incomes below 138% of the federal poverty level. In the decade that followed, \u003ca href=\"https://www.ppic.org/blog/medi-cal-has-expanded-health-coverage-in-california/\">Medi-Cal enrollment soared\u003c/a>, with the biggest increase in that newly-eligible group.\u003c/p>\n\u003cfigure id=\"attachment_12079783\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12079783\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/04/022726_FREE-CLINICS-_GH_009-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/04/022726_FREE-CLINICS-_GH_009-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/04/022726_FREE-CLINICS-_GH_009-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/04/022726_FREE-CLINICS-_GH_009-KQED-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">A hallway inside the San Francisco Free Clinic in the Richmond District on Feb. 27, 2026. The clinic provides free primary care and specialty services to patients without health insurance. \u003ccite>(Gustavo Hernandez/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Under the OBBB, Medi-Cal recipients will need to renew their eligibility every six months, instead of annually, and those who are able-bodied and without dependents have to either work, go to school or do community service for at least 80 hours each month.\u003c/p>\n\u003cp>State officials \u003ca href=\"https://www.gov.ca.gov/wp-content/uploads/2025/05/newsom-medicaid-impacts-memo.pdf\">estimated\u003c/a> the new requirements would result in up to 3.4 million Californians losing their Medi-Cal coverage. And because federal funding for Medi-Cal is dependent on how many people are enrolled, the state could lose over $30 billion.\u003c/p>\n\u003cp>That’s unfortunate, said Ashley Tsang, medical director for the San Francisco Free Clinic, because more people on Medi-Cal means fewer people who are uninsured.[aside postID=news_12078480 hero='https://cdn.kqed.org/wp-content/uploads/sites/10/2026/04/AffordabilitySeriesIntro_Lede.jpg']“We were hoping that there were going to be fewer people uninsured as Medi-Cal covered more people,” Tsang said. “At some point, our numbers would have actually dropped.”\u003c/p>\n\u003cp>The clinic currently sees around 1,500 uninsured patients each year with the help of a few dozen physicians and medical students. Tsang — who helps run the Richmond District clinic along with her husband and fellow physician Ian Nelligan — said the team hasn’t yet needed to expand service hours, but that’s something they are thinking about given the political situation.\u003c/p>\n\u003cp>“COVID-19 taught us that [infectious diseases don’t] know if you have insurance or not, and people will end up at the emergency department one way or the other,” she said. “We all end up paying for patients who have no health insurance.”\u003c/p>\n\u003cp>A \u003ca href=\"https://lao.ca.gov/reports/2026/5180/Changing_Landscape_Affects_Californias_Health_Care_System_050426.pdf\">recent report\u003c/a> from the state Legislative Analyst’s Office predicts that care providers — including private and public hospitals that treat patients with coverage — may feel greater financial pressure as the uninsured population grows in the coming years.\u003c/p>\n\u003cp>Many providers, the report finds, “will still provide some care to these populations without receiving reimbursement,” and as these expenses go up, they may negotiate higher rates with private insurance plans.\u003c/p>\n\u003ch2>Pushing back on closed doors\u003c/h2>\n\u003cp>White House officials have argued that other parts of the OBBB — like larger tax deductibles and expanded flexible spending accounts — will make it easier for individuals to pay for health insurance.\u003c/p>\n\u003cp>But the administration has made clear the changes will limit access to low-cost care for one group of people in particular: undocumented immigrants. Blocking this group from Medicaid is necessary “to preserve it for hardworking Americans who need it,” press secretary Karoline Leavitt said before the bill’s passage.\u003c/p>\n\u003cp>The OBBB reduced federal funds that helped states provide emergency Medicaid coverage to undocumented immigrants — a \u003ca href=\"https://www.whitehouse.gov/wp-content/uploads/2025/10/WFTCA-Illegal-Immigrant-Healthcare-Memo-FINAL.pdf\">White House memo\u003c/a> went as far as calling this move “closing the California loophole.”\u003c/p>\n\u003cfigure id=\"attachment_12078937\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12078937\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/04/033126Free-Clinics-Brentwood_GH_001_qed.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/04/033126Free-Clinics-Brentwood_GH_001_qed.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/04/033126Free-Clinics-Brentwood_GH_001_qed-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/04/033126Free-Clinics-Brentwood_GH_001_qed-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Pro-farmworker posters adorn the walls inside the Hijas del Campo workspace. The group helps coordinate services including food distribution, healthcare access and legal aid for farmworkers and their families, on March 31, 2026, in Brentwood, California. \u003ccite>(Gustavo Hernandez/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>This change — along with other expected healthcare cuts from the federal government — prompted state lawmakers last year to \u003ca href=\"https://calmatters.org/politics/2025/06/california-budget-newsom-democrats/\">block new Medi-Cal enrollment\u003c/a> for undocumented immigrants aged 19 and older.\u003c/p>\n\u003cp>That means Marisol can no longer sign up for Medi-Cal, leaving her with only the mobile clinic outside Hijas del Campo for care.\u003c/p>\n\u003cp>“This is an injustice,” the farmworker said. “Our work is very intense, and it’s what brings food to people’s tables. But this work is not valued.”\u003c/p>\n\u003cfigure id=\"attachment_12078938\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12078938\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/04/033126Free-Clinics-Brentwood_GH_008_qed.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/04/033126Free-Clinics-Brentwood_GH_008_qed.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/04/033126Free-Clinics-Brentwood_GH_008_qed-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/04/033126Free-Clinics-Brentwood_GH_008_qed-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Dorina Salgado-Moraida, co-founder of Hijas del Campo, stands beside a Contra Costa Health Department mobile clinic used to provide free and low-cost medical services to farmworkers and underserved residents, on March 31, 2026, in Brentwood, California. \u003ccite>(Gustavo Hernandez/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>When she first felt those bumps on her breasts in 2023, a doctor at the clinic confirmed she had a tumor — but a benign one that was treated thanks to the county program. Marisol still comes to the mobile clinic for follow-ups.\u003c/p>\n\u003cp>“People are still going to be sick,” said Hijas del Campo co-founder Dorina Salgado-Moraida, who pointed out that there are thousands of undocumented immigrants in other parts of the state who will be left with no options for care.\u003c/p>\n\u003cp>“We had some learnings from the pandemic, but then at the same time, we didn’t really learn much,” she said. “We didn’t put systems in place to protect those who are the most essential.”\u003c/p>\n\u003cp>\u003cem>Editor’s Note: This story was updated to clarify medical terminology. \u003c/em>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"excerpt": "After the passage of the One Big Beautiful Bill, many Californians no longer have access to healthcare because of higher premiums or their immigration status. Free clinics are rushing to fill the gaps in coverage.",
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"title": "After the One Big Beautiful Bill, Free Clinics Are Stepping Up | KQED",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cem>This story is part of \u003c/em>\u003ca href=\"https://www.kqed.org/affordability\">\u003cem>How We Get By\u003c/em>\u003c/a>\u003cem>, a KQED series exploring how people are coping with rising costs in the Bay Area and California. Find the \u003c/em>\u003ca href=\"https://www.kqed.org/affordability\">\u003cem>full series here\u003c/em>\u003c/a>\u003cem>. \u003c/em>\u003c/p>\n\u003cp>For Marisol, it’s not strange to feel aches and pains all over her body when she comes home after work. She picks and packages fruit for farms in \u003ca href=\"https://www.kqed.org/news/tag/contra-costa-county\">Contra Costa County\u003c/a>. Even when temperatures rise over 100 degrees Fahrenheit, she’s out in the field collecting cherries, peaches, nectarines and apricots.\u003c/p>\n\u003cp>She knows it takes a toll on her body. “Sometimes you’re so exhausted that it feels like there’s something wrong with your body, and you don’t know if you’re actually sick or just tired,” she said in Spanish.\u003c/p>\n\u003cp>As an undocumented immigrant without employer-provided health insurance, actually finding out if she’s sick is a luxury. KQED is withholding her full name because publishing it could expose her to potential immigration enforcement. “I either pay my rent or I go to the doctor,” she said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>But in the summer of 2023 — when she began to feel several bumps on her breasts — she decided her health could no longer wait. She went to the one place she knew she could get care at no cost: \u003ca href=\"https://www.hijasdelcampo.org/\">Hijas del Campo\u003c/a>.\u003c/p>\n\u003cp>Every Tuesday afternoon, the Contra Costa County Department of Public Health parks \u003ca href=\"https://www.cchealth.org/get-care/for-people-without-health-coverage/health-care-for-the-homeless\">a mobile clinic\u003c/a> outside the nonprofit’s Brentwood offices. The clinic offers limited free care to residents like Marisol who qualify. It’s one of dozens of free clinics across the Bay Area that serve low-income and undocumented immigrants who don’t have access to healthcare.\u003c/p>\n\u003cfigure id=\"attachment_12078942\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-12078942 size-full\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/04/033126Free-Clinics-Brentwood_GH_016_qed.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/04/033126Free-Clinics-Brentwood_GH_016_qed.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/04/033126Free-Clinics-Brentwood_GH_016_qed-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/04/033126Free-Clinics-Brentwood_GH_016_qed-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Marisol, a farmworker in Brentwood, sits outside the Hijas del Campo offices, an organization that connects agricultural workers and their families to free health services, food assistance and legal support on March 31, 2026, in Brentwood, California. \u003ccite>(Gustavo Hernandez/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Free clinics across California are bracing for a surge of uninsured patients as provisions in President Donald Trump’s “\u003ca href=\"https://www.kqed.org/news/12073880/tax-credits-trump-2026-refund-tips-child-tax-credit-car-loan-interest-documents\">One Big Beautiful Bill\u003c/a>” take effect, eliminating federal subsidies for some Affordable Care Act plans and tightening Medicaid eligibility rules.\u003c/p>\n\u003cp>About 160,000 Californians have already \u003ca href=\"https://www.ppic.org/blog/many-californians-are-paying-more-for-health-insurance-from-covered-california/\">lost federal subsidies\u003c/a> that made their premiums cheaper and in the coming years, state officials \u003ca href=\"https://lao.ca.gov/reports/2026/5180/Changing_Landscape_Affects_Californias_Health_Care_System_050426.pdf\">estimate\u003c/a> that the number of Californians without health insurance — currently around 2 million — could double by 2030, leaving safety-net clinics to absorb the growing demand for care.\u003c/p>\n\u003cp>The White House has \u003ca href=\"https://www.whitehouse.gov/releases/2025/06/myth-vs-fact-the-one-big-beautiful-bill/\">defended\u003c/a> the OBBB, arguing that these changes will help eliminate “waste, fraud, and abuse” from the nation’s healthcare system. But doctors and volunteers who staff free clinics are already seeing people who have lost coverage and warn that a growing uninsured population could negatively impact care for all patients.\u003c/p>\n\u003ch2>How free care works\u003c/h2>\n\u003cp>Free clinics have existed for decades across the Bay Area, offering primary care to those without health insurance. Many serve suburban and rural communities far from the medical infrastructure of the region’s larger cities. But even in San Francisco, free clinics serve thousands each year.\u003c/p>\n\u003cp>The \u003ca href=\"https://www.clinicbythebay.org/\">Clinic by the Bay\u003c/a> — located in San Francisco’s Excelsior District, one of the most \u003ca href=\"https://www.sfchronicle.com/sf/article/demographic-map-san-francisco-21310100.php\">ethnically diverse neighborhoods\u003c/a> in the city — sees many patients who are experiencing a transition that left them uninsured, often a layoff, aging out of their parents’ insurance or migrating to the United States.\u003c/p>\n\u003cfigure id=\"attachment_12079790\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12079790\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/04/030526_FREECLINICS-_GH_017-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/04/030526_FREECLINICS-_GH_017-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/04/030526_FREECLINICS-_GH_017-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/04/030526_FREECLINICS-_GH_017-KQED-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Katelyn McMeekin-Jackson, executive director of Clinic by the Bay, poses for a portrait inside the clinic in San Francisco on March 5, 2026. \u003ccite>(Gustavo Hernandez/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“And there’s people who are working but cannot afford their healthcare premiums, so they have decided to go without health insurance,” said Katelyn McMeekin-Jackson, executive director of Clinic by the Bay. She knows many patients by their first name, greeting them warmly when they come through the front door.\u003c/p>\n\u003cp>There are only a few requirements to get care there, McMeekin-Jackson said. A new patient must share a copy of an ID, proof of income and confirm they do not have health insurance.\u003c/p>\n\u003cp>More than 200 volunteers — many of them retired doctors, resident physicians and medical students — help the clinic offer primary and ongoing care for those living with chronic conditions, like diabetes.\u003c/p>\n\u003cfigure id=\"attachment_12079789\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12079789\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/04/030526_FREECLINICS-_GH_016-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/04/030526_FREECLINICS-_GH_016-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/04/030526_FREECLINICS-_GH_016-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/04/030526_FREECLINICS-_GH_016-KQED-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Volunteer Melissa Castillo, left, and executive director Katelyn McMeekin-Jackson walk through a hallway inside Clinic by the Bay in San Francisco on March 5, 2026. \u003ccite>(Gustavo Hernandez/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>When a patient needs a service that’s not available in-house, staff work with the clinic’s extended network of physicians who are willing to donate their time. Companies like LabCorp also provide a limited number of free screenings, and skilled nursing homes regularly donate surplus medication.\u003c/p>\n\u003cp>“A big part of the puzzle is figuring out how we can get around the limitations to get free care,” McMeekin-Jackson said, adding that over the past year, volunteer numbers increased by about 30% to keep pace with the growing number of patients.\u003c/p>\n\u003cp>“We’re anticipating that patient numbers will grow as premiums increase,” she said. “And there are Medi-Cal changes projected in the future.”\u003c/p>\n\u003ch2>Finding the limits\u003c/h2>\n\u003cp>As Congress raced to finalize the details of the OBBB last summer, lawmakers \u003ca href=\"https://www.wsj.com/politics/policy/trump-wsj-poll-tax-bill-support-ee51c67e\">sought to balance\u003c/a> the price tag of other Trump policy priorities — reshaping the \u003ca href=\"https://www.kqed.org/news/12073880/tax-credits-trump-2026-refund-tips-child-tax-credit-car-loan-interest-documents\">nation’s tax system\u003c/a> and supercharging immigration enforcement — by freeing up funding elsewhere.\u003c/p>\n\u003cp>Republicans moved to end the subsidies that lowered the costs of healthcare premiums for millions of people nationwide who bought their plan through an Affordable Care Act marketplace, which includes Covered California.\u003c/p>\n\u003cfigure id=\"attachment_12079787\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12079787\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/04/022726_FREE-CLINICS-_GH_037-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/04/022726_FREE-CLINICS-_GH_037-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/04/022726_FREE-CLINICS-_GH_037-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/04/022726_FREE-CLINICS-_GH_037-KQED-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">The Jewish Community Free Clinic building is seen on March 2, 2026, in Santa Rosa. The clinic provides free healthcare services to uninsured patients. \u003ccite>(Gustavo Hernandez/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>In 2024, the federal government spent nearly $14 billion \u003ca href=\"https://www.kff.org/medicaid/what-does-the-federal-government-spend-on-health-care/#Appendix-Table-3\">on subsidies\u003c/a>, which helped millions of Americans \u003ca href=\"https://www.pewresearch.org/short-reads/2026/01/22/what-the-data-says-about-affordable-care-act-health-insurance-exchanges/\">enroll in a plan\u003c/a>. According to the \u003ca href=\"https://www.kff.org/affordable-care-act/inflation-reduction-act-health-insurance-subsidies-what-is-their-impact-and-what-would-happen-if-they-expire/#:~:text=The%20enhanced%20subsidies%20in%20the%20Inflation%20Reduction%20Act%20reduce%20net%20premium%20costs%20by%2044%25%2C%20on%20average%2C%20for%20enrollees%20receiving%20premium%20tax%20credits%2C%20though%20the%20amount%20of%20savings%20varies%20by%20person.\">Kaiser Family Foundation\u003c/a>, a San Francisco-based public health research nonprofit, the subsidies lowered the annual premium payment in 2024 from about $1,600 to $900 — a difference of about 44%.\u003c/p>\n\u003cp>On Jan. 1, the majority of Covered California enrollees saw their \u003ca href=\"https://www.ppic.org/blog/many-californians-are-paying-more-for-health-insurance-from-covered-california/\">premiums rise\u003c/a> as the federal government pulled back subsidies. But people making above 400% of the federal poverty level — roughly $62,000 for a single person — began paying the full monthly premium for their health insurance. In the Bay Area, some residents \u003ca href=\"https://www.kqed.org/forum/2010101912612/how-are-you-coping-with-increased-health-insurance-premiums\">have shared\u003c/a> that their premiums have gone up by over 150%.\u003c/p>\n\u003cp>“We’re getting a lot of calls from people who lost their plan because they couldn’t pay these outrageous new premiums,” said Donna Waldman, the executive director of the Santa Rosa-based \u003ca href=\"https://www.jewishfreeclinic.org/\">Jewish Community Free Clinic\u003c/a>.\u003c/p>\n\u003cfigure id=\"attachment_12079785\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12079785\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/04/022726_FREE-CLINICS-_GH_027-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/04/022726_FREE-CLINICS-_GH_027-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/04/022726_FREE-CLINICS-_GH_027-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/04/022726_FREE-CLINICS-_GH_027-KQED-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Donna Waldman, executive director and one of the founders of the Jewish Community Free Clinic, listens during a conversation inside the clinic on March 2, 2026, in Santa Rosa. \u003ccite>(Gustavo Hernandez/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Waldman, along with a handful of doctors and nurses, started the clinic in 2001. The majority of patients are immigrant farmworkers who power Sonoma County’s multimillion-dollar wine industry. Many are seeing a doctor for the first time in years and are coming in for a one-time check-in — a situation that the clinic is well-equipped for, Waldman said.\u003c/p>\n\u003cp>“We are not set up to do chronic disease maintenance,” she said. “Our system’s not set up to have you come back every three or four months to get your blood pressure checked — that’s not our type of practice.”\u003c/p>\n\u003cp>Higher premiums are not just forcing people to drop their plan, but also discouraging those who could qualify for a Covered California plan from signing up.\u003c/p>\n\u003cfigure id=\"attachment_12079786\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12079786\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/04/022726_FREE-CLINICS-_GH_029-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/04/022726_FREE-CLINICS-_GH_029-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/04/022726_FREE-CLINICS-_GH_029-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/04/022726_FREE-CLINICS-_GH_029-KQED-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Rivka Vaughan, who works at the front desk and assists with grant writing, sits in the waiting area of the Jewish Community Free Clinic on March 2, 2026, in Santa Rosa. \u003ccite>(Gustavo Hernandez/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>In Sonoma County, new enrollment this year \u003ca href=\"https://www.pressdemocrat.com/2026/02/28/new-affordable-care-act-enrollment-declines-by-33-in-north-bay/\">decreased by 33%\u003c/a>, with officials reporting a \u003ca href=\"https://www.coveredca.com/newsroom/news-releases/2026/02/26/as-enhanced-federal-subsidies-expire-covered-california-ends-open-enrollment-with-state-subsidies-keeping-renewals-steady-for-now-and-new-signups-down/#:~:text=California%20allocated%20%24190%20million%20from,of%20the%20federal%20poverty%20level.\">similar drop statewide\u003c/a>. And according to \u003ca href=\"https://lao.ca.gov/reports/2026/5180/Changing_Landscape_Affects_Californias_Health_Care_System_050426.pdf\">some researchers\u003c/a>, the first people to drop their Covered California plans are usually younger, healthier individuals who use fewer benefits. Those enrollees help lower the costs of care for everyone else. But with fewer healthier people in the marketplace, premiums could rise even higher.\u003c/p>\n\u003cp>When folks call in after dropping their plan, Waldman said the clinic can see them in the meantime, but they also work with the patient to see if they qualify for care at a \u003ca href=\"https://findahealthcenter.hrsa.gov/\">federally qualified health center\u003c/a> — which serve patients on a sliding fee scale, but are subject to income limits and \u003ca href=\"https://www.hhs.gov/press-room/prwora-hhs-bans-illegal-aliens-accessing-taxpayer-funded-programs.html\">potential immigration rules\u003c/a> from the Trump administration.\u003c/p>\n\u003cp>“We have nothing to lose monetarily from the federal government,” Waldman said. “Free clinics play a really important role in the resiliency of the community right now because we are independent organizations.”\u003c/p>\n\u003ch2>‘Influenza doesn’t know if you have insurance or not’\u003c/h2>\n\u003cp>The OBBB’s next big shock to healthcare is expected at the end of this year. By Dec. 31, states must implement stricter eligibility requirements for patients enrolled in Medicaid — known as Medi-Cal in California, which provides free or low-cost care to roughly 15 million lower-income residents.\u003c/p>\n\u003cp>In 2010, the Obama administration expanded Medicaid eligibility to include adults aged 19-64 with incomes below 138% of the federal poverty level. In the decade that followed, \u003ca href=\"https://www.ppic.org/blog/medi-cal-has-expanded-health-coverage-in-california/\">Medi-Cal enrollment soared\u003c/a>, with the biggest increase in that newly-eligible group.\u003c/p>\n\u003cfigure id=\"attachment_12079783\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12079783\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/04/022726_FREE-CLINICS-_GH_009-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/04/022726_FREE-CLINICS-_GH_009-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/04/022726_FREE-CLINICS-_GH_009-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/04/022726_FREE-CLINICS-_GH_009-KQED-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">A hallway inside the San Francisco Free Clinic in the Richmond District on Feb. 27, 2026. The clinic provides free primary care and specialty services to patients without health insurance. \u003ccite>(Gustavo Hernandez/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Under the OBBB, Medi-Cal recipients will need to renew their eligibility every six months, instead of annually, and those who are able-bodied and without dependents have to either work, go to school or do community service for at least 80 hours each month.\u003c/p>\n\u003cp>State officials \u003ca href=\"https://www.gov.ca.gov/wp-content/uploads/2025/05/newsom-medicaid-impacts-memo.pdf\">estimated\u003c/a> the new requirements would result in up to 3.4 million Californians losing their Medi-Cal coverage. And because federal funding for Medi-Cal is dependent on how many people are enrolled, the state could lose over $30 billion.\u003c/p>\n\u003cp>That’s unfortunate, said Ashley Tsang, medical director for the San Francisco Free Clinic, because more people on Medi-Cal means fewer people who are uninsured.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>“We were hoping that there were going to be fewer people uninsured as Medi-Cal covered more people,” Tsang said. “At some point, our numbers would have actually dropped.”\u003c/p>\n\u003cp>The clinic currently sees around 1,500 uninsured patients each year with the help of a few dozen physicians and medical students. Tsang — who helps run the Richmond District clinic along with her husband and fellow physician Ian Nelligan — said the team hasn’t yet needed to expand service hours, but that’s something they are thinking about given the political situation.\u003c/p>\n\u003cp>“COVID-19 taught us that [infectious diseases don’t] know if you have insurance or not, and people will end up at the emergency department one way or the other,” she said. “We all end up paying for patients who have no health insurance.”\u003c/p>\n\u003cp>A \u003ca href=\"https://lao.ca.gov/reports/2026/5180/Changing_Landscape_Affects_Californias_Health_Care_System_050426.pdf\">recent report\u003c/a> from the state Legislative Analyst’s Office predicts that care providers — including private and public hospitals that treat patients with coverage — may feel greater financial pressure as the uninsured population grows in the coming years.\u003c/p>\n\u003cp>Many providers, the report finds, “will still provide some care to these populations without receiving reimbursement,” and as these expenses go up, they may negotiate higher rates with private insurance plans.\u003c/p>\n\u003ch2>Pushing back on closed doors\u003c/h2>\n\u003cp>White House officials have argued that other parts of the OBBB — like larger tax deductibles and expanded flexible spending accounts — will make it easier for individuals to pay for health insurance.\u003c/p>\n\u003cp>But the administration has made clear the changes will limit access to low-cost care for one group of people in particular: undocumented immigrants. Blocking this group from Medicaid is necessary “to preserve it for hardworking Americans who need it,” press secretary Karoline Leavitt said before the bill’s passage.\u003c/p>\n\u003cp>The OBBB reduced federal funds that helped states provide emergency Medicaid coverage to undocumented immigrants — a \u003ca href=\"https://www.whitehouse.gov/wp-content/uploads/2025/10/WFTCA-Illegal-Immigrant-Healthcare-Memo-FINAL.pdf\">White House memo\u003c/a> went as far as calling this move “closing the California loophole.”\u003c/p>\n\u003cfigure id=\"attachment_12078937\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12078937\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/04/033126Free-Clinics-Brentwood_GH_001_qed.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/04/033126Free-Clinics-Brentwood_GH_001_qed.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/04/033126Free-Clinics-Brentwood_GH_001_qed-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/04/033126Free-Clinics-Brentwood_GH_001_qed-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Pro-farmworker posters adorn the walls inside the Hijas del Campo workspace. The group helps coordinate services including food distribution, healthcare access and legal aid for farmworkers and their families, on March 31, 2026, in Brentwood, California. \u003ccite>(Gustavo Hernandez/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>This change — along with other expected healthcare cuts from the federal government — prompted state lawmakers last year to \u003ca href=\"https://calmatters.org/politics/2025/06/california-budget-newsom-democrats/\">block new Medi-Cal enrollment\u003c/a> for undocumented immigrants aged 19 and older.\u003c/p>\n\u003cp>That means Marisol can no longer sign up for Medi-Cal, leaving her with only the mobile clinic outside Hijas del Campo for care.\u003c/p>\n\u003cp>“This is an injustice,” the farmworker said. “Our work is very intense, and it’s what brings food to people’s tables. But this work is not valued.”\u003c/p>\n\u003cfigure id=\"attachment_12078938\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12078938\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/04/033126Free-Clinics-Brentwood_GH_008_qed.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/04/033126Free-Clinics-Brentwood_GH_008_qed.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/04/033126Free-Clinics-Brentwood_GH_008_qed-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/04/033126Free-Clinics-Brentwood_GH_008_qed-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Dorina Salgado-Moraida, co-founder of Hijas del Campo, stands beside a Contra Costa Health Department mobile clinic used to provide free and low-cost medical services to farmworkers and underserved residents, on March 31, 2026, in Brentwood, California. \u003ccite>(Gustavo Hernandez/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>When she first felt those bumps on her breasts in 2023, a doctor at the clinic confirmed she had a tumor — but a benign one that was treated thanks to the county program. Marisol still comes to the mobile clinic for follow-ups.\u003c/p>\n\u003cp>“People are still going to be sick,” said Hijas del Campo co-founder Dorina Salgado-Moraida, who pointed out that there are thousands of undocumented immigrants in other parts of the state who will be left with no options for care.\u003c/p>\n\u003cp>“We had some learnings from the pandemic, but then at the same time, we didn’t really learn much,” she said. “We didn’t put systems in place to protect those who are the most essential.”\u003c/p>\n\u003cp>\u003cem>Editor’s Note: This story was updated to clarify medical terminology. \u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"slug": "xavier-becerra-backpedals-on-single-payer-as-he-woos-powerful-doctors-lobby",
"title": "Xavier Becerra Backpedals on Single Payer as He Woos Powerful Doctors’ Lobby",
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"headTitle": "Xavier Becerra Backpedals on Single Payer as He Woos Powerful Doctors’ Lobby | KQED",
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"content": "\u003cp>Democratic candidate Xavier Becerra has softened his support for\u003ca href=\"https://www.kqed.org/forum/2010101887613/single-payer-healthcare-bill-dies-in-state-assembly\"> a single-payer healthcare system\u003c/a> as he secures endorsements in his bid to be California’s next governor, most recently from the powerful doctors’ group, the California Medical Association, which officially backed him this week.\u003c/p>\n\u003cp>The former health secretary under President Joe Biden has advocated for government-run healthcare since he was a congressman thirty years ago. But when doctors with the medical association peppered the candidate with questions on single payer during a recent private meeting, they said Becerra told them he had other priorities.\u003c/p>\n\u003cp>“He said very clearly that, at this point, he wasn’t supportive of single payer,” said Dr. René Bravo, president of the \u003ca href=\"https://www.cmadocs.org/\">California Medical Association\u003c/a>.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The trade group for doctors is one of the most influential medical lobbies in California and has\u003ca href=\"https://www.kqed.org/news/11902591/why-do-so-many-doctors-oppose-single-payer-health-care\"> long opposed efforts\u003c/a> to establish a single-payer system in the state, arguing it is not economically feasible and would erode physician autonomy. California lawmakers failed \u003ca href=\"https://advocacy.calchamber.com/policy/issues/single-payer-health-care/\">multiple times\u003c/a> to pass legislation in support of single-payer in recent years. In 2022, legislative analysts estimated the cost of operating such a system \u003ca href=\"https://www.kqed.org/forum/2010101887613/single-payer-healthcare-bill-dies-in-state-assembly\">could top $391 billion a year\u003c/a> and said it would require passing new taxes on California residents and businesses.\u003c/p>\n\u003cp>The association endorsed Becerra in the crowded race for governor on April 28, as he quickly rose to become a frontrunner in the two weeks after\u003ca href=\"https://www.kqed.org/news/12079583/eric-swalwell-ends-california-governor-campaign-after-sexual-assault-allegations\"> Eric Swalwell dropped out\u003c/a>. Becerra’s sudden popularity in the polls and scramble to secure additional campaign financing have forced him to clarify the nuances of his policy positions, including single-payer.\u003c/p>\n\u003cfigure id=\"attachment_12081064\" class=\"wp-caption aligncenter\" style=\"max-width: 1999px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-12081064 size-full\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/04/FTP_9P3A3319_1_qed.jpg\" alt=\"\" width=\"1999\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/04/FTP_9P3A3319_1_qed.jpg 1999w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/04/FTP_9P3A3319_1_qed-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/04/FTP_9P3A3319_1_qed-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 1999px) 100vw, 1999px\">\u003cfigcaption class=\"wp-caption-text\">Matt Mahan, Democratic gubernatorial candidate for California, from left, Xavier Becerra, Democratic gubernatorial candidate for California, Chad Bianco, Republican gubernatorial candidate for California, Steve Hilton, Republican gubernatorial candidate for California, Tom Steyer, Democratic gubernatorial candidate for California, and Katie Porter, Democratic gubernatorial candidate for California, during a gubernatorial debate at KRON Studios in San Francisco, California, on April 22, 2026. \u003ccite>(Jason Henry/Nexstar/Bloomberg)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Becerra’s\u003ca href=\"https://www.xavierbecerra2026.com/priorities/health-care/\"> campaign website\u003c/a> links to a video of him\u003ca href=\"https://x.com/ddiamond/status/1335788821582147589?ref_src=twsrc%5Etfw%7Ctwcamp%5Etweetembed%7Ctwterm%5E1335788821582147589%7Ctwgr%5E%7Ctwcon%5Es1_&ref_url=https%3A%2F%2Fcaliforniahealthline.org%2Fnews%2Fwith-becerra-as-hhs-pick-california-plots-more-progressive-health-care-agenda%2F\"> testifying before Congress in 1994\u003c/a> in support of a single-payer plan, proclaiming, “healthcare is a right, not a privilege.”\u003c/p>\n\u003cp>On March 23, 2026, the anniversary of the passage of the Affordable Care Act, Becerra wrote in \u003ca href=\"https://www.facebook.com/becerraforgovernor/posts/pfbid037DvVA3jWPySUowTRfmmPBotuNWXjRxE2j8vYd3u55NF1A3VtoWs7dPMmpJWrisbCl\">a social media post\u003c/a>: “I proudly helped write it, pass it, and defend it in court. Now I’m ready to go further as Governor and deliver single-payer health care for our state.”\u003c/p>\n\u003cp>But more recently, his message was significantly subdued.\u003c/p>\n\u003cp>“A single payer system is the right goal — but it’s not possible under this administration, and right now we have a crisis on our hands,” wrote Jonathan Underland, a campaign spokesperson, in a statement to KQED on Thursday. “Trump is slashing Medi-Cal and handing tax breaks to billionaires while millions of Californians risk losing their coverage.”\u003c/p>\n\u003cp>Indeed, Bravo relayed that Becerra said as much in his meeting with the medical association, telling the doctors his top focus was how to cope with the funding losses from H.R.1, President Trump’s Big Beautiful Bill that is\u003ca href=\"https://www.counties.org/news-and-media-article/h-r-1-will-cost-california-counties-up-to-9-5-billion-a-year/\"> expected to drain $9.5 billion\u003c/a> per year from California safety net programs, including Medi-Cal, which provides free health coverage to more than 14 million low-income Californians.[aside postID=science_2000002 hero='https://cdn.kqed.org/wp-content/uploads/sites/35/2026/02/2026_02_10_DELAY_DENY_00147-KQED.jpg']“The most important thing was making sure that we’re all on the same page in terms of how H.R.1 is going to affect the healthcare system in California, and how we’re going to ensure funding mechanisms that allow people to have access to care,” Bravo said.\u003c/p>\n\u003cp>Becerra told the doctors that now was not the time for single payer and that making any kind of progress on it while President Trump was in office was unrealistic.\u003c/p>\n\u003cp>For California to launch a single-payer system, it would need permission from the federal government to reallocate federal funding it receives for Medicaid and Medicare to the state’s new system, which the Trump administration almost certainly wouldn’t grant.\u003c/p>\n\u003cp>Becerra’s backpedaling on single payer is reminiscent of Gov. Gavin Newsom’s retreat on the issue: on the campaign trail for governor in 2018, Newsom touted his support of a single payer system, but once in office, he confronted the obstacles posed by the first Trump administration and shifted talk to universal access instead.\u003c/p>\n\u003cp>He supported legislation that expanded eligibility for insurance coverage to immigrants lacking permanent legal status, only to scale it back last year as the state faced a budget deficit and federal cuts.\u003c/p>\n\u003cp>Other Democratic candidates for governor have continued to voice ardent support of a Medicare-for-all type system, including \u003ca href=\"https://www.facebook.com/officialtomsteyer/videos/1956640335278610/\">Tom Steyer\u003c/a>, \u003ca href=\"https://www.facebook.com/reel/1452374689596051/\">Katie Porter,\u003c/a> and \u003ca href=\"https://www.facebook.com/watch/?v=957300880039752&vanity=tonythurmond\">Tony Thurmond\u003c/a>. The two Republican candidates are steadfastly opposed.\u003c/p>\n\u003cp>State Assemblymember Ash Kalra, D-San José, who has backed recent single-payer bills in Sacramento, said Becerra sketched out a road map of how to set up a single-payer system while he was health secretary and “knows how to get it done.” But Kalra has endorsed Steyer for governor “because of his clear commitment” to advancing single-payer policy.\u003c/p>\n\u003cp>\u003cem>KQED’s \u003c/em>\u003ca href=\"https://www.kqed.org/author/gmarzorati\">\u003cem>Guy Marzorati\u003c/em>\u003c/a>\u003cem> contributed to this story.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Democratic candidate Xavier Becerra has softened his support for\u003ca href=\"https://www.kqed.org/forum/2010101887613/single-payer-healthcare-bill-dies-in-state-assembly\"> a single-payer healthcare system\u003c/a> as he secures endorsements in his bid to be California’s next governor, most recently from the powerful doctors’ group, the California Medical Association, which officially backed him this week.\u003c/p>\n\u003cp>The former health secretary under President Joe Biden has advocated for government-run healthcare since he was a congressman thirty years ago. But when doctors with the medical association peppered the candidate with questions on single payer during a recent private meeting, they said Becerra told them he had other priorities.\u003c/p>\n\u003cp>“He said very clearly that, at this point, he wasn’t supportive of single payer,” said Dr. René Bravo, president of the \u003ca href=\"https://www.cmadocs.org/\">California Medical Association\u003c/a>.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The trade group for doctors is one of the most influential medical lobbies in California and has\u003ca href=\"https://www.kqed.org/news/11902591/why-do-so-many-doctors-oppose-single-payer-health-care\"> long opposed efforts\u003c/a> to establish a single-payer system in the state, arguing it is not economically feasible and would erode physician autonomy. California lawmakers failed \u003ca href=\"https://advocacy.calchamber.com/policy/issues/single-payer-health-care/\">multiple times\u003c/a> to pass legislation in support of single-payer in recent years. In 2022, legislative analysts estimated the cost of operating such a system \u003ca href=\"https://www.kqed.org/forum/2010101887613/single-payer-healthcare-bill-dies-in-state-assembly\">could top $391 billion a year\u003c/a> and said it would require passing new taxes on California residents and businesses.\u003c/p>\n\u003cp>The association endorsed Becerra in the crowded race for governor on April 28, as he quickly rose to become a frontrunner in the two weeks after\u003ca href=\"https://www.kqed.org/news/12079583/eric-swalwell-ends-california-governor-campaign-after-sexual-assault-allegations\"> Eric Swalwell dropped out\u003c/a>. Becerra’s sudden popularity in the polls and scramble to secure additional campaign financing have forced him to clarify the nuances of his policy positions, including single-payer.\u003c/p>\n\u003cfigure id=\"attachment_12081064\" class=\"wp-caption aligncenter\" style=\"max-width: 1999px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-12081064 size-full\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/04/FTP_9P3A3319_1_qed.jpg\" alt=\"\" width=\"1999\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/04/FTP_9P3A3319_1_qed.jpg 1999w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/04/FTP_9P3A3319_1_qed-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/04/FTP_9P3A3319_1_qed-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 1999px) 100vw, 1999px\">\u003cfigcaption class=\"wp-caption-text\">Matt Mahan, Democratic gubernatorial candidate for California, from left, Xavier Becerra, Democratic gubernatorial candidate for California, Chad Bianco, Republican gubernatorial candidate for California, Steve Hilton, Republican gubernatorial candidate for California, Tom Steyer, Democratic gubernatorial candidate for California, and Katie Porter, Democratic gubernatorial candidate for California, during a gubernatorial debate at KRON Studios in San Francisco, California, on April 22, 2026. \u003ccite>(Jason Henry/Nexstar/Bloomberg)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Becerra’s\u003ca href=\"https://www.xavierbecerra2026.com/priorities/health-care/\"> campaign website\u003c/a> links to a video of him\u003ca href=\"https://x.com/ddiamond/status/1335788821582147589?ref_src=twsrc%5Etfw%7Ctwcamp%5Etweetembed%7Ctwterm%5E1335788821582147589%7Ctwgr%5E%7Ctwcon%5Es1_&ref_url=https%3A%2F%2Fcaliforniahealthline.org%2Fnews%2Fwith-becerra-as-hhs-pick-california-plots-more-progressive-health-care-agenda%2F\"> testifying before Congress in 1994\u003c/a> in support of a single-payer plan, proclaiming, “healthcare is a right, not a privilege.”\u003c/p>\n\u003cp>On March 23, 2026, the anniversary of the passage of the Affordable Care Act, Becerra wrote in \u003ca href=\"https://www.facebook.com/becerraforgovernor/posts/pfbid037DvVA3jWPySUowTRfmmPBotuNWXjRxE2j8vYd3u55NF1A3VtoWs7dPMmpJWrisbCl\">a social media post\u003c/a>: “I proudly helped write it, pass it, and defend it in court. Now I’m ready to go further as Governor and deliver single-payer health care for our state.”\u003c/p>\n\u003cp>But more recently, his message was significantly subdued.\u003c/p>\n\u003cp>“A single payer system is the right goal — but it’s not possible under this administration, and right now we have a crisis on our hands,” wrote Jonathan Underland, a campaign spokesperson, in a statement to KQED on Thursday. “Trump is slashing Medi-Cal and handing tax breaks to billionaires while millions of Californians risk losing their coverage.”\u003c/p>\n\u003cp>Indeed, Bravo relayed that Becerra said as much in his meeting with the medical association, telling the doctors his top focus was how to cope with the funding losses from H.R.1, President Trump’s Big Beautiful Bill that is\u003ca href=\"https://www.counties.org/news-and-media-article/h-r-1-will-cost-california-counties-up-to-9-5-billion-a-year/\"> expected to drain $9.5 billion\u003c/a> per year from California safety net programs, including Medi-Cal, which provides free health coverage to more than 14 million low-income Californians.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>“The most important thing was making sure that we’re all on the same page in terms of how H.R.1 is going to affect the healthcare system in California, and how we’re going to ensure funding mechanisms that allow people to have access to care,” Bravo said.\u003c/p>\n\u003cp>Becerra told the doctors that now was not the time for single payer and that making any kind of progress on it while President Trump was in office was unrealistic.\u003c/p>\n\u003cp>For California to launch a single-payer system, it would need permission from the federal government to reallocate federal funding it receives for Medicaid and Medicare to the state’s new system, which the Trump administration almost certainly wouldn’t grant.\u003c/p>\n\u003cp>Becerra’s backpedaling on single payer is reminiscent of Gov. Gavin Newsom’s retreat on the issue: on the campaign trail for governor in 2018, Newsom touted his support of a single payer system, but once in office, he confronted the obstacles posed by the first Trump administration and shifted talk to universal access instead.\u003c/p>\n\u003cp>He supported legislation that expanded eligibility for insurance coverage to immigrants lacking permanent legal status, only to scale it back last year as the state faced a budget deficit and federal cuts.\u003c/p>\n\u003cp>Other Democratic candidates for governor have continued to voice ardent support of a Medicare-for-all type system, including \u003ca href=\"https://www.facebook.com/officialtomsteyer/videos/1956640335278610/\">Tom Steyer\u003c/a>, \u003ca href=\"https://www.facebook.com/reel/1452374689596051/\">Katie Porter,\u003c/a> and \u003ca href=\"https://www.facebook.com/watch/?v=957300880039752&vanity=tonythurmond\">Tony Thurmond\u003c/a>. The two Republican candidates are steadfastly opposed.\u003c/p>\n\u003cp>State Assemblymember Ash Kalra, D-San José, who has backed recent single-payer bills in Sacramento, said Becerra sketched out a road map of how to set up a single-payer system while he was health secretary and “knows how to get it done.” But Kalra has endorsed Steyer for governor “because of his clear commitment” to advancing single-payer policy.\u003c/p>\n\u003cp>\u003cem>KQED’s \u003c/em>\u003ca href=\"https://www.kqed.org/author/gmarzorati\">\u003cem>Guy Marzorati\u003c/em>\u003c/a>\u003cem> contributed to this story.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\n\u003c/div>\u003c/p>",
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"content": "\u003cp>The One Big Beautiful Bill Act, signed by President Donald Trump last year, will cut an estimated $900 billion to $1 trillion from Medicaid over the next decade. Between funding cuts and big changes to enrollment and eligibility requirements, residents who rely on Medi-Cal, California’s Medicaid program, are bracing for impact. Doctor and journalist Sejal Parekh explores how this is playing out in Contra Costa County.\u003c/p>\n\u003cp>\u003cstrong>Links:\u003c/strong>\u003c/p>\n\u003cul>\n\u003cli>\u003ca href=\"https://richmondside.org/2026/03/30/trump-medi-cal-cuts-contra-costa/\">Up to 93K Contra Costa County residents could lose health insurance under Trump cuts\u003c/a>\u003c/li>\n\u003c/ul>\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe loading=\"lazy\" frameborder=\"0\" height=\"200\" scrolling=\"no\" src=\"https://playlist.megaphone.fm?e=KQINC2727484835&light=true\" width=\"100%\" class=\"iframe-class\">\u003c/iframe>\u003c/p>\n\u003cp>\u003cspan class=\"\" title=\"\">\u003ci>Some members of the KQED podcast team are represented by The Screen Actors Guild, American Federation of Television and Radio Artists, San Francisco-Northern California Local.\u003c/i>\u003c/span>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>The One Big Beautiful Bill Act, signed by President Donald Trump last year, will cut an estimated $900 billion to $1 trillion from Medicaid over the next decade. Between funding cuts and big changes to enrollment and eligibility requirements, residents who rely on Medi-Cal, California’s Medicaid program, are bracing for impact. Doctor and journalist Sejal Parekh explores how this is playing out in Contra Costa County.\u003c/p>\n\u003cp>\u003cstrong>Links:\u003c/strong>\u003c/p>\n\u003cul>\n\u003cli>\u003ca href=\"https://richmondside.org/2026/03/30/trump-medi-cal-cuts-contra-costa/\">Up to 93K Contra Costa County residents could lose health insurance under Trump cuts\u003c/a>\u003c/li>\n\u003c/ul>\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe loading=\"lazy\" frameborder=\"0\" height=\"200\" scrolling=\"no\" src=\"https://playlist.megaphone.fm?e=KQINC2727484835&light=true\" width=\"100%\" class=\"iframe-class\">\u003c/iframe>\u003c/p>\n\u003cp>\u003cspan class=\"\" title=\"\">\u003ci>Some members of the KQED podcast team are represented by The Screen Actors Guild, American Federation of Television and Radio Artists, San Francisco-Northern California Local.\u003c/i>\u003c/span>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>Tens of thousands of \u003ca href=\"https://www.kqed.org/news/tag/university-of-california\">University of California\u003c/a> patient care and service workers plan to walk off the job May 14 with no return date in sight, union officials announced Wednesday, after long contract negotiations have failed to yield an agreement.\u003c/p>\n\u003cp>The strike would disrupt operations at UC campuses and medical facilities statewide in a historic move, according to the American Federation of State, County and Municipal Employees Local 3299, which represents some of the university’s lowest-paid employees.\u003c/p>\n\u003cp>“It will be incredibly hard on our families, but we know UC is proposing a future where workers’ rights are ignored and we fall further and further behind,” union president Michael Avant said at a press conference outside UCSF’s Mission Bay Medical Center.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“We aren’t demanding millions of dollars in salaries like they give to the executives,” said Avant, who works transporting patients at UC San Diego’s health system. “We are asking for our employer, California’s third-largest employer, to bargain with us in good faith.”\u003c/p>\n\u003cp>The union representing about 42,000 cafeteria and custodial workers, X-ray technicians, respiratory therapists and other employees has held five \u003ca href=\"https://www.kqed.org/news/12028446/tens-of-thousands-uc-workers-strike-disrupting-campuses-hospitals-labs\">short walkouts\u003c/a> at UC during more than two years of bargaining. Avant said those previous work stoppages failed to move the university on workers’ top issues: housing affordability and health care costs.\u003c/p>\n\u003cfigure id=\"attachment_12064418\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12064418\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/11/251117-UCStrike-14-BL.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/11/251117-UCStrike-14-BL.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/11/251117-UCStrike-14-BL-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/11/251117-UCStrike-14-BL-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Patient care and service workers represented by AFSCME Local 3299 picket at the UCSF Medical Center Mission Bay campus on Nov. 17, 2025, striking for living wages, affordable health care, housing benefits and safe staffing. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>AFSCME patient care employees have been working without a contract since August 2024, and service workers since November of that year. As housing and health care costs rise, many of the employees are \u003ca href=\"https://www.kqed.org/news/12064357/uc-service-workers-strike-saying-wages-arent-enough-to-afford-cost-of-living\">struggling to make ends meet\u003c/a>, union officials said.\u003c/p>\n\u003cp>In a statement, university representatives rejected the union’s accusations of unfair labor practices and said the UC system remained committed to giving employees wage increases and other benefits as quickly as possible, recognizing the cost-of-living challenges that many of its workers face.\u003c/p>\n\u003cp>“The University of California remains focused on reaching an agreement that delivers real, immediate benefits for employees and is sustainable over the long term,” the \u003ca href=\"https://www.universityofcalifornia.edu/press-room/uc-highlights-323-pay-proposal-urges-continued-bargaining-following-afscme-strike-notice\">statement\u003c/a> said. “We are disappointed that AFSCME is moving toward an open-ended strike despite the significant progress made at the bargaining table.”[aside postID=news_12064357 hero='https://cdn.kqed.org/wp-content/uploads/sites/10/2025/11/251117-UCStrike-08-BL.jpg']\u003c/p>\n\u003cp>Since bargaining began in January 2024, the university said it has proposed to increase total pay by 32.3% through 2029, adding that the hourly wage for its lowest-paid employees was raised to $25 last year. UC has also offered workers a bonus of up to $1,000, extra payments for long-serving employees, and monthly stipends and other measures to help manage rising health care costs. More than 16,000 AFSCME members pay less than $100 a month in health care premiums, the statement said.\u003c/p>\n\u003cp>“This represents substantial movement and a good-faith effort to respond directly to employee priorities,” the university said.\u003c/p>\n\u003cp>Union representatives said UC’s total pay raise offer was in reality lower, slamming the 32.3% figure as based on “fuzzy math.” They argued that the university proposals have made an affordability crisis worse, including for workers living in homeless shelters and out of their cars.\u003c/p>\n\u003cp>Liz Perlman, executive director of AFSCME Local 3299, said UC has unilaterally increased health care premiums for employees, sometimes doubling their costs. The university has also refused to discuss a union proposal to provide emergency financial assistance to workers at risk of eviction or foreclosure, based on a program already in place at UC Davis, she added.\u003c/p>\n\u003cp>“Our members don’t eat percentages; they pay gas with dollars. Right now they are choosing between buying inhalers and buying a tank of gas,” said Perlman, adding that members earn $62,000 a year on average. “Your take-home pay is going to be so small … We live on so few dollars that any increase is putting people at a breaking point.”\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Tens of thousands of \u003ca href=\"https://www.kqed.org/news/tag/university-of-california\">University of California\u003c/a> patient care and service workers plan to walk off the job May 14 with no return date in sight, union officials announced Wednesday, after long contract negotiations have failed to yield an agreement.\u003c/p>\n\u003cp>The strike would disrupt operations at UC campuses and medical facilities statewide in a historic move, according to the American Federation of State, County and Municipal Employees Local 3299, which represents some of the university’s lowest-paid employees.\u003c/p>\n\u003cp>“It will be incredibly hard on our families, but we know UC is proposing a future where workers’ rights are ignored and we fall further and further behind,” union president Michael Avant said at a press conference outside UCSF’s Mission Bay Medical Center.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“We aren’t demanding millions of dollars in salaries like they give to the executives,” said Avant, who works transporting patients at UC San Diego’s health system. “We are asking for our employer, California’s third-largest employer, to bargain with us in good faith.”\u003c/p>\n\u003cp>The union representing about 42,000 cafeteria and custodial workers, X-ray technicians, respiratory therapists and other employees has held five \u003ca href=\"https://www.kqed.org/news/12028446/tens-of-thousands-uc-workers-strike-disrupting-campuses-hospitals-labs\">short walkouts\u003c/a> at UC during more than two years of bargaining. Avant said those previous work stoppages failed to move the university on workers’ top issues: housing affordability and health care costs.\u003c/p>\n\u003cfigure id=\"attachment_12064418\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12064418\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/11/251117-UCStrike-14-BL.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/11/251117-UCStrike-14-BL.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/11/251117-UCStrike-14-BL-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/11/251117-UCStrike-14-BL-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Patient care and service workers represented by AFSCME Local 3299 picket at the UCSF Medical Center Mission Bay campus on Nov. 17, 2025, striking for living wages, affordable health care, housing benefits and safe staffing. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>AFSCME patient care employees have been working without a contract since August 2024, and service workers since November of that year. As housing and health care costs rise, many of the employees are \u003ca href=\"https://www.kqed.org/news/12064357/uc-service-workers-strike-saying-wages-arent-enough-to-afford-cost-of-living\">struggling to make ends meet\u003c/a>, union officials said.\u003c/p>\n\u003cp>In a statement, university representatives rejected the union’s accusations of unfair labor practices and said the UC system remained committed to giving employees wage increases and other benefits as quickly as possible, recognizing the cost-of-living challenges that many of its workers face.\u003c/p>\n\u003cp>“The University of California remains focused on reaching an agreement that delivers real, immediate benefits for employees and is sustainable over the long term,” the \u003ca href=\"https://www.universityofcalifornia.edu/press-room/uc-highlights-323-pay-proposal-urges-continued-bargaining-following-afscme-strike-notice\">statement\u003c/a> said. “We are disappointed that AFSCME is moving toward an open-ended strike despite the significant progress made at the bargaining table.”\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Since bargaining began in January 2024, the university said it has proposed to increase total pay by 32.3% through 2029, adding that the hourly wage for its lowest-paid employees was raised to $25 last year. UC has also offered workers a bonus of up to $1,000, extra payments for long-serving employees, and monthly stipends and other measures to help manage rising health care costs. More than 16,000 AFSCME members pay less than $100 a month in health care premiums, the statement said.\u003c/p>\n\u003cp>“This represents substantial movement and a good-faith effort to respond directly to employee priorities,” the university said.\u003c/p>\n\u003cp>Union representatives said UC’s total pay raise offer was in reality lower, slamming the 32.3% figure as based on “fuzzy math.” They argued that the university proposals have made an affordability crisis worse, including for workers living in homeless shelters and out of their cars.\u003c/p>\n\u003cp>Liz Perlman, executive director of AFSCME Local 3299, said UC has unilaterally increased health care premiums for employees, sometimes doubling their costs. The university has also refused to discuss a union proposal to provide emergency financial assistance to workers at risk of eviction or foreclosure, based on a program already in place at UC Davis, she added.\u003c/p>\n\u003cp>“Our members don’t eat percentages; they pay gas with dollars. Right now they are choosing between buying inhalers and buying a tank of gas,” said Perlman, adding that members earn $62,000 a year on average. “Your take-home pay is going to be so small … We live on so few dollars that any increase is putting people at a breaking point.”\u003c/p>\n\u003cp>\u003c/p>\n\u003c/div>\u003c/p>",
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"slug": "stanford-study-ai-experts-are-optimistic-about-ai-the-rest-of-us-not-so-much",
"title": "Stanford Study: AI Experts Are Optimistic About AI. The Rest of Us … Not So Much",
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"content": "\u003cp>For nine years now, the \u003ca href=\"https://hai.stanford.edu/ai-index/2026-ai-index-report\">AI Index Report\u003c/a> from the Stanford Institute for Human-Centered AI (HAI) has combed through data from across academia, industry and government to produce an annual snapshot of where artificial intelligence stands, and suggest where it’s heading.\u003c/p>\n\u003cp>The report covers the biggest technical advances, investments, trends in education, \u003ca href=\"https://www.kqed.org/news/12078982/google-updates-suicide-self-harm-safeguards-in-gemini-as-ai-lawsuits-mount\">health\u003c/a>, \u003ca href=\"https://www.kqed.org/news/12076862/scott-wiener-and-garry-tan-team-up-to-tackle-big-techs-anti-competitive-behavior\">legislation \u003c/a>and \u003ca href=\"https://www.kqed.org/news/12063587/ai-boom-leads-to-increased-concerns-of-environmental-impacts-of-data-centers\">the environment\u003c/a>, offering an empirical foundation for understanding AI’s rapid evolution and real-world adoption.\u003c/p>\n\u003cp>The \u003ca href=\"https://hai.stanford.edu/ai-index/2026-ai-index-report\">2026 report\u003c/a> also details a growing tension, especially among Americans: expert excitement about what AI is capable of, and public fear for what it all means for their \u003ca href=\"https://www.kqed.org/news/12034490/ai-companions-seductive-risk-teens-senators-want-more-guardrails\">personal lives\u003c/a> and \u003ca href=\"https://www.kqed.org/news/12076726/ai-is-changing-tech-work-heres-why-it-matters-for-the-rest-of-us\">jobs\u003c/a>.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“Are we well-positioned as a society to manage its direction, absorb its disruption and ultimately decide how we’re going to leverage this technology?” said Sha Sajadieh, who leads the AI Index for Stanford’s Institute for Human-Centered Artificial Intelligence.\u003c/p>\n\u003cp>She added that the general public needs to channel their fear of the unknown, not to mention news of \u003ca href=\"https://www.kqed.org/news/11939910/a-layoff-spree-at-bay-area-tech-companies\">mass layoffs\u003c/a> in one industry after another, and move past reactivity to take advantage of the best AI has to offer. “Part of that is up-skilling at every age, in every way. There’s a lot of opportunity, but the onus is on us to fully realize the opportunity this technology presents us, and understand it.”[aside postID=news_12079267 hero='https://cdn.kqed.org/wp-content/uploads/sites/10/2026/04/Hegseth-Side-by-Side-c.jpg']The survey is considered a must-read for policymakers in academia, business and politics. But as transparency from top AI developers declines, Sajadieh acknowledged it’s harder to know what needs to be addressed, especially with regulation or legislation, “for us to understand what risks we want to mitigate first as a society.”\u003c/p>\n\u003cp>“Enthusiasm and evangelism around AI have relegated considerations about how to responsibly manage its applications and use cases to the back burner,” Stephen Baiter, executive director of the East Bay Economic Development Alliance, wrote KQED.\u003c/p>\n\u003cp>He observed that jobs tied to the physical world, especially in areas like construction, \u003ca href=\"https://www.kqed.org/news/12076753/northern-california-kaiser-therapists-hold-1-day-strike-over-ai-patient-care-concerns\">health care\u003c/a>, and public safety, seem to be at the least risk of disruption. But he has concerns beyond AI’s \u003ca href=\"https://www.kqed.org/news/12076726/ai-is-changing-tech-work-heres-why-it-matters-for-the-rest-of-us\">immediate impacts on labor\u003c/a> markets. “There has been strong deference toward delaying or ignoring sensitive core human rights and \u003ca href=\"https://www.kqed.org/news/12026604/bay-areas-ai-boom-fuels-a-dirty-energy-dilemma/\">quality of life issues\u003c/a> related to individual/personal privacy, safety, and security.”\u003c/p>\n\u003cp>Other critics of AI go further. “The ones who don’t see eye to eye with the leading experts and the general public are the companies themselves, which are engaged in a race to replace humans as quickly as possible,” e-mailed Chase Hardin, spokesman for the non-profit The Future of Life Institute, which is dedicated to reducing global catastrophic and existential risks from transformative technologies.\u003c/p>\n\u003cp>Hardin said that public polling is unambiguously negative about the risks of AI. “We can argue about why that is, but the public is \u003ca href=\"https://www.kqed.org/news/12076608/what-\">deeply skeptical\u003c/a> of the companies themselves, the technology, and it is incredibly anxious about what it means for their children.”\u003c/p>\n\u003ch2>Top takeaways of the AI Index Report include:\u003c/h2>\n\u003cp>\u003cstrong style=\"font-size: 16px\">1. \u003c/strong>\u003cstrong>AI experts and the public have very different perspectives on the technology’s future.\u003c/strong> Assessing AI’s impact on jobs, 73% of U.S. AI experts said the technology’s impacts on jobs are positive, compared with only 23% of the public, a 50 percentage-point gap. Similar divides emerge regarding the economy and medical care.\u003c/p>\n\u003cp>Globally, trust in governments to regulate AI varies. Among surveyed countries, the United States reported the lowest level of trust in its own government to regulate AI, at 31%. Globally, the EU is trusted more than the United States or China to regulate AI effectively.\u003c/p>\n\u003cp>\u003cstrong>2. AI capability is accelerating and reaching more people than ever.\u003c/strong> Private companies built more than 9 in 10 of the world’s most powerful AI models in 2025, and some of those models are now beating human experts on PhD-level science and advanced math exams.\u003c/p>\n\u003cp>\u003cstrong>3. Productivity gains from AI are appearing in many of the same fields where entry-level employment is starting to decline. \u003c/strong>Studies show productivity gains of 14% to 26% in customer support and software development, with weaker or negative effects in tasks requiring more judgment.\u003c/p>\n\u003cp>In software development, where AI’s measured productivity gains are clearest, U.S. developers ages 22 to 25 saw employment fall nearly 20% from 2024, even as the headcount for older developers continues to grow.\u003c/p>\n\u003cp>\u003cstrong>4. Students are using AI, but their educational institutions are still playing catch-up. \u003c/strong>Four out of five U.S. high school and college students now \u003ca href=\"https://www.kqed.org/news/12053799/not-even-ai-can-save-me-students-teachers-on-ai-this-school-year\">use AI for schoolwork\u003c/a>, but only half of middle and high schools have AI policies in place, and just 6% of teachers say those policies are clear.\u003c/p>\n\u003cfigure id=\"attachment_12063947\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-12063947 size-full\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/11/CaregiverGetty.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/11/CaregiverGetty.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/11/CaregiverGetty-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/11/CaregiverGetty-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">A review of more than 500 clinical AI studies found nearly half relied on exam-style questions instead of real patient data, while just 5% used actual clinical data. \u003ccite>(LPETTET via Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>5. AI is transforming clinical health care, but rigorous evidence remains limited. \u003c/strong>AI tools that automatically generate clinical notes from patient visits saw substantial adoption in 2025. Across multiple hospital systems, physicians reported up to 83% less time spent writing notes and significant reductions in burnout.\u003c/p>\n\u003cp>Beyond certain tools, however, the evidence base for clinical AI remains thin. A review of more than 500 clinical AI studies found that nearly half relied on exam-style questions rather than real patient data, with only 5% using real clinical data.\u003c/p>\n\u003cp>\u003cstrong>6. AI’s environmental footprint is expanding alongside its capabilities.\u003c/strong> Training a single AI model last year generated roughly as much carbon as 16,000 round-trip flights from San Francisco to New York. Researchers estimate that running just one widely-used AI model, GPT-4o, may consume enough water annually to meet the drinking needs of every person in Los Angeles and San Francisco combined.\u003c/p>\n\u003cp>\u003cstrong>7. The United States leads the world in AI investment, but its ability to attract global talent is declining.\u003c/strong> U.S. private AI investment reached $285.9 billion in 2025, more than 23 times the $12.4 billion invested in China — though looking at just private investment figures likely understates China’s total AI spending, given its government guidance funds.\u003c/p>\n\u003cp>The U.S. also led in entrepreneurial activity with 1,953 newly funded AI companies in 2025, more than 10 times the next closest country, which was the U.K. However, the number of AI researchers and developers moving to the U.S. has dropped 89% since 2017, with an 80% decline in the last year alone.\u003c/p>\n\u003cp>\u003cstrong>8. The U.S.-China AI model performance gap has effectively closed. \u003c/strong>U.S. and Chinese models have traded the lead multiple times since early 2025.\u003c/p>\n\u003cp>The U.S. still builds more of the world’s most powerful AI models, but China is publishing more research, filing more patents, and installing more robots in its factories. South Korea stands out for its innovation density, leading the world in AI patents per capita.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"excerpt": "The Stanford Institute for Human-Centered AI released its 2026 AI Index report, which reveals that the technology is advancing faster than society’s ability to understand, govern, or trust it.",
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"title": "Stanford Study: AI Experts Are Optimistic About AI. The Rest of Us … Not So Much | KQED",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>For nine years now, the \u003ca href=\"https://hai.stanford.edu/ai-index/2026-ai-index-report\">AI Index Report\u003c/a> from the Stanford Institute for Human-Centered AI (HAI) has combed through data from across academia, industry and government to produce an annual snapshot of where artificial intelligence stands, and suggest where it’s heading.\u003c/p>\n\u003cp>The report covers the biggest technical advances, investments, trends in education, \u003ca href=\"https://www.kqed.org/news/12078982/google-updates-suicide-self-harm-safeguards-in-gemini-as-ai-lawsuits-mount\">health\u003c/a>, \u003ca href=\"https://www.kqed.org/news/12076862/scott-wiener-and-garry-tan-team-up-to-tackle-big-techs-anti-competitive-behavior\">legislation \u003c/a>and \u003ca href=\"https://www.kqed.org/news/12063587/ai-boom-leads-to-increased-concerns-of-environmental-impacts-of-data-centers\">the environment\u003c/a>, offering an empirical foundation for understanding AI’s rapid evolution and real-world adoption.\u003c/p>\n\u003cp>The \u003ca href=\"https://hai.stanford.edu/ai-index/2026-ai-index-report\">2026 report\u003c/a> also details a growing tension, especially among Americans: expert excitement about what AI is capable of, and public fear for what it all means for their \u003ca href=\"https://www.kqed.org/news/12034490/ai-companions-seductive-risk-teens-senators-want-more-guardrails\">personal lives\u003c/a> and \u003ca href=\"https://www.kqed.org/news/12076726/ai-is-changing-tech-work-heres-why-it-matters-for-the-rest-of-us\">jobs\u003c/a>.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“Are we well-positioned as a society to manage its direction, absorb its disruption and ultimately decide how we’re going to leverage this technology?” said Sha Sajadieh, who leads the AI Index for Stanford’s Institute for Human-Centered Artificial Intelligence.\u003c/p>\n\u003cp>She added that the general public needs to channel their fear of the unknown, not to mention news of \u003ca href=\"https://www.kqed.org/news/11939910/a-layoff-spree-at-bay-area-tech-companies\">mass layoffs\u003c/a> in one industry after another, and move past reactivity to take advantage of the best AI has to offer. “Part of that is up-skilling at every age, in every way. There’s a lot of opportunity, but the onus is on us to fully realize the opportunity this technology presents us, and understand it.”\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>The survey is considered a must-read for policymakers in academia, business and politics. But as transparency from top AI developers declines, Sajadieh acknowledged it’s harder to know what needs to be addressed, especially with regulation or legislation, “for us to understand what risks we want to mitigate first as a society.”\u003c/p>\n\u003cp>“Enthusiasm and evangelism around AI have relegated considerations about how to responsibly manage its applications and use cases to the back burner,” Stephen Baiter, executive director of the East Bay Economic Development Alliance, wrote KQED.\u003c/p>\n\u003cp>He observed that jobs tied to the physical world, especially in areas like construction, \u003ca href=\"https://www.kqed.org/news/12076753/northern-california-kaiser-therapists-hold-1-day-strike-over-ai-patient-care-concerns\">health care\u003c/a>, and public safety, seem to be at the least risk of disruption. But he has concerns beyond AI’s \u003ca href=\"https://www.kqed.org/news/12076726/ai-is-changing-tech-work-heres-why-it-matters-for-the-rest-of-us\">immediate impacts on labor\u003c/a> markets. “There has been strong deference toward delaying or ignoring sensitive core human rights and \u003ca href=\"https://www.kqed.org/news/12026604/bay-areas-ai-boom-fuels-a-dirty-energy-dilemma/\">quality of life issues\u003c/a> related to individual/personal privacy, safety, and security.”\u003c/p>\n\u003cp>Other critics of AI go further. “The ones who don’t see eye to eye with the leading experts and the general public are the companies themselves, which are engaged in a race to replace humans as quickly as possible,” e-mailed Chase Hardin, spokesman for the non-profit The Future of Life Institute, which is dedicated to reducing global catastrophic and existential risks from transformative technologies.\u003c/p>\n\u003cp>Hardin said that public polling is unambiguously negative about the risks of AI. “We can argue about why that is, but the public is \u003ca href=\"https://www.kqed.org/news/12076608/what-\">deeply skeptical\u003c/a> of the companies themselves, the technology, and it is incredibly anxious about what it means for their children.”\u003c/p>\n\u003ch2>Top takeaways of the AI Index Report include:\u003c/h2>\n\u003cp>\u003cstrong style=\"font-size: 16px\">1. \u003c/strong>\u003cstrong>AI experts and the public have very different perspectives on the technology’s future.\u003c/strong> Assessing AI’s impact on jobs, 73% of U.S. AI experts said the technology’s impacts on jobs are positive, compared with only 23% of the public, a 50 percentage-point gap. Similar divides emerge regarding the economy and medical care.\u003c/p>\n\u003cp>Globally, trust in governments to regulate AI varies. Among surveyed countries, the United States reported the lowest level of trust in its own government to regulate AI, at 31%. Globally, the EU is trusted more than the United States or China to regulate AI effectively.\u003c/p>\n\u003cp>\u003cstrong>2. AI capability is accelerating and reaching more people than ever.\u003c/strong> Private companies built more than 9 in 10 of the world’s most powerful AI models in 2025, and some of those models are now beating human experts on PhD-level science and advanced math exams.\u003c/p>\n\u003cp>\u003cstrong>3. Productivity gains from AI are appearing in many of the same fields where entry-level employment is starting to decline. \u003c/strong>Studies show productivity gains of 14% to 26% in customer support and software development, with weaker or negative effects in tasks requiring more judgment.\u003c/p>\n\u003cp>In software development, where AI’s measured productivity gains are clearest, U.S. developers ages 22 to 25 saw employment fall nearly 20% from 2024, even as the headcount for older developers continues to grow.\u003c/p>\n\u003cp>\u003cstrong>4. Students are using AI, but their educational institutions are still playing catch-up. \u003c/strong>Four out of five U.S. high school and college students now \u003ca href=\"https://www.kqed.org/news/12053799/not-even-ai-can-save-me-students-teachers-on-ai-this-school-year\">use AI for schoolwork\u003c/a>, but only half of middle and high schools have AI policies in place, and just 6% of teachers say those policies are clear.\u003c/p>\n\u003cfigure id=\"attachment_12063947\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-12063947 size-full\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/11/CaregiverGetty.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/11/CaregiverGetty.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/11/CaregiverGetty-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/11/CaregiverGetty-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">A review of more than 500 clinical AI studies found nearly half relied on exam-style questions instead of real patient data, while just 5% used actual clinical data. \u003ccite>(LPETTET via Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>5. AI is transforming clinical health care, but rigorous evidence remains limited. \u003c/strong>AI tools that automatically generate clinical notes from patient visits saw substantial adoption in 2025. Across multiple hospital systems, physicians reported up to 83% less time spent writing notes and significant reductions in burnout.\u003c/p>\n\u003cp>Beyond certain tools, however, the evidence base for clinical AI remains thin. A review of more than 500 clinical AI studies found that nearly half relied on exam-style questions rather than real patient data, with only 5% using real clinical data.\u003c/p>\n\u003cp>\u003cstrong>6. AI’s environmental footprint is expanding alongside its capabilities.\u003c/strong> Training a single AI model last year generated roughly as much carbon as 16,000 round-trip flights from San Francisco to New York. Researchers estimate that running just one widely-used AI model, GPT-4o, may consume enough water annually to meet the drinking needs of every person in Los Angeles and San Francisco combined.\u003c/p>\n\u003cp>\u003cstrong>7. The United States leads the world in AI investment, but its ability to attract global talent is declining.\u003c/strong> U.S. private AI investment reached $285.9 billion in 2025, more than 23 times the $12.4 billion invested in China — though looking at just private investment figures likely understates China’s total AI spending, given its government guidance funds.\u003c/p>\n\u003cp>The U.S. also led in entrepreneurial activity with 1,953 newly funded AI companies in 2025, more than 10 times the next closest country, which was the U.K. However, the number of AI researchers and developers moving to the U.S. has dropped 89% since 2017, with an 80% decline in the last year alone.\u003c/p>\n\u003cp>\u003cstrong>8. The U.S.-China AI model performance gap has effectively closed. \u003c/strong>U.S. and Chinese models have traded the lead multiple times since early 2025.\u003c/p>\n\u003cp>The U.S. still builds more of the world’s most powerful AI models, but China is publishing more research, filing more patents, and installing more robots in its factories. South Korea stands out for its innovation density, leading the world in AI patents per capita.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>Maria-Elena Healy knew layoffs could be coming, but the vague warnings and whispers she had heard leading up to Monday didn’t prepare her for the shock that morning when she and three other nurses at \u003ca href=\"https://www.kqed.org/news/tag/laguna-honda-hospital\">Laguna Honda Hospital and Rehabilitation Center\u003c/a> found out they were losing their jobs.\u003c/p>\n\u003cp>“It was hard to hear. It just felt like we had leadership who were not transparent and didn’t value the expertise of clinicians that actually work at the bedside,” said Healy, a registered nurse who grew up in San Francisco and has worked at Laguna Honda for 10 years. “Staff members are reaching out to us across all disciplines, saying, ‘What’s going to happen to your work?’ It just doesn’t make sense.”\u003c/p>\n\u003cp>The ax is expected to fall on \u003ca href=\"https://www.kqed.org/news/12075213/san-francisco-mayor-daniel-lurie-looks-to-eliminate-500-city-jobs\">hundreds of city workers\u003c/a> like Healy as San Francisco looks to narrow its $643 million budget deficit over the next two years.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>This week, \u003ca href=\"https://www.kqed.org/news/12070484/tune-in-tonight-san-francisco-mayor-daniel-lurie-live-on-kqed\">Mayor Daniel Lurie’s administration\u003c/a> sent 127 layoff notices to city employees across 18 different departments, part of a total of around 500 positions that the mayor intends to cut. Additional layoffs are expected to be announced later this spring, and the mayor has said he also intends to freeze about 2,000 open positions.\u003c/p>\n\u003cp>“We have a choice: take action now or be forced to do twice as much in the coming years,” Lurie said in a statement. “The steps we’re taking today are a painful but necessary continuation of the work we’ve been doing since last year to manage taxpayer dollars responsibly and deliver the best possible services for San Franciscans.”\u003c/p>\n\u003cp>Departments impacted by the 127 layoffs so far include the Department of Public Health, the Office of Economic and Workforce Development, the City Administrator’s Office, the Human Services Agency and the Police Department. A spokesperson for Lurie’s office did not specify which departments have seen the most layoffs so far.\u003c/p>\n\u003cfigure id=\"attachment_11958378\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11958378\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/RS62463_010_KQED_LagunaHondaHospital_01312023-KQED.jpg\" alt=\"Signage reading Laguna Honda Hospital over the entryway to a large tile-roofed building.\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/RS62463_010_KQED_LagunaHondaHospital_01312023-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/RS62463_010_KQED_LagunaHondaHospital_01312023-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/RS62463_010_KQED_LagunaHondaHospital_01312023-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/RS62463_010_KQED_LagunaHondaHospital_01312023-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/RS62463_010_KQED_LagunaHondaHospital_01312023-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/RS62463_010_KQED_LagunaHondaHospital_01312023-KQED-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">The Laguna Honda Hospital administration building in San Francisco on Jan. 31, 2023. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The layoffs were expected even as the city’s projected budget deficit improved from $936 million to $643 million in a recent \u003ca href=\"https://media.api.sf.gov/documents/March_Update_FY_26-27_through_FY_29-30_FINAL.pdf\">City Controller’s report\u003c/a>. President Donald Trump’s federal spending cuts have drastically deepened the city’s budget shortfall, and in December, Lurie directed departments to find ways to cut a total of $400 million ahead of his budget proposal coming next month.\u003c/p>\n\u003cp>But city workers and advocates for the services they provide say the city is ignoring alternatives that could save jobs and minimize impacts to residents.\u003c/p>\n\u003cp>“The city has funds. They just need to dip into their reserves,” Healy said. “There’s no reason to diminish the care that we provide to the residents of San Francisco. This is a safety net hospital.”[aside postID=news_12078490 hero='https://cdn.kqed.org/wp-content/uploads/sites/10/2026/04/GroceriesAP.jpg']She and others are also calling for the passage of Proposition D, the Overpaid CEO Act, which would levy taxes on large corporations where the chief executive earns more than 100 times their median employee.\u003c/p>\n\u003cp>“In one of the richest cities in the world, cuts like this are a choice, not a necessity,” Mark Leach, Teamsters 856 representative and San Francisco resident, said in a statement. “Large corporations are cashing in on Trump’s tax breaks, but we can make them pay their fair share in San Francisco by passing Prop D in June.”\u003c/p>\n\u003cp>Supporters of the proposition say it could generate up to $300 million in funding to backfill money the city has lost in economic fallout surrounding the pandemic and since cuts by the Trump Administration.\u003c/p>\n\u003cp>Lurie’s goal to shave off $400 million in annual spending includes about $100 million from personnel savings, which his administration has estimated will translate to about 500 positions eliminated.\u003c/p>\n\u003cp>Some workers who received pink slips this week got a 30-day notice, and others may have 60 days, depending on their position and tenure. Some civil service employees whose jobs are being eliminated will be able to request a different position.\u003c/p>\n\u003cfigure id=\"attachment_12079148\" class=\"wp-caption alignleft\" style=\"max-width: 750px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12079148\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/04/Maria-Elena-Healy-2.jpg\" alt=\"\" width=\"750\" height=\"995\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/04/Maria-Elena-Healy-2.jpg 750w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/04/Maria-Elena-Healy-2-160x212.jpg 160w\" sizes=\"auto, (max-width: 750px) 100vw, 750px\">\u003cfigcaption class=\"wp-caption-text\">Maria-Elena Healy, a registered nurse at Laguna Honda Hospital, was among the 127 San Francisco city workers to receive layoff notices this week. \u003ccite>(Courtesy of Maria-Elena Healy)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Healy said she received a 60-day notice for her termination, but any details on her employment options with the city have been opaque.\u003c/p>\n\u003cp>“They actually could not answer some of the questions that we had,” Healy said. “It’s very difficult to make decisions about our lives and our livelihoods when the city failed to even give us the information that we needed to make those decisions.”\u003c/p>\n\u003cp>Healy said she and her three colleagues, who were also laid off, are clinical nurse specialists with expertise in certain areas, like cardiovascular health and diabetes care.\u003c/p>\n\u003cp>She’s seen Laguna Honda, one of the country’s oldest and largest public skilled nursing homes, weather a storm of regulatory challenges in recent years, including when state and federal regulators pulled its Medicaid and Medicare certification and nearly shut the hospital down several years ago amid a series of safety violations. The facility has since made safety improvements and \u003ca href=\"https://www.kqed.org/news/11991292/laguna-honda-recertified-by-medicare-in-major-milestone-for-san-francisco-hospital\">regained certification\u003c/a>.\u003c/p>\n\u003cp>“Part of our role as clinical nurse specialists has actually been to help support the facility through being recertified. We are trained to look at system issues and develop programs to support the needs of patients,” Healy said. “It just felt like the organization doesn’t understand how we helped use our skills to bring us back to certification.”\u003c/p>\n\u003cp>San Francisco has about 30,000 employees overall and a nearly $16 billion budget.\u003c/p>\n\u003cp>The cuts this year come after the city managed to stave off many of the layoffs proposed during last year’s budget cycle. Last cycle, Lurie sought to eliminate 100 filled positions, but after negotiations with city leaders, unions and stakeholders, 40 jobs were cut. The final plan cut about \u003ca href=\"https://www.kqed.org/news/12041773/san-francisco-mayor-daniel-lurie-plans-to-cut-1400-jobs-in-city-budget-proposal\">1,400 mostly vacant positions\u003c/a>.\u003c/p>\n\u003cp>“My job as mayor is to set up our city for success, not just today but for years to come,” Lurie said in response to the recent controller’s report, which projected a lower budget deficit overall. “We will deliver a fiscally sound budget that prioritizes core services, delivers results for San Franciscans and ensures a broad and durable economic recovery.”\u003c/p>\n\u003cp>Lurie must present his upcoming budget proposal by June 1.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Maria-Elena Healy knew layoffs could be coming, but the vague warnings and whispers she had heard leading up to Monday didn’t prepare her for the shock that morning when she and three other nurses at \u003ca href=\"https://www.kqed.org/news/tag/laguna-honda-hospital\">Laguna Honda Hospital and Rehabilitation Center\u003c/a> found out they were losing their jobs.\u003c/p>\n\u003cp>“It was hard to hear. It just felt like we had leadership who were not transparent and didn’t value the expertise of clinicians that actually work at the bedside,” said Healy, a registered nurse who grew up in San Francisco and has worked at Laguna Honda for 10 years. “Staff members are reaching out to us across all disciplines, saying, ‘What’s going to happen to your work?’ It just doesn’t make sense.”\u003c/p>\n\u003cp>The ax is expected to fall on \u003ca href=\"https://www.kqed.org/news/12075213/san-francisco-mayor-daniel-lurie-looks-to-eliminate-500-city-jobs\">hundreds of city workers\u003c/a> like Healy as San Francisco looks to narrow its $643 million budget deficit over the next two years.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>This week, \u003ca href=\"https://www.kqed.org/news/12070484/tune-in-tonight-san-francisco-mayor-daniel-lurie-live-on-kqed\">Mayor Daniel Lurie’s administration\u003c/a> sent 127 layoff notices to city employees across 18 different departments, part of a total of around 500 positions that the mayor intends to cut. Additional layoffs are expected to be announced later this spring, and the mayor has said he also intends to freeze about 2,000 open positions.\u003c/p>\n\u003cp>“We have a choice: take action now or be forced to do twice as much in the coming years,” Lurie said in a statement. “The steps we’re taking today are a painful but necessary continuation of the work we’ve been doing since last year to manage taxpayer dollars responsibly and deliver the best possible services for San Franciscans.”\u003c/p>\n\u003cp>Departments impacted by the 127 layoffs so far include the Department of Public Health, the Office of Economic and Workforce Development, the City Administrator’s Office, the Human Services Agency and the Police Department. A spokesperson for Lurie’s office did not specify which departments have seen the most layoffs so far.\u003c/p>\n\u003cfigure id=\"attachment_11958378\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11958378\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/RS62463_010_KQED_LagunaHondaHospital_01312023-KQED.jpg\" alt=\"Signage reading Laguna Honda Hospital over the entryway to a large tile-roofed building.\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/RS62463_010_KQED_LagunaHondaHospital_01312023-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/RS62463_010_KQED_LagunaHondaHospital_01312023-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/RS62463_010_KQED_LagunaHondaHospital_01312023-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/RS62463_010_KQED_LagunaHondaHospital_01312023-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/RS62463_010_KQED_LagunaHondaHospital_01312023-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/08/RS62463_010_KQED_LagunaHondaHospital_01312023-KQED-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">The Laguna Honda Hospital administration building in San Francisco on Jan. 31, 2023. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The layoffs were expected even as the city’s projected budget deficit improved from $936 million to $643 million in a recent \u003ca href=\"https://media.api.sf.gov/documents/March_Update_FY_26-27_through_FY_29-30_FINAL.pdf\">City Controller’s report\u003c/a>. President Donald Trump’s federal spending cuts have drastically deepened the city’s budget shortfall, and in December, Lurie directed departments to find ways to cut a total of $400 million ahead of his budget proposal coming next month.\u003c/p>\n\u003cp>But city workers and advocates for the services they provide say the city is ignoring alternatives that could save jobs and minimize impacts to residents.\u003c/p>\n\u003cp>“The city has funds. They just need to dip into their reserves,” Healy said. “There’s no reason to diminish the care that we provide to the residents of San Francisco. This is a safety net hospital.”\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>She and others are also calling for the passage of Proposition D, the Overpaid CEO Act, which would levy taxes on large corporations where the chief executive earns more than 100 times their median employee.\u003c/p>\n\u003cp>“In one of the richest cities in the world, cuts like this are a choice, not a necessity,” Mark Leach, Teamsters 856 representative and San Francisco resident, said in a statement. “Large corporations are cashing in on Trump’s tax breaks, but we can make them pay their fair share in San Francisco by passing Prop D in June.”\u003c/p>\n\u003cp>Supporters of the proposition say it could generate up to $300 million in funding to backfill money the city has lost in economic fallout surrounding the pandemic and since cuts by the Trump Administration.\u003c/p>\n\u003cp>Lurie’s goal to shave off $400 million in annual spending includes about $100 million from personnel savings, which his administration has estimated will translate to about 500 positions eliminated.\u003c/p>\n\u003cp>Some workers who received pink slips this week got a 30-day notice, and others may have 60 days, depending on their position and tenure. Some civil service employees whose jobs are being eliminated will be able to request a different position.\u003c/p>\n\u003cfigure id=\"attachment_12079148\" class=\"wp-caption alignleft\" style=\"max-width: 750px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12079148\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/04/Maria-Elena-Healy-2.jpg\" alt=\"\" width=\"750\" height=\"995\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/04/Maria-Elena-Healy-2.jpg 750w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/04/Maria-Elena-Healy-2-160x212.jpg 160w\" sizes=\"auto, (max-width: 750px) 100vw, 750px\">\u003cfigcaption class=\"wp-caption-text\">Maria-Elena Healy, a registered nurse at Laguna Honda Hospital, was among the 127 San Francisco city workers to receive layoff notices this week. \u003ccite>(Courtesy of Maria-Elena Healy)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Healy said she received a 60-day notice for her termination, but any details on her employment options with the city have been opaque.\u003c/p>\n\u003cp>“They actually could not answer some of the questions that we had,” Healy said. “It’s very difficult to make decisions about our lives and our livelihoods when the city failed to even give us the information that we needed to make those decisions.”\u003c/p>\n\u003cp>Healy said she and her three colleagues, who were also laid off, are clinical nurse specialists with expertise in certain areas, like cardiovascular health and diabetes care.\u003c/p>\n\u003cp>She’s seen Laguna Honda, one of the country’s oldest and largest public skilled nursing homes, weather a storm of regulatory challenges in recent years, including when state and federal regulators pulled its Medicaid and Medicare certification and nearly shut the hospital down several years ago amid a series of safety violations. The facility has since made safety improvements and \u003ca href=\"https://www.kqed.org/news/11991292/laguna-honda-recertified-by-medicare-in-major-milestone-for-san-francisco-hospital\">regained certification\u003c/a>.\u003c/p>\n\u003cp>“Part of our role as clinical nurse specialists has actually been to help support the facility through being recertified. We are trained to look at system issues and develop programs to support the needs of patients,” Healy said. “It just felt like the organization doesn’t understand how we helped use our skills to bring us back to certification.”\u003c/p>\n\u003cp>San Francisco has about 30,000 employees overall and a nearly $16 billion budget.\u003c/p>\n\u003cp>The cuts this year come after the city managed to stave off many of the layoffs proposed during last year’s budget cycle. Last cycle, Lurie sought to eliminate 100 filled positions, but after negotiations with city leaders, unions and stakeholders, 40 jobs were cut. The final plan cut about \u003ca href=\"https://www.kqed.org/news/12041773/san-francisco-mayor-daniel-lurie-plans-to-cut-1400-jobs-in-city-budget-proposal\">1,400 mostly vacant positions\u003c/a>.\u003c/p>\n\u003cp>“My job as mayor is to set up our city for success, not just today but for years to come,” Lurie said in response to the recent controller’s report, which projected a lower budget deficit overall. “We will deliver a fiscally sound budget that prioritizes core services, delivers results for San Franciscans and ensures a broad and durable economic recovery.”\u003c/p>\n\u003cp>Lurie must present his upcoming budget proposal by June 1.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"slug": "behind-commercial-surrogacy-and-its-regulations-in-california",
"title": "Behind Commercial Surrogacy and Its Regulations in California",
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"headTitle": "Behind Commercial Surrogacy and Its Regulations in California | KQED",
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"content": "\u003cp>Commercial surrogacy is a \u003ca href=\"https://www.kqed.org/forum/2010101913083/ethical-questions-arise-from-cas-commercial-surrogacy-industry\">life-changing option for couples\u003c/a> who have been unable to conceive. As one listener told KQED’s \u003cem>Forum\u003c/em> in late February, her experience with ovarian cancer meant that she lost her ability to have her own children.\u003c/p>\n\u003cp>“I used surrogacy to have my two children,” the listener said. “And without it, we wouldn’t be able to have this incredible life that we have.”\u003c/p>\n\u003cp>Another caller was a gay father based in San Francisco, who had twin boys through surrogacy.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“The vast, vast majority of parents that have kids through surrogacy — it’s the biggest blessing of their life,” he said. “And they had to work extremely hard to make it happen.”\u003c/p>\n\u003cp>But many in the fertility field — especially commercial surrogacy — were rocked by a recent investigation by \u003ca href=\"https://www.newyorker.com/magazine/2026/02/16/the-babies-kept-in-a-mysterious-los-angeles-mansion\">\u003cem>The New Yorker’s \u003c/em>Ava Kofman\u003c/a>, which followed the story of Kayla Elliott.\u003c/p>\n\u003cp>Elliott was a Texas mother of four, already carrying a baby for a Los Angeles couple, when she found out the couple had more than 20 other children.\u003c/p>\n\u003cfigure id=\"attachment_12076885\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12076885\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/03/SurrogacyGetty2.jpg\" alt=\"\" width=\"2000\" height=\"1408\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/03/SurrogacyGetty2.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/03/SurrogacyGetty2-160x113.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/03/SurrogacyGetty2-1536x1081.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">A newborn lying on a changing table on June 5, 2001, in the maternity ward of the Franco-British Hospital in Levallois-Perret. \u003ccite>(Didier Pallages/AFP via Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>One of the children, a baby, was reportedly hospitalized with bleeding inside the brain and eyes, indicating potential child abuse. That prompted police to visit the couple’s Arcadia home, where they found it crowded with many young infants and children.\u003c/p>\n\u003cp>Authorities also found surveillance footage from devices the couple set up in the house — and allegedly saw that the children were being beaten and neglected by nannies.\u003c/p>\n\u003cp>The children, including the baby Elliott gave birth to, were taken into custody, and the couple was arrested but later released. At the time, several surrogates were still pregnant for the couple.[aside postID=news_12070643 hero='https://cdn.kqed.org/wp-content/uploads/sites/10/2026/01/ivfchanges.jpg']For many of the children, the future remains unclear. Even amid an ongoing battle over who should have custody, the pair has engaged new surrogates.\u003c/p>\n\u003cp>“People are drawn to being surrogates for all sorts of different reasons, but for many of them, like Kayla, this was something they wanted to do to kind of try to make a difference,” Kofman said. “It was especially painful to realize that they might be bringing a child into a situation that not only was not great, but if anything, potentially dangerous.”\u003c/p>\n\u003cp>The case is highly unusual, said Deborah Wald, a certified family law specialist based in San Francisco. She said she has never seen a child born through surrogacy end up in the foster care system in her 35 years in the field.\u003c/p>\n\u003cp>“These typically are very wanted, very planned for, very loved children,” Wald said. “The other times there have been sort of scandals within the industry, it’s been more with professionals figuring out how to take off with the money or those kinds of things.”\u003c/p>\n\u003cp>KQED’s \u003ca href=\"https://www.kqed.org/forum/2010101913083/ethical-questions-arise-from-cas-commercial-surrogacy-industry\">Forum\u003c/a> spoke to Kofman and Wald about the Los Angeles family, commercial surrogacy in California and regulations around the practice.\u003c/p>\n\u003cp>\u003cem>This interview has been edited for brevity and clarity.\u003c/em>\u003c/p>\n\u003ch2>The Los Angeles case and a trend among the wealthy\u003c/h2>\n\u003cp>\u003cstrong>How unusual is this case — and what motivated the Los Angeles couple?\u003c/strong>\u003c/p>\n\u003cp>\u003cstrong>Ava Kofman:\u003c/strong> It’s incredibly unusual to have this many children, and certainly it seems like what was going on inside the home is quite unusual … but there’s also nothing stopping people from having as many children as they would like through surrogacy or assisted reproduction.\u003c/p>\n\u003cp>There’s been some \u003ca href=\"https://www.wsj.com/us-news/chinese-billionaires-surrogacy-pregnancy-7fdfc0c3?gaa_at=eafs&gaa_n=AWEtsqdvbDQdnj9DIEnvCQrLrOYqKlcKqN_RtWLgcWH0dqcHyBD7bV1NGX_HvtmmF3w%3D&gaa_ts=69afae86&gaa_sig=hsKIq7GlEe6jTV_AiBszh8M-VLOFzbVMW-UnX2fkYed7Ly-9K5nIrY-HLpdrbwJtFK3lWqMpL15gNRrlnAJy4w%3D%3D\">great reporting recently in the\u003cem> Wall Street Journa\u003c/em>\u003c/a>\u003cem>l\u003c/em>, as well, showing people having upward of 100 children, in part, using surrogates.\u003c/p>\n\u003cp>[The couple] wanted to have a big family; they wanted to have a lot of kids as they got older, who could be successful and carry on the family bloodline and legacy.\u003c/p>\n\u003cp>It does seem like this is part of a wider trend we’ve seen with \u003ca href=\"https://www.today.com/parents/parents/elon-musk-kids-rcna19692\">billionaires like Elon Musk [who has 14 children]\u003c/a> and others who are really interested in spreading their gene pool and their legacy.\u003c/p>\n\u003cfigure id=\"attachment_12046885\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-12046885 size-full\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/07/iStock_000039661108_Large_qed.jpg\" alt=\"\" width=\"2000\" height=\"1330\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/07/iStock_000039661108_Large_qed.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/07/iStock_000039661108_Large_qed-160x106.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/07/iStock_000039661108_Large_qed-1536x1021.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">A shocking case in Los Angeles has rocked the fertility industry, sparking a conversation around commercial surrogacy and regulations. \u003ccite>(iStock/Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>How were they able to have over 20 children through surrogates?\u003c/strong>\u003c/p>\n\u003cp>\u003cstrong>Kofman: \u003c/strong>This couple — after they had a few children through a professional surrogate agency — actually opened their own agency. And this is what was called Mark Surrogacy. As far as I could tell, no one’s really done this before.\u003c/p>\n\u003cp>The surrogates had no awareness of this, and neither, it seems, did some of the attorneys working with the agency.\u003c/p>\n\u003cp>Most parents are using an agency because they \u003cem>want \u003c/em>a middleman, right? They want to be protected; they want to have someone who really knows the ropes. It’s a field with its own legal particularities. There [are] all kinds of things that can easily go right with experienced people, and can easily go wrong without them.\u003c/p>\n\u003cp>\u003cstrong>If Kayla Elliott or any other surrogates wanted to get custody of the child in this case, could they? \u003c/strong>\u003c/p>\n\u003cp>\u003cstrong>Kofman: \u003c/strong>Legally, it seemed like it would have been quite complicated. She definitely didn’t have any legal custody off the bat, and no surrogates do. The industry kind of wouldn’t work if that [were] the case … the surrogate is not biologically related most of the time.\u003c/p>\n\u003cp>In some states … there’s no federal regulation … and it’s so, so state-based. And some states are in fact even silent on the question of how surrogacy should work.\u003c/p>\n\u003ch2>The regulations and practices around surrogacy in California\u003c/h2>\n\u003cp>\u003cstrong>Are all versions of surrogacy commercial? \u003c/strong>\u003c/p>\n\u003cp>\u003cstrong>Deborah Wald: \u003c/strong>I want to make sure everyone’s aware, there’s a huge amount of surrogacy that happens … [for example] a sister having a baby for her infertile sister, that kind of thing.\u003c/p>\n\u003cp>I think it’s very accepted within certain cultures and in certain communities that if you can’t have a baby and you have someone who loves you who’s going to do that, they’ll do it for you.\u003c/p>\n\u003cfigure id=\"attachment_12075793\" class=\"wp-caption aligncenter\" style=\"max-width: 1980px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12075793\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/03/GettyImages-2183738602.jpg\" alt=\"\" width=\"1980\" height=\"1320\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/03/GettyImages-2183738602.jpg 1980w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/03/GettyImages-2183738602-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/03/GettyImages-2183738602-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 1980px) 100vw, 1980px\">\u003cfigcaption class=\"wp-caption-text\">A couple holds hands as they meet with a pregnant woman who is interviewing them for potential adoptive parents. \u003ccite>(SDI Productions via Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>What are the typical compensation rates for commercial surrogacy in California?\u003c/strong>\u003c/p>\n\u003cp>\u003cstrong>Wald: \u003c/strong>It varies a lot. So this is what the women themselves get paid. This has nothing to do with what the doctors charge or what the agencies charge. Typical rates were in the $30,000 to $50,000 range.\u003c/p>\n\u003cp>I still do sometimes see that. But I also recently saw a $120,000 fee to the surrogate herself. So it’s really jumped during and since COVID.\u003c/p>\n\u003cp>\u003cstrong>Are there protections around surrogacy in California?\u003c/strong>\u003c/p>\n\u003cp>\u003cstrong>Wald: \u003c/strong>Every surrogate I’ve ever represented has been looking for the same reassurance that intended parents look for, which is that she’s not doing this because she wants another child. And she wants to know that no matter what, the intended parents can’t bail. That the baby will be theirs, that she will not be legally and financially responsible for a child that’s not genetically hers, and that she never intended to parent.\u003c/p>\n\u003cp>California law actually requires that a surrogate have a right to independent legal counsel of her own choosing. It can’t be the same attorney who works for the agency or the same attorney who’s representing the intended parents.[aside postID=forum_2010101913083 hero='https://cdn.kqed.org/wp-content/uploads/sites/43/2026/02/GettyImages-2225535809-2000x1333.jpg']She has a right to have all her medical care paid for.\u003c/p>\n\u003cp>Our law is clear that until the moment she gives birth, even if there’s been a pre-birth determination that the intended parents will be the legal parents, that doesn’t go into effect till the moment she gives birth. So there won’t be conflict over her right to make medical choices for herself.\u003c/p>\n\u003cp>In any state, when a woman gives birth, she’s the mother unless a court has said she isn’t. And so, for the intended parents to become the legal parents, there has to be an actual court action in almost every state.\u003c/p>\n\u003cp>In California, we do allow that court action to happen before the baby’s born, so there is complete clarity at the moment of birth as to who the parents are.\u003c/p>\n\u003cp>It facilitates medical decision-making for the baby. It facilitates making sure the baby is on the parents’ health insurance from the beginning. And that the intended parents are able to take the baby home from the hospital. That if the surrogate is ready to be discharged before the baby is, she’s free to leave.\u003c/p>\n\u003cp>There are a number of benefits to having everything clear before the baby’s born.\u003c/p>\n\u003cp>\u003cstrong>Are there future regulations that experts are looking at?\u003c/strong>\u003c/p>\n\u003cp>\u003cstrong>Wald:\u003c/strong> I was one of the attorneys who worked on our statutory structure for gestational surrogacy in California, with an eye toward making sure surrogates were well protected by it. But [Kofman’s reporting] certainly has brought other holes to light.\u003c/p>\n\u003cp>One of the things in real time we’re talking about right now is enacting a surrogate’s Bill of Rights for the state of California, that would include the protections we already have, [like] that she has a right to make her own medical decisions, that she has a right to counsel and good health insurance.\u003c/p>\n\u003cp>Particularly in response to the Mark Surrogacy situation, we’re talking about including that she has a right to better disclosures about who she’s carrying for.\u003c/p>\n\u003cfigure id=\"attachment_12046881\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-12046881 size-full\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/07/MaternityLeaveGetty1.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/07/MaternityLeaveGetty1.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/07/MaternityLeaveGetty1-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/07/MaternityLeaveGetty1-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">California law actually requires that a surrogate have a right to independent legal counsel of her own choosing. It can’t be the same attorney who works for the agency or the same attorney who’s representing the intended parents. \u003ccite>(MoMo Productions/Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>Kofman: \u003c/strong>Just from doing this reporting and talking to so many of these surrogates, I’d like to just lift up kind of what they’ve told me they want to see the most, which is just a lot more transparency.\u003c/p>\n\u003cp>They went through such extensive vetting — psychological evaluations. Now, it’s also clear that some intended parents do the same, but that’s not often the case. That certainly wasn’t the case here.\u003c/p>\n\u003cp>And there’s already such a kind of a potential for a power asymmetry. There’s \u003ca href=\"https://www.wsj.com/us-news/surrogacy-unregulated-debts-profits-b9fdd987?gaa_at=eafs&gaa_n=AWEtsqc6VTBbJAQD14SIAJz06ZQSQDHkRTqfwaxeHircQ2OXbcTIQyPrfEzaejcoZ00%3D&gaa_ts=69af9a29&gaa_sig=AT4QNSJUCK78FyjVv_Gy3eOaEI6-EBddUwynFBqmzVqMDiQ8IvkGBGtKEFnqfoJY_jle0jk_Hqms2DbkPDTmwA%3D%3D\">a financial asymmetry in the exchange\u003c/a>, of course … just rectifying that with truly independent legal counsel, with the ability for agencies to ask hard questions of the parents, like they’re asking of the surrogates.\u003c/p>\n\u003cp>And for the surrogates to just know what they’re getting into. A surrogate wants to know if they’re bringing a baby into a home with 15 other children or a home with one other child.\u003c/p>\n\u003cp>\u003cstrong>Thinking of Elon Musk, some people may wonder about the \u003cem>number \u003c/em>of kids families may be having. Can you speak about this a little bit? \u003c/strong>\u003c/p>\n\u003cp>\u003cstrong>Wald: \u003c/strong>What was one of the things that was so unusual about this case was, you know, people actually raising all, I mean, even Elon Musk, I don’t think he’s actually raising the 14 children.\u003c/p>\n\u003cp>But who’s supposed to decide that? It makes me very nervous to think about the state determining how many children a family can have. I agree that there’s an ethical and moral conversation to be had. State regulation is different from that.\u003c/p>\n\u003cfigure id=\"attachment_11934757\" class=\"wp-caption aligncenter\" style=\"max-width: 2121px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11934757 size-full\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/12/GettyImages-694024327.jpg\" alt=\"The midsection of a pregnant Black woman holding her belly.\" width=\"2121\" height=\"1414\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/12/GettyImages-694024327.jpg 2121w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/12/GettyImages-694024327-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/12/GettyImages-694024327-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/12/GettyImages-694024327-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/12/GettyImages-694024327-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/12/GettyImages-694024327-2048x1365.jpg 2048w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/12/GettyImages-694024327-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2121px) 100vw, 2121px\">\u003cfigcaption class=\"wp-caption-text\">“People are drawn to being surrogates for all sorts of different reasons, but for many of them, like Kayla, this was something they wanted to do to kind of try to make a difference,” The New Yorker’s Ava Kofman said. \u003ccite>(LWA/Dann Tardif via Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>What about strengthening requirements for setting up surrogacy \u003cem>agencies\u003c/em>? \u003c/strong>\u003c/p>\n\u003cp>\u003cstrong>Kofman:\u003c/strong> Right now, it’s very easy to set up a surrogacy agency in every state but New York. [States don’t] require any sort of license. It’s much easier to set up a surrogacy agency than it is to set up a hair salon or adoption agency or child care.\u003c/p>\n\u003cp>\u003cstrong>Wald: \u003c/strong>Within the \u003ca href=\"https://www.acal.org/\">Academy of California Adoption and Assisted Reproduction Lawyers\u003c/a>, we’re definitely looking at the New York statute.\u003c/p>\n\u003cp>It is something we’re looking at, whether we should look at a licensing requirement in the state of California and what that would look like.\u003c/p>\n\u003cp>It’s not easy to get legislation passed. That’s probably true in every state. It’s certainly true in this state. And particularly if it’s gonna cost the state money. So who’s gonna regulate that?\u003c/p>\n\u003cp>So we have to look at all of that when we try to figure out how realistic it is. But I can tell you that there are big conversations happening and a lot of smart, ethical people invested in trying to figure out how to make sure nothing like this happens again.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Commercial surrogacy is a \u003ca href=\"https://www.kqed.org/forum/2010101913083/ethical-questions-arise-from-cas-commercial-surrogacy-industry\">life-changing option for couples\u003c/a> who have been unable to conceive. As one listener told KQED’s \u003cem>Forum\u003c/em> in late February, her experience with ovarian cancer meant that she lost her ability to have her own children.\u003c/p>\n\u003cp>“I used surrogacy to have my two children,” the listener said. “And without it, we wouldn’t be able to have this incredible life that we have.”\u003c/p>\n\u003cp>Another caller was a gay father based in San Francisco, who had twin boys through surrogacy.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“The vast, vast majority of parents that have kids through surrogacy — it’s the biggest blessing of their life,” he said. “And they had to work extremely hard to make it happen.”\u003c/p>\n\u003cp>But many in the fertility field — especially commercial surrogacy — were rocked by a recent investigation by \u003ca href=\"https://www.newyorker.com/magazine/2026/02/16/the-babies-kept-in-a-mysterious-los-angeles-mansion\">\u003cem>The New Yorker’s \u003c/em>Ava Kofman\u003c/a>, which followed the story of Kayla Elliott.\u003c/p>\n\u003cp>Elliott was a Texas mother of four, already carrying a baby for a Los Angeles couple, when she found out the couple had more than 20 other children.\u003c/p>\n\u003cfigure id=\"attachment_12076885\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12076885\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/03/SurrogacyGetty2.jpg\" alt=\"\" width=\"2000\" height=\"1408\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/03/SurrogacyGetty2.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/03/SurrogacyGetty2-160x113.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/03/SurrogacyGetty2-1536x1081.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">A newborn lying on a changing table on June 5, 2001, in the maternity ward of the Franco-British Hospital in Levallois-Perret. \u003ccite>(Didier Pallages/AFP via Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>One of the children, a baby, was reportedly hospitalized with bleeding inside the brain and eyes, indicating potential child abuse. That prompted police to visit the couple’s Arcadia home, where they found it crowded with many young infants and children.\u003c/p>\n\u003cp>Authorities also found surveillance footage from devices the couple set up in the house — and allegedly saw that the children were being beaten and neglected by nannies.\u003c/p>\n\u003cp>The children, including the baby Elliott gave birth to, were taken into custody, and the couple was arrested but later released. At the time, several surrogates were still pregnant for the couple.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>For many of the children, the future remains unclear. Even amid an ongoing battle over who should have custody, the pair has engaged new surrogates.\u003c/p>\n\u003cp>“People are drawn to being surrogates for all sorts of different reasons, but for many of them, like Kayla, this was something they wanted to do to kind of try to make a difference,” Kofman said. “It was especially painful to realize that they might be bringing a child into a situation that not only was not great, but if anything, potentially dangerous.”\u003c/p>\n\u003cp>The case is highly unusual, said Deborah Wald, a certified family law specialist based in San Francisco. She said she has never seen a child born through surrogacy end up in the foster care system in her 35 years in the field.\u003c/p>\n\u003cp>“These typically are very wanted, very planned for, very loved children,” Wald said. “The other times there have been sort of scandals within the industry, it’s been more with professionals figuring out how to take off with the money or those kinds of things.”\u003c/p>\n\u003cp>KQED’s \u003ca href=\"https://www.kqed.org/forum/2010101913083/ethical-questions-arise-from-cas-commercial-surrogacy-industry\">Forum\u003c/a> spoke to Kofman and Wald about the Los Angeles family, commercial surrogacy in California and regulations around the practice.\u003c/p>\n\u003cp>\u003cem>This interview has been edited for brevity and clarity.\u003c/em>\u003c/p>\n\u003ch2>The Los Angeles case and a trend among the wealthy\u003c/h2>\n\u003cp>\u003cstrong>How unusual is this case — and what motivated the Los Angeles couple?\u003c/strong>\u003c/p>\n\u003cp>\u003cstrong>Ava Kofman:\u003c/strong> It’s incredibly unusual to have this many children, and certainly it seems like what was going on inside the home is quite unusual … but there’s also nothing stopping people from having as many children as they would like through surrogacy or assisted reproduction.\u003c/p>\n\u003cp>There’s been some \u003ca href=\"https://www.wsj.com/us-news/chinese-billionaires-surrogacy-pregnancy-7fdfc0c3?gaa_at=eafs&gaa_n=AWEtsqdvbDQdnj9DIEnvCQrLrOYqKlcKqN_RtWLgcWH0dqcHyBD7bV1NGX_HvtmmF3w%3D&gaa_ts=69afae86&gaa_sig=hsKIq7GlEe6jTV_AiBszh8M-VLOFzbVMW-UnX2fkYed7Ly-9K5nIrY-HLpdrbwJtFK3lWqMpL15gNRrlnAJy4w%3D%3D\">great reporting recently in the\u003cem> Wall Street Journa\u003c/em>\u003c/a>\u003cem>l\u003c/em>, as well, showing people having upward of 100 children, in part, using surrogates.\u003c/p>\n\u003cp>[The couple] wanted to have a big family; they wanted to have a lot of kids as they got older, who could be successful and carry on the family bloodline and legacy.\u003c/p>\n\u003cp>It does seem like this is part of a wider trend we’ve seen with \u003ca href=\"https://www.today.com/parents/parents/elon-musk-kids-rcna19692\">billionaires like Elon Musk [who has 14 children]\u003c/a> and others who are really interested in spreading their gene pool and their legacy.\u003c/p>\n\u003cfigure id=\"attachment_12046885\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-12046885 size-full\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/07/iStock_000039661108_Large_qed.jpg\" alt=\"\" width=\"2000\" height=\"1330\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/07/iStock_000039661108_Large_qed.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/07/iStock_000039661108_Large_qed-160x106.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/07/iStock_000039661108_Large_qed-1536x1021.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">A shocking case in Los Angeles has rocked the fertility industry, sparking a conversation around commercial surrogacy and regulations. \u003ccite>(iStock/Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>How were they able to have over 20 children through surrogates?\u003c/strong>\u003c/p>\n\u003cp>\u003cstrong>Kofman: \u003c/strong>This couple — after they had a few children through a professional surrogate agency — actually opened their own agency. And this is what was called Mark Surrogacy. As far as I could tell, no one’s really done this before.\u003c/p>\n\u003cp>The surrogates had no awareness of this, and neither, it seems, did some of the attorneys working with the agency.\u003c/p>\n\u003cp>Most parents are using an agency because they \u003cem>want \u003c/em>a middleman, right? They want to be protected; they want to have someone who really knows the ropes. It’s a field with its own legal particularities. There [are] all kinds of things that can easily go right with experienced people, and can easily go wrong without them.\u003c/p>\n\u003cp>\u003cstrong>If Kayla Elliott or any other surrogates wanted to get custody of the child in this case, could they? \u003c/strong>\u003c/p>\n\u003cp>\u003cstrong>Kofman: \u003c/strong>Legally, it seemed like it would have been quite complicated. She definitely didn’t have any legal custody off the bat, and no surrogates do. The industry kind of wouldn’t work if that [were] the case … the surrogate is not biologically related most of the time.\u003c/p>\n\u003cp>In some states … there’s no federal regulation … and it’s so, so state-based. And some states are in fact even silent on the question of how surrogacy should work.\u003c/p>\n\u003ch2>The regulations and practices around surrogacy in California\u003c/h2>\n\u003cp>\u003cstrong>Are all versions of surrogacy commercial? \u003c/strong>\u003c/p>\n\u003cp>\u003cstrong>Deborah Wald: \u003c/strong>I want to make sure everyone’s aware, there’s a huge amount of surrogacy that happens … [for example] a sister having a baby for her infertile sister, that kind of thing.\u003c/p>\n\u003cp>I think it’s very accepted within certain cultures and in certain communities that if you can’t have a baby and you have someone who loves you who’s going to do that, they’ll do it for you.\u003c/p>\n\u003cfigure id=\"attachment_12075793\" class=\"wp-caption aligncenter\" style=\"max-width: 1980px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12075793\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/03/GettyImages-2183738602.jpg\" alt=\"\" width=\"1980\" height=\"1320\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/03/GettyImages-2183738602.jpg 1980w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/03/GettyImages-2183738602-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/03/GettyImages-2183738602-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 1980px) 100vw, 1980px\">\u003cfigcaption class=\"wp-caption-text\">A couple holds hands as they meet with a pregnant woman who is interviewing them for potential adoptive parents. \u003ccite>(SDI Productions via Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>What are the typical compensation rates for commercial surrogacy in California?\u003c/strong>\u003c/p>\n\u003cp>\u003cstrong>Wald: \u003c/strong>It varies a lot. So this is what the women themselves get paid. This has nothing to do with what the doctors charge or what the agencies charge. Typical rates were in the $30,000 to $50,000 range.\u003c/p>\n\u003cp>I still do sometimes see that. But I also recently saw a $120,000 fee to the surrogate herself. So it’s really jumped during and since COVID.\u003c/p>\n\u003cp>\u003cstrong>Are there protections around surrogacy in California?\u003c/strong>\u003c/p>\n\u003cp>\u003cstrong>Wald: \u003c/strong>Every surrogate I’ve ever represented has been looking for the same reassurance that intended parents look for, which is that she’s not doing this because she wants another child. And she wants to know that no matter what, the intended parents can’t bail. That the baby will be theirs, that she will not be legally and financially responsible for a child that’s not genetically hers, and that she never intended to parent.\u003c/p>\n\u003cp>California law actually requires that a surrogate have a right to independent legal counsel of her own choosing. It can’t be the same attorney who works for the agency or the same attorney who’s representing the intended parents.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>She has a right to have all her medical care paid for.\u003c/p>\n\u003cp>Our law is clear that until the moment she gives birth, even if there’s been a pre-birth determination that the intended parents will be the legal parents, that doesn’t go into effect till the moment she gives birth. So there won’t be conflict over her right to make medical choices for herself.\u003c/p>\n\u003cp>In any state, when a woman gives birth, she’s the mother unless a court has said she isn’t. And so, for the intended parents to become the legal parents, there has to be an actual court action in almost every state.\u003c/p>\n\u003cp>In California, we do allow that court action to happen before the baby’s born, so there is complete clarity at the moment of birth as to who the parents are.\u003c/p>\n\u003cp>It facilitates medical decision-making for the baby. It facilitates making sure the baby is on the parents’ health insurance from the beginning. And that the intended parents are able to take the baby home from the hospital. That if the surrogate is ready to be discharged before the baby is, she’s free to leave.\u003c/p>\n\u003cp>There are a number of benefits to having everything clear before the baby’s born.\u003c/p>\n\u003cp>\u003cstrong>Are there future regulations that experts are looking at?\u003c/strong>\u003c/p>\n\u003cp>\u003cstrong>Wald:\u003c/strong> I was one of the attorneys who worked on our statutory structure for gestational surrogacy in California, with an eye toward making sure surrogates were well protected by it. But [Kofman’s reporting] certainly has brought other holes to light.\u003c/p>\n\u003cp>One of the things in real time we’re talking about right now is enacting a surrogate’s Bill of Rights for the state of California, that would include the protections we already have, [like] that she has a right to make her own medical decisions, that she has a right to counsel and good health insurance.\u003c/p>\n\u003cp>Particularly in response to the Mark Surrogacy situation, we’re talking about including that she has a right to better disclosures about who she’s carrying for.\u003c/p>\n\u003cfigure id=\"attachment_12046881\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-12046881 size-full\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/07/MaternityLeaveGetty1.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/07/MaternityLeaveGetty1.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/07/MaternityLeaveGetty1-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/07/MaternityLeaveGetty1-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">California law actually requires that a surrogate have a right to independent legal counsel of her own choosing. It can’t be the same attorney who works for the agency or the same attorney who’s representing the intended parents. \u003ccite>(MoMo Productions/Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>Kofman: \u003c/strong>Just from doing this reporting and talking to so many of these surrogates, I’d like to just lift up kind of what they’ve told me they want to see the most, which is just a lot more transparency.\u003c/p>\n\u003cp>They went through such extensive vetting — psychological evaluations. Now, it’s also clear that some intended parents do the same, but that’s not often the case. That certainly wasn’t the case here.\u003c/p>\n\u003cp>And there’s already such a kind of a potential for a power asymmetry. There’s \u003ca href=\"https://www.wsj.com/us-news/surrogacy-unregulated-debts-profits-b9fdd987?gaa_at=eafs&gaa_n=AWEtsqc6VTBbJAQD14SIAJz06ZQSQDHkRTqfwaxeHircQ2OXbcTIQyPrfEzaejcoZ00%3D&gaa_ts=69af9a29&gaa_sig=AT4QNSJUCK78FyjVv_Gy3eOaEI6-EBddUwynFBqmzVqMDiQ8IvkGBGtKEFnqfoJY_jle0jk_Hqms2DbkPDTmwA%3D%3D\">a financial asymmetry in the exchange\u003c/a>, of course … just rectifying that with truly independent legal counsel, with the ability for agencies to ask hard questions of the parents, like they’re asking of the surrogates.\u003c/p>\n\u003cp>And for the surrogates to just know what they’re getting into. A surrogate wants to know if they’re bringing a baby into a home with 15 other children or a home with one other child.\u003c/p>\n\u003cp>\u003cstrong>Thinking of Elon Musk, some people may wonder about the \u003cem>number \u003c/em>of kids families may be having. Can you speak about this a little bit? \u003c/strong>\u003c/p>\n\u003cp>\u003cstrong>Wald: \u003c/strong>What was one of the things that was so unusual about this case was, you know, people actually raising all, I mean, even Elon Musk, I don’t think he’s actually raising the 14 children.\u003c/p>\n\u003cp>But who’s supposed to decide that? It makes me very nervous to think about the state determining how many children a family can have. I agree that there’s an ethical and moral conversation to be had. State regulation is different from that.\u003c/p>\n\u003cfigure id=\"attachment_11934757\" class=\"wp-caption aligncenter\" style=\"max-width: 2121px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-11934757 size-full\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/12/GettyImages-694024327.jpg\" alt=\"The midsection of a pregnant Black woman holding her belly.\" width=\"2121\" height=\"1414\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/12/GettyImages-694024327.jpg 2121w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/12/GettyImages-694024327-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/12/GettyImages-694024327-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/12/GettyImages-694024327-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/12/GettyImages-694024327-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/12/GettyImages-694024327-2048x1365.jpg 2048w, https://cdn.kqed.org/wp-content/uploads/sites/10/2022/12/GettyImages-694024327-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2121px) 100vw, 2121px\">\u003cfigcaption class=\"wp-caption-text\">“People are drawn to being surrogates for all sorts of different reasons, but for many of them, like Kayla, this was something they wanted to do to kind of try to make a difference,” The New Yorker’s Ava Kofman said. \u003ccite>(LWA/Dann Tardif via Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>What about strengthening requirements for setting up surrogacy \u003cem>agencies\u003c/em>? \u003c/strong>\u003c/p>\n\u003cp>\u003cstrong>Kofman:\u003c/strong> Right now, it’s very easy to set up a surrogacy agency in every state but New York. [States don’t] require any sort of license. It’s much easier to set up a surrogacy agency than it is to set up a hair salon or adoption agency or child care.\u003c/p>\n\u003cp>\u003cstrong>Wald: \u003c/strong>Within the \u003ca href=\"https://www.acal.org/\">Academy of California Adoption and Assisted Reproduction Lawyers\u003c/a>, we’re definitely looking at the New York statute.\u003c/p>\n\u003cp>It is something we’re looking at, whether we should look at a licensing requirement in the state of California and what that would look like.\u003c/p>\n\u003cp>It’s not easy to get legislation passed. That’s probably true in every state. It’s certainly true in this state. And particularly if it’s gonna cost the state money. So who’s gonna regulate that?\u003c/p>\n\u003cp>So we have to look at all of that when we try to figure out how realistic it is. But I can tell you that there are big conversations happening and a lot of smart, ethical people invested in trying to figure out how to make sure nothing like this happens again.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"officialWebsiteLink": "https://www.cityarts.net/",
"airtime": "SUN 1pm-2pm, TUE 10pm, WED 1am",
"meta": {
"site": "news",
"source": "City Arts & Lectures"
},
"link": "https://www.cityarts.net",
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"rss": "https://www.cityarts.net/feed/"
}
},
"closealltabs": {
"id": "closealltabs",
"title": "Close All Tabs",
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"info": "Close All Tabs breaks down how digital culture shapes our world through thoughtful insights and irreverent humor.",
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"officialWebsiteLink": "/podcasts/closealltabs",
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"order": 1
},
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"id": "code-switch-life-kit",
"title": "Code Switch / Life Kit",
"info": "\u003cem>Code Switch\u003c/em>, which listeners will hear in the first part of the hour, has fearless and much-needed conversations about race. Hosted by journalists of color, the show tackles the subject of race head-on, exploring how it impacts every part of society — from politics and pop culture to history, sports and more.\u003cbr />\u003cbr />\u003cem>Life Kit\u003c/em>, which will be in the second part of the hour, guides you through spaces and feelings no one prepares you for — from finances to mental health, from workplace microaggressions to imposter syndrome, from relationships to parenting. The show features experts with real world experience and shares their knowledge. Because everyone needs a little help being human.\u003cbr />\u003cbr />\u003ca href=\"https://www.npr.org/podcasts/510312/codeswitch\">\u003cem>Code Switch\u003c/em> offical site and podcast\u003c/a>\u003cbr />\u003ca href=\"https://www.npr.org/lifekit\">\u003cem>Life Kit\u003c/em> offical site and podcast\u003c/a>\u003cbr />",
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"meta": {
"site": "radio",
"source": "npr"
},
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"id": "commonwealth-club",
"title": "Commonwealth Club of California Podcast",
"info": "The Commonwealth Club of California is the nation's oldest and largest public affairs forum. As a non-partisan forum, The Club brings to the public airwaves diverse viewpoints on important topics. The Club's weekly radio broadcast - the oldest in the U.S., dating back to 1924 - is carried across the nation on public radio stations and is now podcasting. Our website archive features audio of our recent programs, as well as selected speeches from our long and distinguished history. This podcast feed is usually updated twice a week and is always un-edited.",
"airtime": "THU 10pm, FRI 1am",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Commonwealth-Club-Podcast-Tile-360x360-1.jpg",
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"meta": {
"site": "news",
"source": "Commonwealth Club of California"
},
"link": "/radio/program/commonwealth-club",
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"google": "https://podcasts.google.com/feed/aHR0cDovL3d3dy5jb21tb253ZWFsdGhjbHViLm9yZy9hdWRpby9wb2RjYXN0L3dlZWtseS54bWw",
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}
},
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"id": "forum",
"title": "Forum",
"tagline": "The conversation starts here",
"info": "KQED’s live call-in program discussing local, state, national and international issues, as well as in-depth interviews.",
"airtime": "MON-FRI 9am-11am, 10pm-11pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Forum-Podcast-Tile-703x703-1.jpg",
"imageAlt": "KQED Forum with Mina Kim and Alexis Madrigal",
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"source": "kqed",
"order": 9
},
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"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM5NTU3MzgxNjMz",
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"freakonomics-radio": {
"id": "freakonomics-radio",
"title": "Freakonomics Radio",
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"imageSrc": "https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/05/freakonomicsRadio.png",
"officialWebsiteLink": "http://freakonomics.com/",
"airtime": "SUN 1am-2am, SAT 3pm-4pm",
"meta": {
"site": "radio",
"source": "WNYC"
},
"link": "/radio/program/freakonomics-radio",
"subscribe": {
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"apple": "https://itunes.apple.com/us/podcast/freakonomics-radio/id354668519",
"tuneIn": "https://tunein.com/podcasts/WNYC-Podcasts/Freakonomics-Radio-p272293/",
"rss": "https://feeds.feedburner.com/freakonomicsradio"
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},
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"id": "fresh-air",
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"link": "/radio/program/fresh-air",
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"apple": "https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=214089682&at=11l79Y&ct=nprdirectory",
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"rss": "https://feeds.npr.org/381444908/podcast.xml"
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"info": "A live production of NPR and WBUR Boston, in collaboration with stations across the country, Here & Now reflects the fluid world of news as it's happening in the middle of the day, with timely, in-depth news, interviews and conversation. Hosted by Robin Young, Jeremy Hobson and Tonya Mosley.",
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"rss": "https://feeds.npr.org/510051/podcast.xml"
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},
"hidden-brain": {
"id": "hidden-brain",
"title": "Hidden Brain",
"info": "Shankar Vedantam uses science and storytelling to reveal the unconscious patterns that drive human behavior, shape our choices and direct our relationships.",
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"airtime": "SUN 7pm-8pm",
"meta": {
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"source": "NPR"
},
"link": "/radio/program/hidden-brain",
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},
"how-i-built-this": {
"id": "how-i-built-this",
"title": "How I Built This with Guy Raz",
"info": "Guy Raz dives into the stories behind some of the world's best known companies. How I Built This weaves a narrative journey about innovators, entrepreneurs and idealists—and the movements they built.",
"imageSrc": "https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/05/howIBuiltThis.png",
"officialWebsiteLink": "https://www.npr.org/podcasts/510313/how-i-built-this",
"airtime": "SUN 7:30pm-8pm",
"meta": {
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"source": "npr"
},
"link": "/radio/program/how-i-built-this",
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"npr": "https://rpb3r.app.goo.gl/3zxy",
"apple": "https://itunes.apple.com/us/podcast/how-i-built-this-with-guy-raz/id1150510297?mt=2",
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},
"hyphenacion": {
"id": "hyphenacion",
"title": "Hyphenación",
"tagline": "Where conversation and cultura meet",
"info": "What kind of no sabo word is Hyphenación? For us, it’s about living within a hyphenation. Like being a third-gen Mexican-American from the Texas border now living that Bay Area Chicano life. Like Xorje! Each week we bring together a couple of hyphenated Latinos to talk all about personal life choices: family, careers, relationships, belonging … everything is on the table. ",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2025/03/Hyphenacion_FinalAssets_PodcastTile.png",
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"officialWebsiteLink": "/podcasts/hyphenacion",
"meta": {
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"order": 15
},
"link": "/podcasts/hyphenacion",
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"spotify": "https://open.spotify.com/show/2p3Fifq96nw9BPcmFdIq0o?si=39209f7b25774f38",
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},
"jerrybrown": {
"id": "jerrybrown",
"title": "The Political Mind of Jerry Brown",
"tagline": "Lessons from a lifetime in politics",
"info": "The Political Mind of Jerry Brown brings listeners the wisdom of the former Governor, Mayor, and presidential candidate. Scott Shafer interviewed Brown for more than 40 hours, covering the former governor's life and half-century in the political game – and Brown has some lessons he'd like to share. ",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/The-Political-Mind-of-Jerry-Brown-Podcast-Tile-703x703-1.jpg",
"imageAlt": "KQED The Political Mind of Jerry Brown",
"officialWebsiteLink": "/podcasts/jerrybrown",
"meta": {
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"source": "kqed",
"order": 18
},
"link": "/podcasts/jerrybrown",
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}
},
"latino-usa": {
"id": "latino-usa",
"title": "Latino USA",
"airtime": "MON 1am-2am, SUN 6pm-7pm",
"info": "Latino USA, the radio journal of news and culture, is the only national, English-language radio program produced from a Latino perspective.",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/latinoUsa.jpg",
"officialWebsiteLink": "http://latinousa.org/",
"meta": {
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"source": "npr"
},
"link": "/radio/program/latino-usa",
"subscribe": {
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"apple": "https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=79681317&at=11l79Y&ct=nprdirectory",
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"rss": "https://feeds.npr.org/510016/podcast.xml"
}
},
"marketplace": {
"id": "marketplace",
"title": "Marketplace",
"info": "Our flagship program, helmed by Kai Ryssdal, examines what the day in money delivered, through stories, conversations, newsworthy numbers and more. Updated Monday through Friday at about 3:30 p.m. PT.",
"airtime": "MON-FRI 4pm-4:30pm, MON-WED 6:30pm-7pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Marketplace-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.marketplace.org/",
"meta": {
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"source": "American Public Media"
},
"link": "/radio/program/marketplace",
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"rss": "https://feeds.publicradio.org/public_feeds/marketplace-pm/rss/rss"
}
},
"masters-of-scale": {
"id": "masters-of-scale",
"title": "Masters of Scale",
"info": "Masters of Scale is an original podcast in which LinkedIn co-founder and Greylock Partner Reid Hoffman sets out to describe and prove theories that explain how great entrepreneurs take their companies from zero to a gazillion in ingenious fashion.",
"airtime": "Every other Wednesday June 12 through October 16 at 8pm (repeats Thursdays at 2am)",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Masters-of-Scale-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://mastersofscale.com/",
"meta": {
"site": "radio",
"source": "WaitWhat"
},
"link": "/radio/program/masters-of-scale",
"subscribe": {
"apple": "http://mastersofscale.app.link/",
"rss": "https://rss.art19.com/masters-of-scale"
}
},
"mindshift": {
"id": "mindshift",
"title": "MindShift",
"tagline": "A podcast about the future of learning and how we raise our kids",
"info": "The MindShift podcast explores the innovations in education that are shaping how kids learn. Hosts Ki Sung and Katrina Schwartz introduce listeners to educators, researchers, parents and students who are developing effective ways to improve how kids learn. We cover topics like how fed-up administrators are developing surprising tactics to deal with classroom disruptions; how listening to podcasts are helping kids develop reading skills; the consequences of overparenting; and why interdisciplinary learning can engage students on all ends of the traditional achievement spectrum. This podcast is part of the MindShift education site, a division of KQED News. KQED is an NPR/PBS member station based in San Francisco. You can also visit the MindShift website for episodes and supplemental blog posts or tweet us \u003ca href=\"https://twitter.com/MindShiftKQED\">@MindShiftKQED\u003c/a> or visit us at \u003ca href=\"/mindshift\">MindShift.KQED.org\u003c/a>",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Mindshift-Podcast-Tile-703x703-1.jpg",
"imageAlt": "KQED MindShift: How We Will Learn",
"officialWebsiteLink": "/mindshift/",
"meta": {
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"source": "kqed",
"order": 12
},
"link": "/podcasts/mindshift",
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"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM1NzY0NjAwNDI5",
"npr": "https://www.npr.org/podcasts/464615685/mind-shift-podcast",
"stitcher": "https://www.stitcher.com/podcast/kqed/stories-teachers-share",
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}
},
"morning-edition": {
"id": "morning-edition",
"title": "Morning Edition",
"info": "\u003cem>Morning Edition\u003c/em> takes listeners around the country and the world with multi-faceted stories and commentaries every weekday. Hosts Steve Inskeep, David Greene and Rachel Martin bring you the latest breaking news and features to prepare you for the day.",
"airtime": "MON-FRI 3am-9am",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Morning-Edition-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.npr.org/programs/morning-edition/",
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"link": "/radio/program/morning-edition"
},
"onourwatch": {
"id": "onourwatch",
"title": "On Our Watch",
"tagline": "Deeply-reported investigative journalism",
"info": "For decades, the process for how police police themselves has been inconsistent – if not opaque. In some states, like California, these proceedings were completely hidden. After a new police transparency law unsealed scores of internal affairs files, our reporters set out to examine these cases and the shadow world of police discipline. On Our Watch brings listeners into the rooms where officers are questioned and witnesses are interrogated to find out who this system is really protecting. Is it the officers, or the public they've sworn to serve?",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/On-Our-Watch-Podcast-Tile-703x703-1.jpg",
"imageAlt": "On Our Watch from NPR and KQED",
"officialWebsiteLink": "/podcasts/onourwatch",
"meta": {
"site": "news",
"source": "kqed",
"order": 11
},
"link": "/podcasts/onourwatch",
"subscribe": {
"apple": "https://podcasts.apple.com/podcast/id1567098962",
"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5ucHIub3JnLzUxMDM2MC9wb2RjYXN0LnhtbD9zYz1nb29nbGVwb2RjYXN0cw",
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"rss": "https://feeds.npr.org/510360/podcast.xml"
}
},
"on-the-media": {
"id": "on-the-media",
"title": "On The Media",
"info": "Our weekly podcast explores how the media 'sausage' is made, casts an incisive eye on fluctuations in the marketplace of ideas, and examines threats to the freedom of information and expression in America and abroad. For one hour a week, the show tries to lift the veil from the process of \"making media,\" especially news media, because it's through that lens that we see the world and the world sees us",
"airtime": "SUN 2pm-3pm, MON 12am-1am",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/onTheMedia.png",
"officialWebsiteLink": "https://www.wnycstudios.org/shows/otm",
"meta": {
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"source": "wnyc"
},
"link": "/radio/program/on-the-media",
"subscribe": {
"apple": "https://itunes.apple.com/us/podcast/on-the-media/id73330715?mt=2",
"tuneIn": "https://tunein.com/radio/On-the-Media-p69/",
"rss": "http://feeds.wnyc.org/onthemedia"
}
},
"pbs-newshour": {
"id": "pbs-newshour",
"title": "PBS NewsHour",
"info": "Analysis, background reports and updates from the PBS NewsHour putting today's news in context.",
"airtime": "MON-FRI 3pm-4pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/PBS-News-Hour-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.pbs.org/newshour/",
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"source": "pbs"
},
"link": "/radio/program/pbs-newshour",
"subscribe": {
"apple": "https://itunes.apple.com/us/podcast/pbs-newshour-full-show/id394432287?mt=2",
"tuneIn": "https://tunein.com/radio/PBS-NewsHour---Full-Show-p425698/",
"rss": "https://www.pbs.org/newshour/feeds/rss/podcasts/show"
}
},
"perspectives": {
"id": "perspectives",
"title": "Perspectives",
"tagline": "KQED's series of daily listener commentaries since 1991",
"info": "KQED's series of daily listener commentaries since 1991.",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2025/01/Perspectives_Tile_Final.jpg",
"imageAlt": "KQED Perspectives",
"officialWebsiteLink": "/perspectives/",
"meta": {
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"source": "kqed",
"order": 14
},
"link": "/perspectives",
"subscribe": {
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"npr": "https://www.npr.org/podcasts/432309616/perspectives",
"rss": "https://ww2.kqed.org/perspectives/category/perspectives/feed/",
"google": "https://podcasts.google.com/feed/aHR0cHM6Ly93dzIua3FlZC5vcmcvcGVyc3BlY3RpdmVzL2NhdGVnb3J5L3BlcnNwZWN0aXZlcy9mZWVkLw"
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},
"planet-money": {
"id": "planet-money",
"title": "Planet Money",
"info": "The economy explained. Imagine you could call up a friend and say, Meet me at the bar and tell me what's going on with the economy. Now imagine that's actually a fun evening.",
"airtime": "SUN 3pm-4pm",
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