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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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"excerpt": "Becerra indicated that making progress on government-run healthcare while President Donald Trump is in office was unrealistic.",
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"title": "Xavier Becerra Backpedals on Single Payer as He Woos Powerful Doctors’ Lobby | KQED",
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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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"slug": "medi-cal-cuts-are-coming-contra-costa-county-is-bracing-for-impact",
"title": "Medi-Cal Cuts Are Coming. Contra Costa County Is Bracing for Impact",
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"headTitle": "Medi-Cal Cuts Are Coming. Contra Costa County Is Bracing for Impact | KQED",
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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\u003ch3>Episode transcript\u003c/h3>\n\u003cp>\u003cem>This transcript is computer-generated. While our team has reviewed it, there may be errors.\u003c/em>\u003c/p>\n\u003cp>\u003cb>Ericka Cruz Guevarra: \u003c/b>\u003cem>[00:00:48] \u003c/em>I’m Ericka Cruz Guevara and welcome to the Bay local news to keep you rooted.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003cb>Sejal Parekh: \u003c/b>\u003cem>[00:00:54] \u003c/em>I saw a newborn this morning, fresh, it was great.\u003c/p>\n\u003cp>\u003cb>Ericka Cruz Guevarra: \u003c/b>\u003cem>[00:00:56] \u003c/em>Wow. This is Sejal Parekh. She’s a pediatrician in the Bay Area. And in her downtime, if you can imagine it, she’s a freelance health reporter for the Richmond side. And lately, Sejal has been thinking a lot about big changes coming to health insurance for low-income residents in Contra Costa County.\u003c/p>\n\u003cp>\u003cb>Sejal Parekh: \u003c/b>\u003cem>[00:01:21] \u003c/em>My personal fear is that patients in general, people in general don’t get the care they need as their health worsens.\u003c/p>\n\u003cp>\u003cb>Ericka Cruz Guevarra: \u003c/b>\u003cem>[00:01:32] \u003c/em>Californians who have Medicaid are bracing for big changes. And in Contra Costa County alone, up to 93,000 residents could lose their health insurance as a result of the One Big Beautiful Bill Act that President Donald Trump signed into law last year. Today, doctor and journalist Sejal Parekh explains how Contra Costa County is bracing for impact.\u003c/p>\n\u003cp>\u003cb>Ericka Cruz Guevarra: \u003c/b>\u003cem>[00:02:11] \u003c/em>First, what exactly was Medicaid set up to do, and who is it supposed to serve?\u003c/p>\n\u003cp>\u003cb>Sejal Parekh: \u003c/b>\u003cem>[00:02:17] \u003c/em>Medicaid was originally set up as a safety net, as a place where low-income people can get health insurance and so that their services can be appropriately paid for, that there’s not a lot of people without health insurance not getting the care that they need. Medicaid is this federal program, which is kind of a federal-state partnership, in which the federal government gives X amount of dollars and California chips in X amount of dollars. And we get the state plan called Medi-Cal, which was administered by the State Department of health care services.\u003c/p>\n\u003cp>\u003cb>Ericka Cruz Guevarra: \u003c/b>\u003cem>[00:02:47] \u003c/em>So when we are talking about Medicaid in California, we’re going to be referring to it as Medi-Cal. And you spoke with folks who rely on this program, including a woman named Lisa. Can you tell me a little bit about her and where she lives and what’s her story?\u003c/p>\n\u003cp>\u003cb>Sejal Parekh: \u003c/b>\u003cem>[00:03:05] \u003c/em>Yeah, Lisa lives in Richmond, she’s 58. She relies heavily on Medi-Cal.\u003c/p>\n\u003cp>\u003cb>Lisa: \u003c/b>\u003cem>[00:03:11] \u003c/em>I am approved for cancer treatment at UCSF, which I know is probably very expensive.\u003c/p>\n\u003cp>\u003cb>Sejal Parekh: \u003c/b>\u003cem>[00:03:18] \u003c/em>So we’re only using Lisa’s first name for privacy concerns. She has a lot of health conditions she doesn’t want others to know about. And so she requested for privacy that we only use her first name.\u003c/p>\n\u003cp>\u003cb>Lisa: \u003c/b>\u003cem>[00:03:28] \u003c/em>I’ve been diagnosed with bipolar disorder, which is very well controlled with really good, but very expensive medication. I have autoimmune disease, Hashimoto’s, thyroiditis.\u003c/p>\n\u003cp>\u003cb>Sejal Parekh: \u003c/b>\u003cem>[00:03:46] \u003c/em>She has several different health conditions, including a blood cancer, chronic back pain, several other issues, autoimmune issue affecting her thyroid. And so she needs to see a lot of doctors, get blood tests regularly, and is on many medications. And so for all of this, she relies on Medi-Cal coverage.\u003c/p>\n\u003cp>\u003cb>Lisa: \u003c/b>\u003cem>[00:04:07] \u003c/em>I see a hematologist, oncologist, cancer specialist at UCSF as well. So I am really praying I can continue to get my care there.\u003c/p>\n\u003cp>\u003cb>Sejal Parekh: \u003c/b>\u003cem>[00:04:21] \u003c/em>If she were to lose Medi-Cal, Lisa would have to figure something out, maybe she would have to move, maybe should have to find some other plan she’s covered under. But when I first talked to Lisa she told me in no uncertain terms that losing Medi Cal would be kind of the difference between life and death.\u003c/p>\n\u003cp>\u003cb>Lisa: \u003c/b>\u003cem>[00:04:37] \u003c/em>It’s not an option for me to just go get a job, even though I did work for 45 years, I’m just not able to. I definitely need to sleep 12 to 14 hours a day just to function.\u003c/p>\n\u003cp>\u003cb>Ericka Cruz Guevarra: \u003c/b>\u003cem>[00:04:52] \u003c/em>Of course, we’re talking about this now because a lot of changes are coming to Medi-Cal under Trump’s big, beautiful bill. What is changing for MediCal patients exactly? What do we know about that?\u003c/p>\n\u003cp>\u003cb>Sejal Parekh: \u003c/b>\u003cem>[00:05:04] \u003c/em>Big cuts are coming. I think that’s the biggest point. The amount people estimate might be between $900 billion to $1 trillion. This will be over the next 10 years. Another big change is going to be work requirements for those aged 18 to 64. That might mean working a certain number of hours a week, studying some hours a weak, volunteering some number of hour, but the work requirements are going to new and required in starting 2027. There’s this new determination that those with unsatisfactory immigration status will no longer be able to sign up for new Medi-Cal. What does that mean? That unsatisfactorily immigration status loosely refers to undocumented immigrants. I don’t know if you remember, but a couple of years ago, Governor Newsom made a big deal about extending MediCal to all undocumented immigrants, and so this is clearly seen as a rollback of that policy.\u003c/p>\n\u003cp>\u003cb>Ericka Cruz Guevarra: \u003c/b>\u003cem>[00:06:03] \u003c/em>Other changes coming to Medi-Cal are seen as new barriers to enrollment. Starting next year, enrollees will have to renew their benefits more frequently, every six months instead of every year. That’s expected to create more paperwork for personnel, too. And in Contra Costa County, new federal restrictions and state budget cuts could mean $307 million in losses for Medi-Cal patients there by 2029.\u003c/p>\n\u003cp>\u003cb>Ericka Cruz Guevarra: \u003c/b>\u003cem>[00:06:40] \u003c/em>This is something that Contra Costa County and really counties around the state and the Bay Area have really been preparing for these changes to Medi-Cal. What has Contra-Costa County said about the anticipated impacts?\u003c/p>\n\u003cp>\u003cb>Sejal Parekh: \u003c/b>\u003cem>[00:06:54] \u003c/em>County officials are really worried.\u003c/p>\n\u003cp>\u003cb>Grant Colfax: \u003c/b>\u003cem>[00:06:57] \u003c/em>I’m not going to sugarcoat it. Without intervention, our hospitals and clinics across the country will be in dire straits.\u003c/p>\n\u003cp>\u003cb>Sejal Parekh: \u003c/b>\u003cem>[00:07:06] \u003c/em>In public hearings, such as the Board of Supervisors meeting in December 2025, Grant Colfax, who’s the health director, said the changes coming through were unprecedented.\u003c/p>\n\u003cp>\u003cb>Grant Colfax: \u003c/b>\u003cem>[00:07:17] \u003c/em>And by the numbers, while difficult to predict, EHSD estimates that as many as 93,000 people in Contra Costa County will be subject to these new rules implemented by HR 1 and the state changes.\u003c/p>\n\u003cp>\u003cb>Sejal Parekh: \u003c/b>\u003cem>[00:07:33] \u003c/em>Changes happen to the county kind of a couple of different ways. One is that the county is required now to process all of these every six month eligibility kind of packets. So that’s doubling the work that they have to do. So there’s an increase in the amount of resources the county needs to just implement these changes. There’s also a fear that the more people that lose the Medi-Cal, those people don’t stop using health services. If you break a leg, you break leg. And so there’s a concern that, with a lot of people potentially losing MediCal, they’re still gonna need the same ER services and the hospital services, but who’s gonna pay for that?\u003c/p>\n\u003cp>\u003cb>Ericka Cruz Guevarra: \u003c/b>\u003cem>[00:08:18] \u003c/em>Coming up, what’s happening inside local clinics in Contra Costa County as they brace for changes to Medi-Cal. We’ll be right back.\u003c/p>\n\u003cp>\u003cb>Ericka Cruz Guevarra: \u003c/b>\u003cem>[00:09:21] \u003c/em>And I know you’ve actually talked with folks at local clinics in Contra Costa County about what they’re already seeing. How is it trickling down to these clinics now?\u003c/p>\n\u003cp>\u003cb>Sejal Parekh: \u003c/b>\u003cem>[00:09:32] \u003c/em>Yeah, great question. So I talked with Amit Randhawa, who is the clinic manager for RotaCare West Contra Costa County.\u003c/p>\n\u003cp>\u003cb>Amit Randhawa: \u003c/b>\u003cem>[00:09:39] \u003c/em>We are part of a larger organization called RotaCare Bay Area, serving uninsured folks throughout the Bay Area as far north as San Rafael and as far down south as Monterey.\u003c/p>\n\u003cp>\u003cb>Sejal Parekh: \u003c/b>\u003cem>[00:09:51] \u003c/em>And it’s a free clinic that he runs with volunteer doctors and other health care professionals and some social workers.\u003c/p>\n\u003cp>\u003cb>Amit Randhawa: \u003c/b>\u003cem>[00:09:58] \u003c/em>And we will serve anyone who is uninsured for any reason.\u003c/p>\n\u003cp>\u003cb>Sejal Parekh: \u003c/b>\u003cem>[00:10:03] \u003c/em>And so he said that in the first couple of months of 2026, he’s seen a big increase in the number of people asking about changes to Medi-Cal if they’re going to be eligible.\u003c/p>\n\u003cp>\u003cb>Amit Randhawa: \u003c/b>\u003cem>[00:10:14] \u003c/em>And I’ve got to say some of the calls are just a bit distressing, you know, there’s a lot of people with fear and despair, it’s very scary, you don’t really know how to navigate the systems.\u003c/p>\n\u003cp>\u003cb>Sejal Parekh: \u003c/b>\u003cem>[00:10:25] \u003c/em>He sees a lot of fear in the community of not wanting to even mention anything about immigration status. He also mentioned that as much free care as he and the clinic want to offer, it’s not gonna be able to keep up with the number of people who are gonna lose their Medi-Cal insurance.\u003c/p>\n\u003cp>\u003cb>Amit Randhawa: \u003c/b>\u003cem>[00:10:42] \u003c/em>I would hate to think that folks are going to be utilizing the emergency department more, but that is most likely what’s going to happen.\u003c/p>\n\u003cp>\u003cb>Sejal Parekh: \u003c/b>\u003cem>[00:10:53] \u003c/em>When I asked him at, you know, how ready, willing, and able are you to deal with this? He said, we’re willing, but we’re not able.\u003c/p>\n\u003cp>\u003cb>Amit Randhawa: \u003c/b>\u003cem>[00:11:02] \u003c/em>If folks don’t have any other way to access preventive care or seek treatment for things that could be managed. You know, ahead of time, they may just wait until things cannot be managed anymore and they end up in an emergency department. Who’s going to support all of these uninsured people and who’s going pay for the medical providers to provide that care? I wish I had an answer, but we’re all kind of in this together to figure out what’s gonna be next.\u003c/p>\n\u003cp>\u003cb>Sejal Parekh: \u003c/b>\u003cem>[00:11:35] \u003c/em>One of the things that’s been tough is that you may not know if you’re going to be affected by these upcoming changes to Medi-Cal. And that’s because a lot of this is handled by the state, by the Department of Health Care Services. And they’re kind of in the process of figuring out who’s going to affected and who’s not. And does that mean that you get a letter in the mail saying, hey, just so you know, you’re going to to be effected? So a lot patients, especially the patients I talk to, were fearful that they were gonna lose their medical, but they didn’t actually know if they were going to be affected or not. And that contributes to, you know, an atmosphere of fear and concern and maybe not seeking the healthcare that you need.\u003c/p>\n\u003cp>\u003cb>Ericka Cruz Guevarra: \u003c/b>\u003cem>[00:12:14] \u003c/em>Yeah, I mean, I can only imagine the anxiety that that creates, which I guess to that point, I wanna come back to Lisa, who is someone who relies very heavily on Medi-Cal. I mean, has she been told anything about what these potential changes could mean for her specifically?\u003c/p>\n\u003cp>\u003cb>Sejal Parekh: \u003c/b>\u003cem>[00:12:33] \u003c/em>She has not heard from the state if she’s gonna be affected, and I think that adds to her anxiety.\u003c/p>\n\u003cp>\u003cb>Lisa: \u003c/b>\u003cem>[00:12:39] \u003c/em>Even with a good RX, one of my psychiatric medications is about $4,000 a month.\u003c/p>\n\u003cp>\u003cb>Sejal Parekh: \u003c/b>\u003cem>[00:12:46] \u003c/em>She told me that other people on Medi-Cal might start hoarding their medications, refilling their medications on the first date it’s available, even if they haven’t run out of the medication yet.\u003c/p>\n\u003cp>\u003cb>Lisa: \u003c/b>\u003cem>[00:12:56] \u003c/em>Even if I’m not out, I am cutting some of my medications in half.\u003c/p>\n\u003cp>\u003cb>Sejal Parekh: \u003c/b>\u003cem>[00:13:02] \u003c/em>And I don’t think anyone wants to do that. I think this is a response out of fear.\u003c/p>\n\u003cp>\u003cb>Ericka Cruz Guevarra: \u003c/b>\u003cem>[00:13:07] \u003c/em>Just fear that she doesn’t know that she’ll be able to get access to those medications on the line.\u003c/p>\n\u003cp>\u003cb>Sejal Parekh: \u003c/b>\u003cem>[00:13:12] \u003c/em>Exactly, exactly.\u003cem> \u003c/em>\u003c/p>\n\u003cp>\u003cb>Lisa: \u003c/b>\u003cem>[00:13:16] \u003c/em>Just trying to do the best I can with what I have, knowing what could be coming.\u003c/p>\n\u003cp>\u003cb>Ericka Cruz Guevarra: \u003c/b>\u003cem>[00:13:27] \u003c/em>I mean, how is Contra Costa County responding to all of this? It seems like there’s a lot of anticipation on their end. How are they responding to these changes at the federal level?\u003c/p>\n\u003cp>\u003cb>Sejal Parekh: \u003c/b>\u003cem>[00:13:40] \u003c/em>I think the best way to characterize it right now is that they’re taking these changes seriously. They’re also in a tough spot, because for example, they need a lot more funding for eligibility workers to check everyone’s paperwork every six months, right? And some of that also has to do with the state budget. They have started hiring more eligibility workers. They’re starting to prepare estimates for the hospital of what financial changes are coming up. And I would say the most notable thing they’re doing is there’s a ballot measure coming up in November, measure B, which would be, I think, 5 eighths a cent sales tax on goods sold in Contra Costa County. Theoretically, this money would be specifically for kind of shoring up the health care infrastructure.\u003c/p>\n\u003cp>\u003cb>\u003c/b>\u003cem>[00:14:24] \u003c/em>So, trying to fill in the gaps left by these federal cuts, essentially\u003c/p>\n\u003cp>\u003cb>Sejal Parekh: \u003c/b>\u003cem>[00:14:30] \u003c/em>It could be a stopgap measure, but there’s no way it would replace lost federal dollars.\u003c/p>\n\u003cp>\u003cb>Ericka Cruz Guevarra: \u003c/b>\u003cem>[00:14:36] \u003c/em>I mean, Sejal, I feel like you’re describing so many trickle-down impacts as a result of these federal cuts, this squeeze on the county healthcare system, but also this like very personal everyday impacts to people’s health. Looking ahead as you cover health as a journalist, but also as a doctor yourself, like what is your fear moving forward for? Your patients are just people seeking care who could be impacted by these cuts.\u003c/p>\n\u003cp>\u003cb>Sejal Parekh: \u003c/b>\u003cem>[00:15:09] \u003c/em>My personal fear is that patients in general, people in general don’t get the care they need and their health worsens. For example, for me as a pediatrician, I worry that if one of my patients who loses their health insurance doesn’t come to me for their cold that it turns into an asthma attack and then they need to be hospitalized. Another example for preventative care is mammograms. If there’s breast cancer that’s caught early, there may be an option to have quicker treatment versus if breast cancer spreads, there might not be a surgical option. Patient might have to go through chemo and radiation. I think that changes like this erode trust in the health care system, erode trust that I can just go to the hospital, I’m going to get what I need, I am going to be okay. There’s a lot of calculations people make of, well, am I going to afford my medications this month? Am I going afford rent this month. And so it creates a culture in which there’s so much uncertainty that that itself can also negatively impact people’s health.\u003c/p>\n\u003cp>\u003cb>Ericka Cruz Guevarra: \u003c/b>\u003cem>[00:16:20] \u003c/em>Well, Sejal, thank you so much for sharing your reporting with us and for joining me on the show. I really appreciate it.\u003c/p>\n\u003cp>\u003cb>Sejal Parekh: \u003c/b>\u003cem>[00:16:25] \u003c/em>Thank you so for having me.\u003c/p>\n\u003cp>[ad floatright]\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\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\u003ch3>Episode transcript\u003c/h3>\n\u003cp>\u003cem>This transcript is computer-generated. While our team has reviewed it, there may be errors.\u003c/em>\u003c/p>\n\u003cp>\u003cb>Ericka Cruz Guevarra: \u003c/b>\u003cem>[00:00:48] \u003c/em>I’m Ericka Cruz Guevara and welcome to the Bay local news to keep you rooted.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cb>Sejal Parekh: \u003c/b>\u003cem>[00:00:54] \u003c/em>I saw a newborn this morning, fresh, it was great.\u003c/p>\n\u003cp>\u003cb>Ericka Cruz Guevarra: \u003c/b>\u003cem>[00:00:56] \u003c/em>Wow. This is Sejal Parekh. She’s a pediatrician in the Bay Area. And in her downtime, if you can imagine it, she’s a freelance health reporter for the Richmond side. And lately, Sejal has been thinking a lot about big changes coming to health insurance for low-income residents in Contra Costa County.\u003c/p>\n\u003cp>\u003cb>Sejal Parekh: \u003c/b>\u003cem>[00:01:21] \u003c/em>My personal fear is that patients in general, people in general don’t get the care they need as their health worsens.\u003c/p>\n\u003cp>\u003cb>Ericka Cruz Guevarra: \u003c/b>\u003cem>[00:01:32] \u003c/em>Californians who have Medicaid are bracing for big changes. And in Contra Costa County alone, up to 93,000 residents could lose their health insurance as a result of the One Big Beautiful Bill Act that President Donald Trump signed into law last year. Today, doctor and journalist Sejal Parekh explains how Contra Costa County is bracing for impact.\u003c/p>\n\u003cp>\u003cb>Ericka Cruz Guevarra: \u003c/b>\u003cem>[00:02:11] \u003c/em>First, what exactly was Medicaid set up to do, and who is it supposed to serve?\u003c/p>\n\u003cp>\u003cb>Sejal Parekh: \u003c/b>\u003cem>[00:02:17] \u003c/em>Medicaid was originally set up as a safety net, as a place where low-income people can get health insurance and so that their services can be appropriately paid for, that there’s not a lot of people without health insurance not getting the care that they need. Medicaid is this federal program, which is kind of a federal-state partnership, in which the federal government gives X amount of dollars and California chips in X amount of dollars. And we get the state plan called Medi-Cal, which was administered by the State Department of health care services.\u003c/p>\n\u003cp>\u003cb>Ericka Cruz Guevarra: \u003c/b>\u003cem>[00:02:47] \u003c/em>So when we are talking about Medicaid in California, we’re going to be referring to it as Medi-Cal. And you spoke with folks who rely on this program, including a woman named Lisa. Can you tell me a little bit about her and where she lives and what’s her story?\u003c/p>\n\u003cp>\u003cb>Sejal Parekh: \u003c/b>\u003cem>[00:03:05] \u003c/em>Yeah, Lisa lives in Richmond, she’s 58. She relies heavily on Medi-Cal.\u003c/p>\n\u003cp>\u003cb>Lisa: \u003c/b>\u003cem>[00:03:11] \u003c/em>I am approved for cancer treatment at UCSF, which I know is probably very expensive.\u003c/p>\n\u003cp>\u003cb>Sejal Parekh: \u003c/b>\u003cem>[00:03:18] \u003c/em>So we’re only using Lisa’s first name for privacy concerns. She has a lot of health conditions she doesn’t want others to know about. And so she requested for privacy that we only use her first name.\u003c/p>\n\u003cp>\u003cb>Lisa: \u003c/b>\u003cem>[00:03:28] \u003c/em>I’ve been diagnosed with bipolar disorder, which is very well controlled with really good, but very expensive medication. I have autoimmune disease, Hashimoto’s, thyroiditis.\u003c/p>\n\u003cp>\u003cb>Sejal Parekh: \u003c/b>\u003cem>[00:03:46] \u003c/em>She has several different health conditions, including a blood cancer, chronic back pain, several other issues, autoimmune issue affecting her thyroid. And so she needs to see a lot of doctors, get blood tests regularly, and is on many medications. And so for all of this, she relies on Medi-Cal coverage.\u003c/p>\n\u003cp>\u003cb>Lisa: \u003c/b>\u003cem>[00:04:07] \u003c/em>I see a hematologist, oncologist, cancer specialist at UCSF as well. So I am really praying I can continue to get my care there.\u003c/p>\n\u003cp>\u003cb>Sejal Parekh: \u003c/b>\u003cem>[00:04:21] \u003c/em>If she were to lose Medi-Cal, Lisa would have to figure something out, maybe she would have to move, maybe should have to find some other plan she’s covered under. But when I first talked to Lisa she told me in no uncertain terms that losing Medi Cal would be kind of the difference between life and death.\u003c/p>\n\u003cp>\u003cb>Lisa: \u003c/b>\u003cem>[00:04:37] \u003c/em>It’s not an option for me to just go get a job, even though I did work for 45 years, I’m just not able to. I definitely need to sleep 12 to 14 hours a day just to function.\u003c/p>\n\u003cp>\u003cb>Ericka Cruz Guevarra: \u003c/b>\u003cem>[00:04:52] \u003c/em>Of course, we’re talking about this now because a lot of changes are coming to Medi-Cal under Trump’s big, beautiful bill. What is changing for MediCal patients exactly? What do we know about that?\u003c/p>\n\u003cp>\u003cb>Sejal Parekh: \u003c/b>\u003cem>[00:05:04] \u003c/em>Big cuts are coming. I think that’s the biggest point. The amount people estimate might be between $900 billion to $1 trillion. This will be over the next 10 years. Another big change is going to be work requirements for those aged 18 to 64. That might mean working a certain number of hours a week, studying some hours a weak, volunteering some number of hour, but the work requirements are going to new and required in starting 2027. There’s this new determination that those with unsatisfactory immigration status will no longer be able to sign up for new Medi-Cal. What does that mean? That unsatisfactorily immigration status loosely refers to undocumented immigrants. I don’t know if you remember, but a couple of years ago, Governor Newsom made a big deal about extending MediCal to all undocumented immigrants, and so this is clearly seen as a rollback of that policy.\u003c/p>\n\u003cp>\u003cb>Ericka Cruz Guevarra: \u003c/b>\u003cem>[00:06:03] \u003c/em>Other changes coming to Medi-Cal are seen as new barriers to enrollment. Starting next year, enrollees will have to renew their benefits more frequently, every six months instead of every year. That’s expected to create more paperwork for personnel, too. And in Contra Costa County, new federal restrictions and state budget cuts could mean $307 million in losses for Medi-Cal patients there by 2029.\u003c/p>\n\u003cp>\u003cb>Ericka Cruz Guevarra: \u003c/b>\u003cem>[00:06:40] \u003c/em>This is something that Contra Costa County and really counties around the state and the Bay Area have really been preparing for these changes to Medi-Cal. What has Contra-Costa County said about the anticipated impacts?\u003c/p>\n\u003cp>\u003cb>Sejal Parekh: \u003c/b>\u003cem>[00:06:54] \u003c/em>County officials are really worried.\u003c/p>\n\u003cp>\u003cb>Grant Colfax: \u003c/b>\u003cem>[00:06:57] \u003c/em>I’m not going to sugarcoat it. Without intervention, our hospitals and clinics across the country will be in dire straits.\u003c/p>\n\u003cp>\u003cb>Sejal Parekh: \u003c/b>\u003cem>[00:07:06] \u003c/em>In public hearings, such as the Board of Supervisors meeting in December 2025, Grant Colfax, who’s the health director, said the changes coming through were unprecedented.\u003c/p>\n\u003cp>\u003cb>Grant Colfax: \u003c/b>\u003cem>[00:07:17] \u003c/em>And by the numbers, while difficult to predict, EHSD estimates that as many as 93,000 people in Contra Costa County will be subject to these new rules implemented by HR 1 and the state changes.\u003c/p>\n\u003cp>\u003cb>Sejal Parekh: \u003c/b>\u003cem>[00:07:33] \u003c/em>Changes happen to the county kind of a couple of different ways. One is that the county is required now to process all of these every six month eligibility kind of packets. So that’s doubling the work that they have to do. So there’s an increase in the amount of resources the county needs to just implement these changes. There’s also a fear that the more people that lose the Medi-Cal, those people don’t stop using health services. If you break a leg, you break leg. And so there’s a concern that, with a lot of people potentially losing MediCal, they’re still gonna need the same ER services and the hospital services, but who’s gonna pay for that?\u003c/p>\n\u003cp>\u003cb>Ericka Cruz Guevarra: \u003c/b>\u003cem>[00:08:18] \u003c/em>Coming up, what’s happening inside local clinics in Contra Costa County as they brace for changes to Medi-Cal. We’ll be right back.\u003c/p>\n\u003cp>\u003cb>Ericka Cruz Guevarra: \u003c/b>\u003cem>[00:09:21] \u003c/em>And I know you’ve actually talked with folks at local clinics in Contra Costa County about what they’re already seeing. How is it trickling down to these clinics now?\u003c/p>\n\u003cp>\u003cb>Sejal Parekh: \u003c/b>\u003cem>[00:09:32] \u003c/em>Yeah, great question. So I talked with Amit Randhawa, who is the clinic manager for RotaCare West Contra Costa County.\u003c/p>\n\u003cp>\u003cb>Amit Randhawa: \u003c/b>\u003cem>[00:09:39] \u003c/em>We are part of a larger organization called RotaCare Bay Area, serving uninsured folks throughout the Bay Area as far north as San Rafael and as far down south as Monterey.\u003c/p>\n\u003cp>\u003cb>Sejal Parekh: \u003c/b>\u003cem>[00:09:51] \u003c/em>And it’s a free clinic that he runs with volunteer doctors and other health care professionals and some social workers.\u003c/p>\n\u003cp>\u003cb>Amit Randhawa: \u003c/b>\u003cem>[00:09:58] \u003c/em>And we will serve anyone who is uninsured for any reason.\u003c/p>\n\u003cp>\u003cb>Sejal Parekh: \u003c/b>\u003cem>[00:10:03] \u003c/em>And so he said that in the first couple of months of 2026, he’s seen a big increase in the number of people asking about changes to Medi-Cal if they’re going to be eligible.\u003c/p>\n\u003cp>\u003cb>Amit Randhawa: \u003c/b>\u003cem>[00:10:14] \u003c/em>And I’ve got to say some of the calls are just a bit distressing, you know, there’s a lot of people with fear and despair, it’s very scary, you don’t really know how to navigate the systems.\u003c/p>\n\u003cp>\u003cb>Sejal Parekh: \u003c/b>\u003cem>[00:10:25] \u003c/em>He sees a lot of fear in the community of not wanting to even mention anything about immigration status. He also mentioned that as much free care as he and the clinic want to offer, it’s not gonna be able to keep up with the number of people who are gonna lose their Medi-Cal insurance.\u003c/p>\n\u003cp>\u003cb>Amit Randhawa: \u003c/b>\u003cem>[00:10:42] \u003c/em>I would hate to think that folks are going to be utilizing the emergency department more, but that is most likely what’s going to happen.\u003c/p>\n\u003cp>\u003cb>Sejal Parekh: \u003c/b>\u003cem>[00:10:53] \u003c/em>When I asked him at, you know, how ready, willing, and able are you to deal with this? He said, we’re willing, but we’re not able.\u003c/p>\n\u003cp>\u003cb>Amit Randhawa: \u003c/b>\u003cem>[00:11:02] \u003c/em>If folks don’t have any other way to access preventive care or seek treatment for things that could be managed. You know, ahead of time, they may just wait until things cannot be managed anymore and they end up in an emergency department. Who’s going to support all of these uninsured people and who’s going pay for the medical providers to provide that care? I wish I had an answer, but we’re all kind of in this together to figure out what’s gonna be next.\u003c/p>\n\u003cp>\u003cb>Sejal Parekh: \u003c/b>\u003cem>[00:11:35] \u003c/em>One of the things that’s been tough is that you may not know if you’re going to be affected by these upcoming changes to Medi-Cal. And that’s because a lot of this is handled by the state, by the Department of Health Care Services. And they’re kind of in the process of figuring out who’s going to affected and who’s not. And does that mean that you get a letter in the mail saying, hey, just so you know, you’re going to to be effected? So a lot patients, especially the patients I talk to, were fearful that they were gonna lose their medical, but they didn’t actually know if they were going to be affected or not. And that contributes to, you know, an atmosphere of fear and concern and maybe not seeking the healthcare that you need.\u003c/p>\n\u003cp>\u003cb>Ericka Cruz Guevarra: \u003c/b>\u003cem>[00:12:14] \u003c/em>Yeah, I mean, I can only imagine the anxiety that that creates, which I guess to that point, I wanna come back to Lisa, who is someone who relies very heavily on Medi-Cal. I mean, has she been told anything about what these potential changes could mean for her specifically?\u003c/p>\n\u003cp>\u003cb>Sejal Parekh: \u003c/b>\u003cem>[00:12:33] \u003c/em>She has not heard from the state if she’s gonna be affected, and I think that adds to her anxiety.\u003c/p>\n\u003cp>\u003cb>Lisa: \u003c/b>\u003cem>[00:12:39] \u003c/em>Even with a good RX, one of my psychiatric medications is about $4,000 a month.\u003c/p>\n\u003cp>\u003cb>Sejal Parekh: \u003c/b>\u003cem>[00:12:46] \u003c/em>She told me that other people on Medi-Cal might start hoarding their medications, refilling their medications on the first date it’s available, even if they haven’t run out of the medication yet.\u003c/p>\n\u003cp>\u003cb>Lisa: \u003c/b>\u003cem>[00:12:56] \u003c/em>Even if I’m not out, I am cutting some of my medications in half.\u003c/p>\n\u003cp>\u003cb>Sejal Parekh: \u003c/b>\u003cem>[00:13:02] \u003c/em>And I don’t think anyone wants to do that. I think this is a response out of fear.\u003c/p>\n\u003cp>\u003cb>Ericka Cruz Guevarra: \u003c/b>\u003cem>[00:13:07] \u003c/em>Just fear that she doesn’t know that she’ll be able to get access to those medications on the line.\u003c/p>\n\u003cp>\u003cb>Sejal Parekh: \u003c/b>\u003cem>[00:13:12] \u003c/em>Exactly, exactly.\u003cem> \u003c/em>\u003c/p>\n\u003cp>\u003cb>Lisa: \u003c/b>\u003cem>[00:13:16] \u003c/em>Just trying to do the best I can with what I have, knowing what could be coming.\u003c/p>\n\u003cp>\u003cb>Ericka Cruz Guevarra: \u003c/b>\u003cem>[00:13:27] \u003c/em>I mean, how is Contra Costa County responding to all of this? It seems like there’s a lot of anticipation on their end. How are they responding to these changes at the federal level?\u003c/p>\n\u003cp>\u003cb>Sejal Parekh: \u003c/b>\u003cem>[00:13:40] \u003c/em>I think the best way to characterize it right now is that they’re taking these changes seriously. They’re also in a tough spot, because for example, they need a lot more funding for eligibility workers to check everyone’s paperwork every six months, right? And some of that also has to do with the state budget. They have started hiring more eligibility workers. They’re starting to prepare estimates for the hospital of what financial changes are coming up. And I would say the most notable thing they’re doing is there’s a ballot measure coming up in November, measure B, which would be, I think, 5 eighths a cent sales tax on goods sold in Contra Costa County. Theoretically, this money would be specifically for kind of shoring up the health care infrastructure.\u003c/p>\n\u003cp>\u003cb>\u003c/b>\u003cem>[00:14:24] \u003c/em>So, trying to fill in the gaps left by these federal cuts, essentially\u003c/p>\n\u003cp>\u003cb>Sejal Parekh: \u003c/b>\u003cem>[00:14:30] \u003c/em>It could be a stopgap measure, but there’s no way it would replace lost federal dollars.\u003c/p>\n\u003cp>\u003cb>Ericka Cruz Guevarra: \u003c/b>\u003cem>[00:14:36] \u003c/em>I mean, Sejal, I feel like you’re describing so many trickle-down impacts as a result of these federal cuts, this squeeze on the county healthcare system, but also this like very personal everyday impacts to people’s health. Looking ahead as you cover health as a journalist, but also as a doctor yourself, like what is your fear moving forward for? Your patients are just people seeking care who could be impacted by these cuts.\u003c/p>\n\u003cp>\u003cb>Sejal Parekh: \u003c/b>\u003cem>[00:15:09] \u003c/em>My personal fear is that patients in general, people in general don’t get the care they need and their health worsens. For example, for me as a pediatrician, I worry that if one of my patients who loses their health insurance doesn’t come to me for their cold that it turns into an asthma attack and then they need to be hospitalized. Another example for preventative care is mammograms. If there’s breast cancer that’s caught early, there may be an option to have quicker treatment versus if breast cancer spreads, there might not be a surgical option. Patient might have to go through chemo and radiation. I think that changes like this erode trust in the health care system, erode trust that I can just go to the hospital, I’m going to get what I need, I am going to be okay. There’s a lot of calculations people make of, well, am I going to afford my medications this month? Am I going afford rent this month. And so it creates a culture in which there’s so much uncertainty that that itself can also negatively impact people’s health.\u003c/p>\n\u003cp>\u003cb>Ericka Cruz Guevarra: \u003c/b>\u003cem>[00:16:20] \u003c/em>Well, Sejal, thank you so much for sharing your reporting with us and for joining me on the show. I really appreciate it.\u003c/p>\n\u003cp>\u003cb>Sejal Parekh: \u003c/b>\u003cem>[00:16:25] \u003c/em>Thank you so for having me.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\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\n\u003c/div>\u003c/p>",
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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>\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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"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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"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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"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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"title": "Behind Commercial Surrogacy and Its Regulations in California | KQED",
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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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"content": "\u003cp>Gov. Gavin Newsom announced Monday that California is expanding resources to support its first-of-its-kind \u003ca href=\"https://www.kqed.org/news/12007175/care-court-was-supposed-to-help-those-hardest-to-treat-heres-how-its-going\">mental health court program\u003c/a>, but threatened to divert those funds from counties, including multiple in the Bay Area, where implementation is falling behind.\u003c/p>\n\u003cp>Two years after the launch of the CARE Court program, which aims to connect unhoused Californians suffering from psychosis with housing and treatment plans, Newsom’s office awarded an additional $291 million toward housing and behavioral health services. The governor’s office is also adding accountability measures to speed up the adoption of CARE Court programs for counties like San Francisco, where the programs are struggling to connect people to services.\u003c/p>\n\u003cp>“Through CARE Court, we have seen inspirational stories of recovery and resilience, but many counties continue to lag behind their peers,” Newsom said in a statement. “Local leaders have a moral and legal obligation to deliver this transformational tool for those who need it most. We will not accept failure and excuses when lives are on the line.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>In October 2023, counties across the state began rolling out CARE Court programs created by the Community Assistance, Recovery, and Empowerment Act. All 58 counties implemented the programs by the end of 2024. The legislation aims to make it easier for first responders, doctors and family members to petition the court to help people suffering from psychosis due to schizophrenia and other behavioral health challenges.\u003c/p>\n\u003cp>If a case is accepted, a civil court judge presents a voluntary treatment plan, which can include access to housing, mental health counseling, medication and other services. If the person refuses, a judge can compel them into treatment.\u003c/p>\n\u003cp>So far, it’s \u003ca href=\"https://www.kqed.org/news/12073589/californias-care-court-is-falling-short-of-expectations\">failed to keep up with expectations\u003c/a> in some parts of the state. While Newsom’s office predicted CARE could reach \u003ca href=\"https://www.kqed.org/news/12007175/care-court-was-supposed-to-help-those-hardest-to-treat-heres-how-its-going\">7,000 to 12,000 people annually\u003c/a> when it was introduced, only about 3,800 CARE petitions have been submitted to courts. An additional 4,000 cases where people have been considered for CARE have been diverted by connecting them with services without court participation, Newsom’s office said.\u003c/p>\n\u003cfigure id=\"attachment_12047982\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12047982\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/07/230707-ORANGE-COUNTY-CARE-COURT-AD-02-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/07/230707-ORANGE-COUNTY-CARE-COURT-AD-02-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/07/230707-ORANGE-COUNTY-CARE-COURT-AD-02-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/07/230707-ORANGE-COUNTY-CARE-COURT-AD-02-KQED-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Orange County Superior Court will technically house the local CARE Court, though judges say they will more likely hold meetings with patients at a more neutral site, like a conference room at the county health office. \u003ccite>(April Dembosky/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Le Ondra Clark Harvey, the CEO of the advocacy organization California Council of Community Behavioral Health Agencies, said she had “expected more” when the program was initially announced.\u003c/p>\n\u003cp>“I do believe that the trickle [of cases] may represent that there’s not enough thoughtfulness and planning around coordination and tracking,” she told KQED. “We know as providers on the ground that every handoff matters and that people can easily fall through the safety net if that’s not done and crafted very well.”\u003c/p>\n\u003cp>Still, CARE \u003ca href=\"https://www.kqed.org/news/12059464/newsom-expands-care-court-mental-health-law-to-reach-more-californians\">expanded in October\u003c/a> to include people experiencing psychotic symptoms as a result of bipolar disorder. Now, Newsom is throwing additional resources behind the program — and calling out counties, like San Francisco, that are underperforming.\u003c/p>\n\u003cp>Newsom said that his office would direct $131.8 million in Proposition 1 funding to eight Homekey+ affordable housing projects, which provide supportive housing with services for veterans, people who are at-risk or experiencing homelessness, or living with behavioral health challenges.\u003c/p>\n\u003cp>Newsom’s office estimates that the funding will create 443 additional homes across the communities, including in Stockton and Contra Costa County.\u003c/p>\n\u003cp>The other $159 million is in newly awarded Homeless Housing Assistance and Prevention funding, which will go toward 20 regions throughout the state to create permanent housing, sustain interim housing and “accelerate proven local interventions.”[aside postID=news_12073589 hero='https://cdn.kqed.org/wp-content/uploads/sites/10/2026/02/CARECourt_SFChronicle-2000x1333.jpg']Among those counties is Alameda, which Newsom called a “shining example” of CARE implementation. The county has one of the highest rates of petitions submitted per capita, and has seen an 11% drop in unsheltered homelessness since 2023.\u003c/p>\n\u003cp>San Francisco and Santa Clara counties, by contrast, are among 10 that have struggled to implement CARE programs. Both had fewer than 100 petitions in 2025, according to a new state dashboard, and San Francisco has seen a significantly lower percentage decrease in unsheltered homelessness than the state average since 2023.\u003c/p>\n\u003cp>“There are counties that haven’t gotten it done, like Santa Clara County,” Newsom said. “We’re calling [San Francisco] out as well.”\u003c/p>\n\u003cp>“They’re the care court ICU,” Newsom said, referring to the term his office has coined for the 10 “bottom” counties in terms of implementation.\u003c/p>\n\u003cp>Santa Clara recorded just 47 CARE petitions in 2025, equaling a rate of about two petitions per 100,000 residents, compared to the state’s six. New state data tracking counties’ progress on reducing unsheltered homelessness says that the county does not have publicly available data. But last year’s point-in-time count in its most populous city, San José — where Mayor Matt Mahan has also cracked down on street homelessness and encampments — reported a 10% drop between 2023 and 2025.\u003c/p>\n\u003cp>“Long before the creation of CARE Court, the County of Santa Clara has been at the forefront of innovative strategies to address the behavioral health crisis facing California,” Santa Clara County Executive James Williams said in a statement. “Our approach is grounded in what works: rapidly connecting people to clinically appropriate treatment and housing, rather than defaulting to lengthy, costly, and often inadequate court-based processes that do not produce better outcomes.”\u003c/p>\n\u003cp>Williams called the CARE program “one tool among many. He said via email that counties need sustained funding and partnership, not “reducing a complex system to a single scorecard.”\u003c/p>\n\u003cp>In a statement, San Francisco Mayor Daniel Lurie’s office, which has been focused on the homelessness crisis since taking office in 2024, said it “has been using every tool in our toolbox to address the crisis on our streets — reimagining street outreach and adding recovery and treatment resources so we can get people off the street and connected to the support they need.”\u003c/p>\n\u003cp>“Today, encampments are at record lows, more people are getting connected to shelter and treatment, and San Franciscans feel safer than they have in years,” a spokesperson for the office said in a statement.\u003c/p>\n\u003cfigure id=\"attachment_12070970\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12070970\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/01/260123-SIGNATUREKICKOFF00606_TV-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/01/260123-SIGNATUREKICKOFF00606_TV-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/01/260123-SIGNATUREKICKOFF00606_TV-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/01/260123-SIGNATUREKICKOFF00606_TV-KQED-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Mayor Daniel Lurie speaks on his support for California Senate Bill 63 at a press conference at Embarcadero Plaza in San Francisco on Jan. 23, 2026. \u003ccite>(Tâm Vũ/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>But \u003ca href=\"https://www.accountability.ca.gov/county/san-francisco/housing/\">state data shows\u003c/a> that the city has seen just a 1% decline in unsheltered homelessness since 2023, compared to California’s 9% drop. Fifty CARE petitions were filed in 2025. As of last September, about two-thirds of submitted petitions were dismissed, according to an \u003ca href=\"https://calmatters.org/health/mental-health/2025/09/care-court-2025-data/\">investigation by \u003cem>CalMatters\u003c/em>\u003c/a>.\u003c/p>\n\u003cp>The state dashboard notes that the city has increased its number of beds available for unhoused residents by nearly 10% since 2024.\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400;\">Clark Harvey said flagging the counties that are performing both well and poorly is important to identify what is and isn’t working, and help bring struggling counties up to speed.\u003c/span>\u003c/p>\n\u003cp>“It’s really now time to drill down and say, ‘Why aren’t things working well for these 10 counties? What can we do to support them? And what can we do to ensure that people aren’t cycling back through the system?’” she said.[aside postID=news_12074462 hero='https://cdn.kqed.org/wp-content/uploads/sites/10/2026/02/022426_ALAMEDA-COUNTY-HEALTH-CUTS-_GH_003-KQED.jpg']\u003cspan style=\"font-weight: 400;\">But Monica Porter Gilbert with the advocacy group Disability Rights California said she was concerned about how the governor’s office is measuring a county’s performance on its new accountability dashboard.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400;\"> “We’re not seeing a ton of rigor in how the governor is defining performance or underperformance,” she told KQED. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400;\">She said she was concerned about the number of petitions a county receives being considered a marker of success. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400;\">“What CARE Court does is it orders people into services without increasing access to them,” she told KQED. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400;\">She said that the program’s first annual report found that more than half of CARE participants were unable to receive at least one mental health service that was part of their treatment plan, such as peer support, medication or therapy. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400;\">The report cited administrative delays like pending applications for services, or a lack of availability of some services in some counties, as well as coordination mishaps that led to these issues.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400;\">“The California Legislature did some analysis this past summer and found CARE Court to be — and this is a quote from them — a very expensive way to coordinate but not directly provide important services,” Gilbert said.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400;\">Despite awarding San Francisco \u003c/span>\u003ca href=\"https://www.kqed.org/news/12070144/lurie-newsom-tout-millions-in-homelessness-funding-for-san-francisco-amid-budget-blows\">\u003cspan style=\"font-weight: 400;\">nearly $40 million\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400;\"> in HHAP funding in January, the governor suggested that money could be diverted from those counties in his May budget revision if they don’t improve implementation.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400;\">“I’m happy to direct every damn penny in these programs to the counties that are getting things done,” Newsom said. “I’m not interested in funding failure.”\u003c/span>\u003c/p>\n\u003cp>\u003ci>\u003cspan style=\"font-weight: 400;\">KQED’s \u003c/span>\u003c/i>\u003ca href=\"https://www.kqed.org/author/vrancano\">\u003ci>\u003cspan style=\"font-weight: 400;\">Vanessa Rancaño\u003c/span>\u003c/i>\u003c/a>\u003ci>\u003cspan style=\"font-weight: 400;\"> contributed to this report. \u003c/span>\u003c/i>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Gov. Gavin Newsom announced Monday that California is expanding resources to support its first-of-its-kind \u003ca href=\"https://www.kqed.org/news/12007175/care-court-was-supposed-to-help-those-hardest-to-treat-heres-how-its-going\">mental health court program\u003c/a>, but threatened to divert those funds from counties, including multiple in the Bay Area, where implementation is falling behind.\u003c/p>\n\u003cp>Two years after the launch of the CARE Court program, which aims to connect unhoused Californians suffering from psychosis with housing and treatment plans, Newsom’s office awarded an additional $291 million toward housing and behavioral health services. The governor’s office is also adding accountability measures to speed up the adoption of CARE Court programs for counties like San Francisco, where the programs are struggling to connect people to services.\u003c/p>\n\u003cp>“Through CARE Court, we have seen inspirational stories of recovery and resilience, but many counties continue to lag behind their peers,” Newsom said in a statement. “Local leaders have a moral and legal obligation to deliver this transformational tool for those who need it most. We will not accept failure and excuses when lives are on the line.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>In October 2023, counties across the state began rolling out CARE Court programs created by the Community Assistance, Recovery, and Empowerment Act. All 58 counties implemented the programs by the end of 2024. The legislation aims to make it easier for first responders, doctors and family members to petition the court to help people suffering from psychosis due to schizophrenia and other behavioral health challenges.\u003c/p>\n\u003cp>If a case is accepted, a civil court judge presents a voluntary treatment plan, which can include access to housing, mental health counseling, medication and other services. If the person refuses, a judge can compel them into treatment.\u003c/p>\n\u003cp>So far, it’s \u003ca href=\"https://www.kqed.org/news/12073589/californias-care-court-is-falling-short-of-expectations\">failed to keep up with expectations\u003c/a> in some parts of the state. While Newsom’s office predicted CARE could reach \u003ca href=\"https://www.kqed.org/news/12007175/care-court-was-supposed-to-help-those-hardest-to-treat-heres-how-its-going\">7,000 to 12,000 people annually\u003c/a> when it was introduced, only about 3,800 CARE petitions have been submitted to courts. An additional 4,000 cases where people have been considered for CARE have been diverted by connecting them with services without court participation, Newsom’s office said.\u003c/p>\n\u003cfigure id=\"attachment_12047982\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12047982\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/07/230707-ORANGE-COUNTY-CARE-COURT-AD-02-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2025/07/230707-ORANGE-COUNTY-CARE-COURT-AD-02-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/07/230707-ORANGE-COUNTY-CARE-COURT-AD-02-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2025/07/230707-ORANGE-COUNTY-CARE-COURT-AD-02-KQED-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Orange County Superior Court will technically house the local CARE Court, though judges say they will more likely hold meetings with patients at a more neutral site, like a conference room at the county health office. \u003ccite>(April Dembosky/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Le Ondra Clark Harvey, the CEO of the advocacy organization California Council of Community Behavioral Health Agencies, said she had “expected more” when the program was initially announced.\u003c/p>\n\u003cp>“I do believe that the trickle [of cases] may represent that there’s not enough thoughtfulness and planning around coordination and tracking,” she told KQED. “We know as providers on the ground that every handoff matters and that people can easily fall through the safety net if that’s not done and crafted very well.”\u003c/p>\n\u003cp>Still, CARE \u003ca href=\"https://www.kqed.org/news/12059464/newsom-expands-care-court-mental-health-law-to-reach-more-californians\">expanded in October\u003c/a> to include people experiencing psychotic symptoms as a result of bipolar disorder. Now, Newsom is throwing additional resources behind the program — and calling out counties, like San Francisco, that are underperforming.\u003c/p>\n\u003cp>Newsom said that his office would direct $131.8 million in Proposition 1 funding to eight Homekey+ affordable housing projects, which provide supportive housing with services for veterans, people who are at-risk or experiencing homelessness, or living with behavioral health challenges.\u003c/p>\n\u003cp>Newsom’s office estimates that the funding will create 443 additional homes across the communities, including in Stockton and Contra Costa County.\u003c/p>\n\u003cp>The other $159 million is in newly awarded Homeless Housing Assistance and Prevention funding, which will go toward 20 regions throughout the state to create permanent housing, sustain interim housing and “accelerate proven local interventions.”\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Among those counties is Alameda, which Newsom called a “shining example” of CARE implementation. The county has one of the highest rates of petitions submitted per capita, and has seen an 11% drop in unsheltered homelessness since 2023.\u003c/p>\n\u003cp>San Francisco and Santa Clara counties, by contrast, are among 10 that have struggled to implement CARE programs. Both had fewer than 100 petitions in 2025, according to a new state dashboard, and San Francisco has seen a significantly lower percentage decrease in unsheltered homelessness than the state average since 2023.\u003c/p>\n\u003cp>“There are counties that haven’t gotten it done, like Santa Clara County,” Newsom said. “We’re calling [San Francisco] out as well.”\u003c/p>\n\u003cp>“They’re the care court ICU,” Newsom said, referring to the term his office has coined for the 10 “bottom” counties in terms of implementation.\u003c/p>\n\u003cp>Santa Clara recorded just 47 CARE petitions in 2025, equaling a rate of about two petitions per 100,000 residents, compared to the state’s six. New state data tracking counties’ progress on reducing unsheltered homelessness says that the county does not have publicly available data. But last year’s point-in-time count in its most populous city, San José — where Mayor Matt Mahan has also cracked down on street homelessness and encampments — reported a 10% drop between 2023 and 2025.\u003c/p>\n\u003cp>“Long before the creation of CARE Court, the County of Santa Clara has been at the forefront of innovative strategies to address the behavioral health crisis facing California,” Santa Clara County Executive James Williams said in a statement. “Our approach is grounded in what works: rapidly connecting people to clinically appropriate treatment and housing, rather than defaulting to lengthy, costly, and often inadequate court-based processes that do not produce better outcomes.”\u003c/p>\n\u003cp>Williams called the CARE program “one tool among many. He said via email that counties need sustained funding and partnership, not “reducing a complex system to a single scorecard.”\u003c/p>\n\u003cp>In a statement, San Francisco Mayor Daniel Lurie’s office, which has been focused on the homelessness crisis since taking office in 2024, said it “has been using every tool in our toolbox to address the crisis on our streets — reimagining street outreach and adding recovery and treatment resources so we can get people off the street and connected to the support they need.”\u003c/p>\n\u003cp>“Today, encampments are at record lows, more people are getting connected to shelter and treatment, and San Franciscans feel safer than they have in years,” a spokesperson for the office said in a statement.\u003c/p>\n\u003cfigure id=\"attachment_12070970\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12070970\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/01/260123-SIGNATUREKICKOFF00606_TV-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/01/260123-SIGNATUREKICKOFF00606_TV-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/01/260123-SIGNATUREKICKOFF00606_TV-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/01/260123-SIGNATUREKICKOFF00606_TV-KQED-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Mayor Daniel Lurie speaks on his support for California Senate Bill 63 at a press conference at Embarcadero Plaza in San Francisco on Jan. 23, 2026. \u003ccite>(Tâm Vũ/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>But \u003ca href=\"https://www.accountability.ca.gov/county/san-francisco/housing/\">state data shows\u003c/a> that the city has seen just a 1% decline in unsheltered homelessness since 2023, compared to California’s 9% drop. Fifty CARE petitions were filed in 2025. As of last September, about two-thirds of submitted petitions were dismissed, according to an \u003ca href=\"https://calmatters.org/health/mental-health/2025/09/care-court-2025-data/\">investigation by \u003cem>CalMatters\u003c/em>\u003c/a>.\u003c/p>\n\u003cp>The state dashboard notes that the city has increased its number of beds available for unhoused residents by nearly 10% since 2024.\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400;\">Clark Harvey said flagging the counties that are performing both well and poorly is important to identify what is and isn’t working, and help bring struggling counties up to speed.\u003c/span>\u003c/p>\n\u003cp>“It’s really now time to drill down and say, ‘Why aren’t things working well for these 10 counties? What can we do to support them? And what can we do to ensure that people aren’t cycling back through the system?’” she said.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cspan style=\"font-weight: 400;\">But Monica Porter Gilbert with the advocacy group Disability Rights California said she was concerned about how the governor’s office is measuring a county’s performance on its new accountability dashboard.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400;\"> “We’re not seeing a ton of rigor in how the governor is defining performance or underperformance,” she told KQED. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400;\">She said she was concerned about the number of petitions a county receives being considered a marker of success. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400;\">“What CARE Court does is it orders people into services without increasing access to them,” she told KQED. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400;\">She said that the program’s first annual report found that more than half of CARE participants were unable to receive at least one mental health service that was part of their treatment plan, such as peer support, medication or therapy. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400;\">The report cited administrative delays like pending applications for services, or a lack of availability of some services in some counties, as well as coordination mishaps that led to these issues.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400;\">“The California Legislature did some analysis this past summer and found CARE Court to be — and this is a quote from them — a very expensive way to coordinate but not directly provide important services,” Gilbert said.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400;\">Despite awarding San Francisco \u003c/span>\u003ca href=\"https://www.kqed.org/news/12070144/lurie-newsom-tout-millions-in-homelessness-funding-for-san-francisco-amid-budget-blows\">\u003cspan style=\"font-weight: 400;\">nearly $40 million\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400;\"> in HHAP funding in January, the governor suggested that money could be diverted from those counties in his May budget revision if they don’t improve implementation.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400;\">“I’m happy to direct every damn penny in these programs to the counties that are getting things done,” Newsom said. “I’m not interested in funding failure.”\u003c/span>\u003c/p>\n\u003cp>\u003ci>\u003cspan style=\"font-weight: 400;\">KQED’s \u003c/span>\u003c/i>\u003ca href=\"https://www.kqed.org/author/vrancano\">\u003ci>\u003cspan style=\"font-weight: 400;\">Vanessa Rancaño\u003c/span>\u003c/i>\u003c/a>\u003ci>\u003cspan style=\"font-weight: 400;\"> contributed to this report. \u003c/span>\u003c/i>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>\u003ca href=\"https://www.kqed.org/news/tag/alameda-county\">Alameda County\u003c/a> leaders are sounding cautiously optimistic about stopping mass layoffs at the East Bay’s public safety-net hospital system ahead of a hearing on the layoff plan on Wednesday.\u003c/p>\n\u003cp>The \u003ca href=\"https://www.alamedahealthsystem.org/service-reductions/\">latest proposal\u003c/a> from Alameda Health System would cut 187 positions, down from earlier plans for close to 300, as executives brace for \u003ca href=\"https://www.kqed.org/science/1997707/how-will-trumps-mega-bill-impact-health-care-in-california\">major reductions in Medicaid revenue\u003c/a> because of HR 1 — the so-called “Big Beautiful Bill” signed into law by President Donald Trump last year.\u003c/p>\n\u003cp>The 187 full-time-equivalent positions equate to 211 individuals, AHS said, some of them working part-time. Those 211 employees have already received layoff notices with a March 9 separation date, though that could change. The cuts would affect nurses, therapists, food workers and administrative assistants, among others, and would eliminate some programs completely, including two that provide outpatient behavioral health services.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>At a rally outside Wilma Chan Highland Hospital Campus in Oakland on Tuesday, Alameda County Supervisor Nate Miley urged health care workers to weigh in \u003ca href=\"https://alamedacounty.granicus.com/AgendaViewer.php?view_id=2&event_id=7805\">at the hearing\u003c/a>.\u003c/p>\n\u003cp>“Speak your mind, let us know how these reductions in force, the reduction in labor, is going to impact safety net services so that the Board of Supervisors can come to the rescue,” he said.\u003c/p>\n\u003cp>The layoff plans come as AHS expects to lose over $100 million a year by 2030 as a result of HR 1 and its Medicaid cuts, a spokesperson \u003ca href=\"https://www.kqed.org/news/12068383/alameda-health-system-to-lay-off-hundreds-in-january-after-massive-federal-cuts\">previously told KQED\u003c/a>. Medicaid payments make up about 60% of the health system’s revenue.\u003c/p>\n\u003cfigure id=\"attachment_12074475\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12074475\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/02/022426_ALAMEDA-COUNTY-HEALTH-CUTS-_GH_015-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/02/022426_ALAMEDA-COUNTY-HEALTH-CUTS-_GH_015-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/02/022426_ALAMEDA-COUNTY-HEALTH-CUTS-_GH_015-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/02/022426_ALAMEDA-COUNTY-HEALTH-CUTS-_GH_015-KQED-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Alameda County Supervisor Nate Miley, who represents District 4, speaks during a resident physician “unity break” outside Highland Hospital in Oakland on Feb. 24, 2026. \u003ccite>(Gustavo Hernandez/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Miley, who leads the Board of Supervisors’ health committee, said he met with AHS leaders last week and sees a path for the county to come up with funding to suspend the layoffs — at least in the short term.\u003c/p>\n\u003cp>The current estimate, he said, is that AHS needs between $44 million and $52 million to hold back layoffs for a year. AHS officials confirmed that they are in conversations with the county “about ways they can help us, given the extensive funding cuts we’re facing,” but wouldn’t confirm the figures Miley provided, saying it was “premature.”\u003c/p>\n\u003cp>“My hope is the county is going to be able to kick in at least the initial $11 [million] to $13 million so that we can suspend the layoffs for a period of time,” Miley said.[aside postID=news_12072837 hero='https://cdn.kqed.org/wp-content/uploads/sites/10/2026/02/020926_KAISERSTRIKE_8137B-KQED.jpg']He aims to create a working group made up of labor leaders, county staff, supervisors and Alameda Health System administrators and trustees to develop a more long-term plan.\u003c/p>\n\u003cp>Miley suggested that revenue from \u003ca href=\"https://www.acgov.org/board/bos_calendar/documents/MeasureWAllocationPresentation.pdf\">Measures W\u003c/a> \u003ca href=\"https://budget.alamedacountyca.gov/Content/pdf/FY24-25/FY2024-25ProposedBudget-7_10_24.pdf?utm_source=chatgpt.com\">and A\u003c/a> — sales taxes approved by voters to raise money for medical and essential services, among other things — could help offset some of the cuts.\u003c/p>\n\u003cp>He also floated the idea of the county easing up, at least temporarily, on repayment of what’s known as the “net negative balance,” essentially a county line of credit that Alameda Health System uses to cover expenses when bills come due before large state or federal reimbursements arrive.\u003c/p>\n\u003cp>“There are avenues we can pursue,” he said, noting that cuts to non-safety-net services might be left standing. “There might be some things that are good to have but are not necessary.”\u003c/p>\n\u003cp>Supervisor Nikki Fortunato Bas agreed that the county can likely stanch the bleeding in the near term, but she emphasized that the real solutions are systemic: “It’s about single payer. It’s about making sure that we close the loophole in Prop. 13 and really address how resources and wealth are distributed in our country, as well as our state and our communities.”\u003c/p>\n\u003cfigure id=\"attachment_12074473\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12074473\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/02/022426_ALAMEDA-COUNTY-HEALTH-CUTS-_GH_007-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/02/022426_ALAMEDA-COUNTY-HEALTH-CUTS-_GH_007-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/02/022426_ALAMEDA-COUNTY-HEALTH-CUTS-_GH_007-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/02/022426_ALAMEDA-COUNTY-HEALTH-CUTS-_GH_007-KQED-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Nikki Fortunato Bas, a member of the Alameda County Board of Supervisors, speaks during a resident physician “unity break” outside Highland Hospital in Oakland on Feb. 24, 2026. Physicians cited layoffs, staffing shortages and contract negotiations with Alameda Health System. \u003ccite>(Gustavo Hernandez/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>In the meantime, she said she would seek to hold AHS accountable for doing everything possible to raise revenue and ensure officials there are “very clear and thoughtful about what they’re looking at, and that they’re actually talking in good faith with our labor partners to make sure that we’re addressing all the potential impacts.”\u003c/p>\n\u003cp>Some AHS employees and their unions have criticized system executives for acting rashly.\u003c/p>\n\u003cp>“These layoffs are anticipatory,” said Dr. Elijah Lustig, a resident physician at Highland Hospital and union leader with the Committee of Interns and Residents, part of Service Employees International Union.\u003c/p>\n\u003cp>“They’re not talking to our department heads before instituting cuts or proposing layoffs,” he said of the process. “The people who are deciding who gets fired, frankly, do not have a good grasp on how this hospital runs, on what services are crucial, on what services are impacted.”\u003c/p>\n\u003cfigure id=\"attachment_12074474\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12074474\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/02/022426_ALAMEDA-COUNTY-HEALTH-CUTS-_GH_010-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/02/022426_ALAMEDA-COUNTY-HEALTH-CUTS-_GH_010-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/02/022426_ALAMEDA-COUNTY-HEALTH-CUTS-_GH_010-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/02/022426_ALAMEDA-COUNTY-HEALTH-CUTS-_GH_010-KQED-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">The Wilma Chan Highland Hospital Campus is seen through flowering branches in Oakland on Feb. 24, 2026. The hospital is part of Alameda Health System. \u003ccite>(Gustavo Hernandez/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>In a statement, AHS said it “must take a proactive approach” to reducing costs. “We do not approach this painful decision lightly,” it said. “However, AHS reasonably predicts that it will run out of funds within six months, by August of 2026, if it does not act now.”\u003c/p>\n\u003cp>Wednesday’s hearing is required by law to give the public an opportunity to comment on the proposed cuts to health care services. Supervisors won’t take any action there, but Miley said he hopes the board will reach a decision on allocating funding to prevent layoffs as soon as March 3.\u003c/p>\n\u003cp>The hearing takes place at 3 p.m. at the Alameda County Administration Building, Board of Supervisors’ Chambers, Fifth Floor, Room 512, 1221 Oak St.\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003ca href=\"https://www.kqed.org/news/tag/alameda-county\">Alameda County\u003c/a> leaders are sounding cautiously optimistic about stopping mass layoffs at the East Bay’s public safety-net hospital system ahead of a hearing on the layoff plan on Wednesday.\u003c/p>\n\u003cp>The \u003ca href=\"https://www.alamedahealthsystem.org/service-reductions/\">latest proposal\u003c/a> from Alameda Health System would cut 187 positions, down from earlier plans for close to 300, as executives brace for \u003ca href=\"https://www.kqed.org/science/1997707/how-will-trumps-mega-bill-impact-health-care-in-california\">major reductions in Medicaid revenue\u003c/a> because of HR 1 — the so-called “Big Beautiful Bill” signed into law by President Donald Trump last year.\u003c/p>\n\u003cp>The 187 full-time-equivalent positions equate to 211 individuals, AHS said, some of them working part-time. Those 211 employees have already received layoff notices with a March 9 separation date, though that could change. The cuts would affect nurses, therapists, food workers and administrative assistants, among others, and would eliminate some programs completely, including two that provide outpatient behavioral health services.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>At a rally outside Wilma Chan Highland Hospital Campus in Oakland on Tuesday, Alameda County Supervisor Nate Miley urged health care workers to weigh in \u003ca href=\"https://alamedacounty.granicus.com/AgendaViewer.php?view_id=2&event_id=7805\">at the hearing\u003c/a>.\u003c/p>\n\u003cp>“Speak your mind, let us know how these reductions in force, the reduction in labor, is going to impact safety net services so that the Board of Supervisors can come to the rescue,” he said.\u003c/p>\n\u003cp>The layoff plans come as AHS expects to lose over $100 million a year by 2030 as a result of HR 1 and its Medicaid cuts, a spokesperson \u003ca href=\"https://www.kqed.org/news/12068383/alameda-health-system-to-lay-off-hundreds-in-january-after-massive-federal-cuts\">previously told KQED\u003c/a>. Medicaid payments make up about 60% of the health system’s revenue.\u003c/p>\n\u003cfigure id=\"attachment_12074475\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12074475\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/02/022426_ALAMEDA-COUNTY-HEALTH-CUTS-_GH_015-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/02/022426_ALAMEDA-COUNTY-HEALTH-CUTS-_GH_015-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/02/022426_ALAMEDA-COUNTY-HEALTH-CUTS-_GH_015-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/02/022426_ALAMEDA-COUNTY-HEALTH-CUTS-_GH_015-KQED-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Alameda County Supervisor Nate Miley, who represents District 4, speaks during a resident physician “unity break” outside Highland Hospital in Oakland on Feb. 24, 2026. \u003ccite>(Gustavo Hernandez/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Miley, who leads the Board of Supervisors’ health committee, said he met with AHS leaders last week and sees a path for the county to come up with funding to suspend the layoffs — at least in the short term.\u003c/p>\n\u003cp>The current estimate, he said, is that AHS needs between $44 million and $52 million to hold back layoffs for a year. AHS officials confirmed that they are in conversations with the county “about ways they can help us, given the extensive funding cuts we’re facing,” but wouldn’t confirm the figures Miley provided, saying it was “premature.”\u003c/p>\n\u003cp>“My hope is the county is going to be able to kick in at least the initial $11 [million] to $13 million so that we can suspend the layoffs for a period of time,” Miley said.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>He aims to create a working group made up of labor leaders, county staff, supervisors and Alameda Health System administrators and trustees to develop a more long-term plan.\u003c/p>\n\u003cp>Miley suggested that revenue from \u003ca href=\"https://www.acgov.org/board/bos_calendar/documents/MeasureWAllocationPresentation.pdf\">Measures W\u003c/a> \u003ca href=\"https://budget.alamedacountyca.gov/Content/pdf/FY24-25/FY2024-25ProposedBudget-7_10_24.pdf?utm_source=chatgpt.com\">and A\u003c/a> — sales taxes approved by voters to raise money for medical and essential services, among other things — could help offset some of the cuts.\u003c/p>\n\u003cp>He also floated the idea of the county easing up, at least temporarily, on repayment of what’s known as the “net negative balance,” essentially a county line of credit that Alameda Health System uses to cover expenses when bills come due before large state or federal reimbursements arrive.\u003c/p>\n\u003cp>“There are avenues we can pursue,” he said, noting that cuts to non-safety-net services might be left standing. “There might be some things that are good to have but are not necessary.”\u003c/p>\n\u003cp>Supervisor Nikki Fortunato Bas agreed that the county can likely stanch the bleeding in the near term, but she emphasized that the real solutions are systemic: “It’s about single payer. It’s about making sure that we close the loophole in Prop. 13 and really address how resources and wealth are distributed in our country, as well as our state and our communities.”\u003c/p>\n\u003cfigure id=\"attachment_12074473\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12074473\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/02/022426_ALAMEDA-COUNTY-HEALTH-CUTS-_GH_007-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/02/022426_ALAMEDA-COUNTY-HEALTH-CUTS-_GH_007-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/02/022426_ALAMEDA-COUNTY-HEALTH-CUTS-_GH_007-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/02/022426_ALAMEDA-COUNTY-HEALTH-CUTS-_GH_007-KQED-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Nikki Fortunato Bas, a member of the Alameda County Board of Supervisors, speaks during a resident physician “unity break” outside Highland Hospital in Oakland on Feb. 24, 2026. Physicians cited layoffs, staffing shortages and contract negotiations with Alameda Health System. \u003ccite>(Gustavo Hernandez/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>In the meantime, she said she would seek to hold AHS accountable for doing everything possible to raise revenue and ensure officials there are “very clear and thoughtful about what they’re looking at, and that they’re actually talking in good faith with our labor partners to make sure that we’re addressing all the potential impacts.”\u003c/p>\n\u003cp>Some AHS employees and their unions have criticized system executives for acting rashly.\u003c/p>\n\u003cp>“These layoffs are anticipatory,” said Dr. Elijah Lustig, a resident physician at Highland Hospital and union leader with the Committee of Interns and Residents, part of Service Employees International Union.\u003c/p>\n\u003cp>“They’re not talking to our department heads before instituting cuts or proposing layoffs,” he said of the process. “The people who are deciding who gets fired, frankly, do not have a good grasp on how this hospital runs, on what services are crucial, on what services are impacted.”\u003c/p>\n\u003cfigure id=\"attachment_12074474\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12074474\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/02/022426_ALAMEDA-COUNTY-HEALTH-CUTS-_GH_010-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/02/022426_ALAMEDA-COUNTY-HEALTH-CUTS-_GH_010-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/02/022426_ALAMEDA-COUNTY-HEALTH-CUTS-_GH_010-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/02/022426_ALAMEDA-COUNTY-HEALTH-CUTS-_GH_010-KQED-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">The Wilma Chan Highland Hospital Campus is seen through flowering branches in Oakland on Feb. 24, 2026. The hospital is part of Alameda Health System. \u003ccite>(Gustavo Hernandez/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>In a statement, AHS said it “must take a proactive approach” to reducing costs. “We do not approach this painful decision lightly,” it said. “However, AHS reasonably predicts that it will run out of funds within six months, by August of 2026, if it does not act now.”\u003c/p>\n\u003cp>Wednesday’s hearing is required by law to give the public an opportunity to comment on the proposed cuts to health care services. Supervisors won’t take any action there, but Miley said he hopes the board will reach a decision on allocating funding to prevent layoffs as soon as March 3.\u003c/p>\n\u003cp>The hearing takes place at 3 p.m. at the Alameda County Administration Building, Board of Supervisors’ Chambers, Fifth Floor, Room 512, 1221 Oak St.\u003c/p>\n\u003cp>\u003c/p>\n\u003c/div>\u003c/p>",
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"title": "Widespread Kaiser Strike Ends After 4 Weeks With No Full Deal Yet",
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"content": "\u003cp>A four-week strike by thousands of \u003ca href=\"https://www.kqed.org/news/tag/kaiser-permanente\">Kaiser Permanente\u003c/a> health care workers in California and Hawaii ended Tuesday morning, even though no full contract deal has been reached.\u003c/p>\n\u003cp>The walkout \u003ca href=\"https://www.kqed.org/news/12071014/kaiser-strike-sees-thousands-walk-out-in-california-this-time-with-no-end-in-sight\">initially involved\u003c/a> up to 31,000 nurses, physician assistants, physical therapists, optometrists and others. Following significant movement at the bargaining table over the weekend, according to the union, no picket lines were held Monday as return-to-work agreements were finalized.\u003c/p>\n\u003cp>“We decided to end this because we were making meaningful progress at the tables. And returning to work allows us to closely deal with the issues, the few that are still outstanding, while getting back to taking care of our patients,” said Elizabeth Hawkins, secretary of the United Nurses Associations of California/Union of Health Care Professionals.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Nurses and other health care workers who walked picket lines several days a week are now expected to return to clinics and hospitals as early as Tuesday.\u003c/p>\n\u003cp>In a statement, Kaiser, which hired contingency staffers during the strike, said it was working to schedule returning employees over the coming days.\u003c/p>\n\u003cp>The Oakland-based health care organization said union leadership recently accepted an across-the-board 21.5% wage increase over four years that Kaiser had offered since October 2025. The union sought a 25% raise.\u003c/p>\n\u003cfigure id=\"attachment_12073903\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12073903\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/02/260219-STRIKINGKAISERWORKERS00368_TV-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1334\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/02/260219-STRIKINGKAISERWORKERS00368_TV-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/02/260219-STRIKINGKAISERWORKERS00368_TV-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/02/260219-STRIKINGKAISERWORKERS00368_TV-KQED-1536x1025.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Workers on strike at the picket line outside Kaiser Permanente Oakland Medical Center in Oakland on Feb. 19, 2026. Kaiser workers on the picket lines have gone without their paychecks for four weeks, and many are facing financial and other difficulties. \u003ccite>(Tâm Vũ/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“We have remained committed to reaching agreements that recognize the vital contributions of our employees while ensuring excellent, affordable care for our members,” Kaiser’s statement said. “Importantly, the increase is higher than any other health care provider in the country and keeps our employees at above market pay and among the best paid caregivers in the country.”\u003c/p>\n\u003cp>As the strike dragged on, the nation’s largest private nonprofit health care organization drew a hard line, maintaining that anything higher than a 21.5% raise would be unsustainable and lead it to increase premiums for its more than 9 million customers in California. The union said it acquiesced on wages because Kaiser agreed to additional improvements in safe staffing, recruitment and retention.\u003c/p>\n\u003cp>Both parties have been focused on completing contracts for each of dozens of local units forming UNAC/UHCP, Hawkins said. Kaiser walked away from bargaining on a long-standing national contract in December, a move the union calls unlawful and said partly led to the strike.\u003c/p>\n\u003cp>Pressure had been mounting on both parties to end the walkout, which began Jan. 26 and was dubbed the largest open-ended strike by nurses and other health care workers in the U.S. Top priorities in negotiations for Kaiser employees have been staffing levels and compensation, common concerns for health care workers nationwide.[aside postID=news_12073887 hero='https://cdn.kqed.org/wp-content/uploads/sites/10/2026/02/260219-STRIKINGKAISERWORKERS01224_TV-KQED.jpg']The company reassigned non-picketing staffers, rescheduled non-urgent surgeries and modified other appointments at affected locations. But some patients were frustrated by \u003ca href=\"https://www.kqed.org/news/12072837/kaiser-strike-delays-surgeries-disrupts-care-as-more-workers-walk-off-jobs\">delays\u003c/a> in their operations, especially in Southern California, where most striking union members are located.\u003c/p>\n\u003cp>At the picket lines, several workers told KQED they were \u003ca href=\"https://www.kqed.org/news/12073887/californias-striking-kaiser-workers-without-pay-for-weeks-feel-the-financial-pressure\">financially and emotionally stressed\u003c/a> by forgoing their paychecks for weeks, as the union did not offer assistance via a strike fund.\u003c/p>\n\u003cp>Last week, Kaiser said about 40% of nurses and pharmacists across striking locations had returned to their jobs, though union officials countered that those figures were inflated.\u003c/p>\n\u003cp>“While they will keep negotiating, they are losing leverage by going back to work, which suggests that they didn’t feel they had the capacity to sustain the strike any longer,” said Rebecca Givan, an associate professor of labor studies and employment relations at Rutgers University who specializes in the health care industry. “This is a tough outcome for these workers.”\u003c/p>\n\u003cp>Givan contrasted the outcome in California and Hawaii with a weeks-long strike by about 15,000 nurses in New York City, which led to significant employer concessions, including maintenance of health care benefits and improvements to pay and staffing, before workers agreed to return to their jobs.\u003c/p>\n\u003cp>Michelle Baird, a nurse midwife at Kaiser Oakland, said she would have preferred to end the strike with a contract deal in hand, but she’s cautiously optimistic about what’s left of the bargaining progress.\u003c/p>\n\u003cfigure id=\"attachment_12073902\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12073902\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/02/260219-STRIKINGKAISERWORKERS00295_TV-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1334\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/02/260219-STRIKINGKAISERWORKERS00295_TV-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/02/260219-STRIKINGKAISERWORKERS00295_TV-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/02/260219-STRIKINGKAISERWORKERS00295_TV-KQED-1536x1025.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Michelle Baird, a nurse midwife from Kaiser Oakland, poses for a portrait while on strike at the picket line outside Kaiser Permanente Oakland Medical Center in Oakland on Feb. 19, 2026. \u003ccite>(Tâm Vũ/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“Kaiser really saw how united we were and how strong we were, and even though we don’t have a contract in place now, I believe that my employer is negotiating in good faith and has been at the bargaining table,” said Baird, 53. ”I’m definitely feeling more like there’s a good chance of getting the things that we need in a contract, even if we don’t get everything we want.”\u003c/p>\n\u003cp>Baird said she was looking forward to seeing patients and regaining her income. She’s nervous about the strain that the long strike could have on her relationships with co-workers who pitched in more hours to continue caring for patients. Still, she feels the strike will likely lead to improvements for patients.\u003c/p>\n\u003cp>“Even with the disruptions in patient care, if we have a solid contract, we’ll have much more staff continuity. We’ll have people who are dedicated to being there, it will decrease the risks of turnover. And I think in the long run, it’s better for patients,” she said.\u003c/p>\n\u003cfigure id=\"attachment_12073905\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12073905\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/02/260219-STRIKINGKAISERWORKERS01145_TV-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1334\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/02/260219-STRIKINGKAISERWORKERS01145_TV-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/02/260219-STRIKINGKAISERWORKERS01145_TV-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/02/260219-STRIKINGKAISERWORKERS01145_TV-KQED-1536x1025.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Workers on strike at the picket line outside Kaiser Permanente Oakland Medical Center in Oakland on Feb. 19, 2026. \u003ccite>(Tâm Vũ/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Hawkins, the UNAC/UHCP secretary, said the union had not held a walkout at Kaiser for about 45 years prior to last year, when two much shorter strikes were held.\u003c/p>\n\u003cp>Labor experts said the company had a shining reputation as an employer with positive labor relations, but the recent walkout suggested a turning point for Kaiser, which has expanded to eight states and the District of Columbia.\u003c/p>\n\u003cp>Kaiser, which has dismissed employee claims of chronic understaffing and long delays for patients, said its health care workers are already paid on average more than those at other companies.\u003c/p>\n\u003cp>Health care workers in California often earn more money than in other states, which labor experts say is due to the state’s high cost of living and unionization in the industry. Registered nurses, for example, make an annual \u003ca href=\"https://www.bls.gov/oes/2019/may/oes291141.htm\">mean of $113,200\u003c/a> in California, significantly higher than the national mean of $77,500, according to the U.S. Bureau of Labor Statistics.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>A four-week strike by thousands of \u003ca href=\"https://www.kqed.org/news/tag/kaiser-permanente\">Kaiser Permanente\u003c/a> health care workers in California and Hawaii ended Tuesday morning, even though no full contract deal has been reached.\u003c/p>\n\u003cp>The walkout \u003ca href=\"https://www.kqed.org/news/12071014/kaiser-strike-sees-thousands-walk-out-in-california-this-time-with-no-end-in-sight\">initially involved\u003c/a> up to 31,000 nurses, physician assistants, physical therapists, optometrists and others. Following significant movement at the bargaining table over the weekend, according to the union, no picket lines were held Monday as return-to-work agreements were finalized.\u003c/p>\n\u003cp>“We decided to end this because we were making meaningful progress at the tables. And returning to work allows us to closely deal with the issues, the few that are still outstanding, while getting back to taking care of our patients,” said Elizabeth Hawkins, secretary of the United Nurses Associations of California/Union of Health Care Professionals.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Nurses and other health care workers who walked picket lines several days a week are now expected to return to clinics and hospitals as early as Tuesday.\u003c/p>\n\u003cp>In a statement, Kaiser, which hired contingency staffers during the strike, said it was working to schedule returning employees over the coming days.\u003c/p>\n\u003cp>The Oakland-based health care organization said union leadership recently accepted an across-the-board 21.5% wage increase over four years that Kaiser had offered since October 2025. The union sought a 25% raise.\u003c/p>\n\u003cfigure id=\"attachment_12073903\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12073903\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/02/260219-STRIKINGKAISERWORKERS00368_TV-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1334\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/02/260219-STRIKINGKAISERWORKERS00368_TV-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/02/260219-STRIKINGKAISERWORKERS00368_TV-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/02/260219-STRIKINGKAISERWORKERS00368_TV-KQED-1536x1025.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Workers on strike at the picket line outside Kaiser Permanente Oakland Medical Center in Oakland on Feb. 19, 2026. Kaiser workers on the picket lines have gone without their paychecks for four weeks, and many are facing financial and other difficulties. \u003ccite>(Tâm Vũ/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“We have remained committed to reaching agreements that recognize the vital contributions of our employees while ensuring excellent, affordable care for our members,” Kaiser’s statement said. “Importantly, the increase is higher than any other health care provider in the country and keeps our employees at above market pay and among the best paid caregivers in the country.”\u003c/p>\n\u003cp>As the strike dragged on, the nation’s largest private nonprofit health care organization drew a hard line, maintaining that anything higher than a 21.5% raise would be unsustainable and lead it to increase premiums for its more than 9 million customers in California. The union said it acquiesced on wages because Kaiser agreed to additional improvements in safe staffing, recruitment and retention.\u003c/p>\n\u003cp>Both parties have been focused on completing contracts for each of dozens of local units forming UNAC/UHCP, Hawkins said. Kaiser walked away from bargaining on a long-standing national contract in December, a move the union calls unlawful and said partly led to the strike.\u003c/p>\n\u003cp>Pressure had been mounting on both parties to end the walkout, which began Jan. 26 and was dubbed the largest open-ended strike by nurses and other health care workers in the U.S. Top priorities in negotiations for Kaiser employees have been staffing levels and compensation, common concerns for health care workers nationwide.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>The company reassigned non-picketing staffers, rescheduled non-urgent surgeries and modified other appointments at affected locations. But some patients were frustrated by \u003ca href=\"https://www.kqed.org/news/12072837/kaiser-strike-delays-surgeries-disrupts-care-as-more-workers-walk-off-jobs\">delays\u003c/a> in their operations, especially in Southern California, where most striking union members are located.\u003c/p>\n\u003cp>At the picket lines, several workers told KQED they were \u003ca href=\"https://www.kqed.org/news/12073887/californias-striking-kaiser-workers-without-pay-for-weeks-feel-the-financial-pressure\">financially and emotionally stressed\u003c/a> by forgoing their paychecks for weeks, as the union did not offer assistance via a strike fund.\u003c/p>\n\u003cp>Last week, Kaiser said about 40% of nurses and pharmacists across striking locations had returned to their jobs, though union officials countered that those figures were inflated.\u003c/p>\n\u003cp>“While they will keep negotiating, they are losing leverage by going back to work, which suggests that they didn’t feel they had the capacity to sustain the strike any longer,” said Rebecca Givan, an associate professor of labor studies and employment relations at Rutgers University who specializes in the health care industry. “This is a tough outcome for these workers.”\u003c/p>\n\u003cp>Givan contrasted the outcome in California and Hawaii with a weeks-long strike by about 15,000 nurses in New York City, which led to significant employer concessions, including maintenance of health care benefits and improvements to pay and staffing, before workers agreed to return to their jobs.\u003c/p>\n\u003cp>Michelle Baird, a nurse midwife at Kaiser Oakland, said she would have preferred to end the strike with a contract deal in hand, but she’s cautiously optimistic about what’s left of the bargaining progress.\u003c/p>\n\u003cfigure id=\"attachment_12073902\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12073902\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/02/260219-STRIKINGKAISERWORKERS00295_TV-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1334\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/02/260219-STRIKINGKAISERWORKERS00295_TV-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/02/260219-STRIKINGKAISERWORKERS00295_TV-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/02/260219-STRIKINGKAISERWORKERS00295_TV-KQED-1536x1025.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Michelle Baird, a nurse midwife from Kaiser Oakland, poses for a portrait while on strike at the picket line outside Kaiser Permanente Oakland Medical Center in Oakland on Feb. 19, 2026. \u003ccite>(Tâm Vũ/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“Kaiser really saw how united we were and how strong we were, and even though we don’t have a contract in place now, I believe that my employer is negotiating in good faith and has been at the bargaining table,” said Baird, 53. ”I’m definitely feeling more like there’s a good chance of getting the things that we need in a contract, even if we don’t get everything we want.”\u003c/p>\n\u003cp>Baird said she was looking forward to seeing patients and regaining her income. She’s nervous about the strain that the long strike could have on her relationships with co-workers who pitched in more hours to continue caring for patients. Still, she feels the strike will likely lead to improvements for patients.\u003c/p>\n\u003cp>“Even with the disruptions in patient care, if we have a solid contract, we’ll have much more staff continuity. We’ll have people who are dedicated to being there, it will decrease the risks of turnover. And I think in the long run, it’s better for patients,” she said.\u003c/p>\n\u003cfigure id=\"attachment_12073905\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12073905\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/02/260219-STRIKINGKAISERWORKERS01145_TV-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1334\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/02/260219-STRIKINGKAISERWORKERS01145_TV-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/02/260219-STRIKINGKAISERWORKERS01145_TV-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/02/260219-STRIKINGKAISERWORKERS01145_TV-KQED-1536x1025.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Workers on strike at the picket line outside Kaiser Permanente Oakland Medical Center in Oakland on Feb. 19, 2026. \u003ccite>(Tâm Vũ/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Hawkins, the UNAC/UHCP secretary, said the union had not held a walkout at Kaiser for about 45 years prior to last year, when two much shorter strikes were held.\u003c/p>\n\u003cp>Labor experts said the company had a shining reputation as an employer with positive labor relations, but the recent walkout suggested a turning point for Kaiser, which has expanded to eight states and the District of Columbia.\u003c/p>\n\u003cp>Kaiser, which has dismissed employee claims of chronic understaffing and long delays for patients, said its health care workers are already paid on average more than those at other companies.\u003c/p>\n\u003cp>Health care workers in California often earn more money than in other states, which labor experts say is due to the state’s high cost of living and unionization in the industry. Registered nurses, for example, make an annual \u003ca href=\"https://www.bls.gov/oes/2019/may/oes291141.htm\">mean of $113,200\u003c/a> in California, significantly higher than the national mean of $77,500, according to the U.S. Bureau of Labor Statistics.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>Nearly 31,000 health care workers with the United Nurses Associations of California/Union of Health Care Professionals have been on strike for the last four weeks. Nurses, physicians assistants, pharmacists and other workers at Kaiser Permanente say that their wages have not kept up with inflation and that their workloads have negatively impacted patient care. As the strike drags on and negotiations continue to stall, more patients face canceled surgeries and appointments without an end in sight.\u003c/p>\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=KQINC4078420376\" width=\"100%\" class=\"iframe-class\">\u003c/iframe>\u003c/p>\n\u003cp>\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/p>\n\u003cp>\u003ci>This is a computer-generated transcript. While our team has reviewed it, there may be errors.\u003c/i>\u003c/p>\n\u003cp>\u003cb>Ericka Cruz Guevarra: \u003c/b>\u003cem>[00:00:33] \u003c/em>I’m Ericka Cruz Guevarra and welcome to The Bay, local news to keep you rooted. Outside of Kaiser Oakland on Monday, Kaiser Permanente nurses, physicians assistants, and other workers stood out in the rain to hold the picket line.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003cb>Picket Line: \u003c/b>\u003cem>[00:00:53] \u003c/em>Thank you. Be safe in the rain. Let’s get this contract done!\u003cem> \u003c/em>\u003c/p>\n\u003cp>\u003cb>Ericka Cruz Guevarra: \u003c/b>\u003cem>[00:01:03] \u003c/em>It’s been four weeks since tens of thousands of Kaiser workers who make up the backbone of patient care for the company began striking over staffing and pay, including Chris Pyper, a physicians assistant at the Kaiser in San Leandro.\u003c/p>\n\u003cp>\u003cb>Chris Pyper: \u003c/b>\u003cem>[00:01:22] \u003c/em>It just kind of feels like they’ve forgotten the healthcare workers who are doing a lot of the patient care. I’m basically using up savings that I’ve had, hoping that this is going to produce a good contract and I’m willing to stay out as long as we need.\u003c/p>\n\u003cp>\u003cb>Ericka Cruz Guevarra: \u003c/b>\u003cem>[00:01:40] \u003c/em>Workers also have larger concerns over the direction of the company. Kaiser is the largest non-profit health insurer in the country. And employees say that as Kaiser has grown, their work has gotten harder and harder. Today, we talk with KQED labor correspondent, Farida Javala Romero, about the Kaiser strike and what it means for patients.\u003c/p>\n\u003cp>\u003cb>Farida Jhabvala Romero: \u003c/b>\u003cem>[00:02:21] \u003c/em>This is a large strike, even for a very large company like Kaiser.\u003c/p>\n\u003cp>\u003cb>Ericka Cruz Guevarra: \u003c/b>\u003cem>[00:02:29] \u003c/em>Farida Javala-Romero is a labor correspondent for KQED.\u003c/p>\n\u003cp>\u003cb>Farida Jhabvala Romero: \u003c/b>\u003cem>[00:02:33] \u003c/em>So this particular strike involves up to 31,000 employees in California. Most of them are based in Southern California, but there are some happening in Northern California as well. It’s made up of nurses, including nurse anesthetists, physicians assistants, physical therapists, midwives. And then in Southern California, there’s also pharmacists and other very key healthcare workers. They’re key people for operations and surgeries. So we’ve heard of some surgeries being delayed. And so I wanted to speak with Kaiser patients who are facing some of these disruptions in care because of the strike.\u003c/p>\n\u003cp>\u003cb>Kayla Howell: \u003c/b>\u003cem>[00:03:25] \u003c/em>Honestly, when the scheduler first called me and told me about it, I sobbed.\u003c/p>\n\u003cp>\u003cb>Farida Jhabvala Romero: \u003c/b>\u003cem>[00:03:31] \u003c/em>So I spoke with folks like Kayla Howell in San Jose. She was going to have surgery to repair her torn ACL.\u003c/p>\n\u003cp>\u003cb>Kayla Howell: \u003c/b>\u003cem>[00:03:39] \u003c/em>Having that taken away you realize like oh my god i use my leg for everything going to the bathroom taking a shower is extremely difficult and painful\u003c/p>\n\u003cp>\u003cb>Farida Jhabvala Romero: \u003c/b>\u003cem>[00:03:48] \u003c/em>And so she was one of the folks who got a call saying, this thing is gonna be delayed until March.\u003c/p>\n\u003cp>\u003cb>Kayla Howell: \u003c/b>\u003cem>[00:03:55] \u003c/em>I’ve never had surgery before. It’s kind of a big thing. And so in my head, I was like, OK, this is what I’m going to do. I’m ready for it. You know, I’m preparing myself. It’s going to happen on this day. And then to have that, like, snatched away from me just like five days before it’s supposed to happen. I was, like Oh, that’s like a big paradigm shift, you know.\u003c/p>\n\u003cp>\u003cb>Farida Jhabvala Romero: \u003c/b>\u003cem>[00:04:13] \u003c/em>Her mom was gonna travel from abroad to care for her. Her mom couldn’t change her ticket to come to the U.S. To help her and her lodging. It just seemed like there were so many ripple effects just for one patient.\u003c/p>\n\u003cp>\u003cb>Kayla Howell: \u003c/b>\u003cem>[00:04:27] \u003c/em>When Kaiser said they’re canceling non-essential surgeries, like before I would think like, oh, non-essential, like plastic surgery, stuff that like people don’t really like need, you know, but like I need my mobility and I need to my legs.\u003c/p>\n\u003cp>\u003cb>Farida Jhabvala Romero: \u003c/b>\u003cem>[00:04:41] \u003c/em>Some of the people that wrote to us, you know, to tell us about their stories, they had hip replacement surgeries, you know where everything hurts, like it hurts to get in and out of their car. They told me that they’ve been waiting for these surgeries for months already to get on the schedule. So this, you now, additional delay hit really hard.\u003c/p>\n\u003cp>\u003cb>Ericka Cruz Guevarra: \u003c/b>\u003cem>[00:05:02] \u003c/em>I mean, that’s a huge inconvenience for people I can’t imagine. And we are already on week four which feels that feels pretty long to me is that long I guess in comparison to these other strikes that you’ve been talking about?\u003c/p>\n\u003cp>\u003cb>Farida Jhabvala Romero: \u003c/b>\u003cem>[00:05:18] \u003c/em>Yeah, I think so. Since September, this is the third time they’ve gone on strike. But the previous strikes were limited duration, so they lasted one day or five days. And they said ahead of time how long it was going to last, which helps the employer prepare and also for people to know what’s going to happen. With this situation we have now, the stakes are higher because this could go on for a lot longer. It seems like many of these issues, at least from the employee’s perspective, are not getting resolved. And a lot of them have to do with staffing levels.\u003c/p>\n\u003cp>\u003cb>Sanne Jacobsen: \u003c/b>\u003cem>[00:06:06] \u003c/em>I’ve been here for 14 years, I really am honestly at this point feeling like I work for an investment bank that poses as a healthcare organization.\u003c/p>\n\u003cp>\u003cb>Farida Jabvala Romero: \u003c/b>\u003cem>[00:06:17] \u003c/em>Sanne Jacobson, I met her outside of the Oakland Medical Center. It was the first day of this strike on January 26. And she’s part of the bargaining committee. So they’re looking for more input into their scheduling, the number of patients that they see.\u003c/p>\n\u003cp>\u003cb>Sanne Jacobsen: \u003c/b>\u003cem>[00:06:36] \u003c/em>You get providers that are double and triple booked and they can’t adequately provide care for the patients. And they suffer moral injury when they go to work and they can’t practice like they are supposed to be practicing.\u003c/p>\n\u003cp>\u003cb>Farida Jhabvala Romero: \u003c/b>\u003cem>[00:06:50] \u003c/em>What she, and this is echoing what a lot of other folks have told me at Picket Lines, is that increasing pressure to see more and more patients, they feel like they need to rush more to see more patients. They’re seeing their patients have to wait longer to be able to return to come see them for follow-up visits. And then from Kaiser’s perspective, they have been, for months, dismissing any claims that their patient care quality is sliding. And that there aren’t enough staffers to see patients. They say they meet all of the staffing levels that are required. And so, at least from workers’ perspective, the company is focusing on wages and wage increases, but not so much talking about the staffing problems that workers see.\u003c/p>\n\u003cp>\u003cb>\u003c/b>\u003cem>[00:07:38] \u003c/em>So would you say that’s like, the main sticking point for workers in this particular strike? This feeling that they’re just a little overwhelmed with low staffing compared to the number of patients they have to take care of, and that wages maybe actually isn’t the number one issue for them?\u003cem> \u003c/em>\u003c/p>\n\u003cp>\u003cb>Farida Jhabvala Romero: \u003c/b>\u003cem>[00:07:58] \u003c/em>I think it’s all connected. We can say that compensation and staffing levels are the two top issues. And those are nationwide top concerns for nurses and other healthcare workers. And when we’re talking about wages in this particular strike, the union wants a 25% increase over four years and Kaiser has drawn the line at 21.5%.\u003c/p>\n\u003cp>\u003cb>Ericka Cruz Guevarra: \u003c/b>\u003cem>[00:08:31] \u003c/em>Well, I wanna zoom out a little bit from this strike because I feel like I’ve seen a lot of strikes from Kaiser workers lately. Why is that?\u003c/p>\n\u003cp>\u003cb>Farida Jhabvala Romero: \u003c/b>\u003cem>[00:08:39] \u003c/em>We have seen several strikes in the last few years as these contracts expire and Kaiser is in negotiations for a new contract with different unions. This is a company where many of their employees, I think it’s more than 130,000, are unionized. And I think that goes back to this central conflict that we’re seeing for a company like Kaiser, which is. Employees feel like the company is moving away from its mission as a nonprofit, and that instead the company has expanded to new states, building new facilities, buying hospitals, and investing the revenues they’re getting from their health insurance business into growing. Meanwhile, the employees feel like they’ve been sort of left behind.\u003c/p>\n\u003cp>\u003cb>John Logan: \u003c/b>\u003cem>[00:09:36] \u003c/em>What’s happening at Kaiser in some ways reflects what’s happening in terms of the structure of the healthcare industry at the national level.\u003c/p>\n\u003cp>\u003cb>Farida Jhabvala Romero: \u003c/b>\u003cem>[00:09:45] \u003c/em>John Logan chairs the Labor Studies Department at San Francisco State University. He’s a really interesting person to talk to about the strike because he’s kept an eye on Kaiser for a long time.\u003c/p>\n\u003cp>\u003cb>John Logan: \u003c/b>\u003cem>[00:10:01] \u003c/em>You know, the one thing about the Kaiser partnership that’s existed now for over 25 years, nurses, technicians, others had a great deal more say over working conditions, scheduling, and those types of things. And that’s what a lot of the workers say has been eroded in recent years.\u003c/p>\n\u003cp>\u003cb>Farida Jhabvala Romero: \u003c/b>\u003cem>[00:10:22] \u003c/em>The mission of Kaiser is to reinvest all of its revenues into patient care and their facilities. But employees, many of them who’ve worked at Kaiser for more than 10 years, they see the company as changing, they describe it as more corporate, more top-down, and I think that’s some of the conflict that we’re seeing now. It’s making billions of dollars in net income. It has really large reserves. That Kaiser says it needs to deal with long-term commitments, like pensions and building maintenance, and have enough money in case there’s another emergency, like a pandemic. And employees say, hey, this company has a lot of money. How come they’re not investing in their workforce and improving patient care?\u003c/p>\n\u003cp>\u003cb>Ericka Cruz Guevarra: \u003c/b>\u003cem>[00:11:14] \u003c/em>It sounds like employees are feeling like they have to shoulder a lot of this growth that is happening in Kaiser without necessarily getting the support to do that. What is Kaiser saying in response?\u003c/p>\n\u003cp>\u003cb>Farida Jhabvala Romero: \u003c/b>\u003cem>[00:11:28] \u003c/em>What they’ve said in their public statements is that Kaiser is a great health care provider, that they have a really good model benefiting patients, and that they’re trying their best to meet the demand of Kaiser customers or members, which is what they call them. They have not really addressed these employee big concerns about staffing, about scheduling problems. We have not been able to get an interview with like a Kaiser executive or a representative to really dig into you know how they’re thinking about their reality and this you know labor conflict they have now. And then what we talked about earlier that the policies of the federal government are giving health care executives a really uncertain financial picture for the next couple of years. At companies like Kaiser, which is a health insurer and health provider. I mean, this means they could see a lot less money from people not being able to buy insurance or losing their health insurance, at the same time that they could higher costs from uninsured folks coming to hospitals for care.\u003c/p>\n\u003cp>\u003cb>Ericka Cruz Guevarra: \u003c/b>\u003cem>[00:12:42] \u003c/em>Well, I want to come back to Kayla who has the torn ACL. I mean, we’re four weeks into the strike now. I imagine she’s watching this all very, very closely. Do you have any sense of what public support is like from people like Kayla who are directly affected?\u003c/p>\n\u003cp>\u003cb>Farida Jhabvala Romero: \u003c/b>\u003cem>[00:13:03] \u003c/em>Kayla and other patients I spoke with, they all feel like they need the strike to be resolved as soon as possible so that they can get the care that they need.\u003c/p>\n\u003cp>\u003cb>Kayla Howell: \u003c/b>\u003cem>[00:13:15] \u003c/em>We live in one of the richest countries in the world. I pay my health insurance and I pay my premiums and where is that money going to? I just wish they would figure out a way to resolve it.\u003c/p>\n\u003cp>\u003cb>Farida Jhabvala Romero: \u003c/b>\u003cem>[00:13:27] \u003c/em>I think many of these folks sympathize with the employees and they want Kaiser to treat this as a very urgent matter and, you know, come to some deal. I think from both sides, but definitely when you go talk to people at the picket line, they really feel for the patients.\u003c/p>\n\u003cp>\u003cb>Ericka Cruz Guevarra: \u003c/b>\u003cem>[00:13:47] \u003c/em>What is it going to take for this to end and when could it end?\u003c/p>\n\u003cp>\u003cb>Farida Jhabvala Romero: \u003c/b>\u003cem>[00:13:52] \u003c/em>So, there’s a national contract for all of these workers. And then there are locals in each of the regions where workers are represented. And Kaiser, at this point, is refusing to meet with national union negotiators. And there is some bargaining at the local level. What the union folks have told me is that the strike is not going to be resolved without a national contract, or that would be the easiest way for Kaiser to resolve it. The conflict has gone to such a bad place on both sides that you have the employer saying, we’re not going to deal with these national union negotiators anymore. And so we’re just going to try to resolve everything at the local level. And meanwhile, the union is saying, ‘That’s illegal. No, you have to talk to us.’\u003cem> \u003c/em>\u003c/p>\n\u003cp>\u003cb>Ericka Cruz Guevarra: \u003c/b>\u003cem>[00:14:45] \u003c/em>Do you see any parallels between this Kaiser strike and the teacher strike that just ended in San Francisco last week?\u003c/p>\n\u003cp>\u003cb>Farida Jhabvala Romero: \u003c/b>\u003cem>[00:14:53] \u003c/em>Yeah, I mean, so much right now with these big conflicts we’re seeing are about affordability. For example, the Kaiser employees on strike say that during the pandemic, they agreed to much smaller wage increases because Kaiser had some big financial and other challenges, as many health systems did. And so now they feel like it’s a time to catch up and to really try to keep up with inflation and the high prices of everything. And then in San Francisco, with the teachers… It was a similar big issue, which is people feel like they can’t afford to live, you know, where do they work in San Francisco? And so the big topic over all of this is affordability.\u003c/p>\n\u003cp>\u003cb>Ericka Cruz Guevarra: \u003c/b>\u003cem>[00:15:47] \u003c/em>And the teachers were talking about not being able to afford their health care\u003cem> \u003c/em>\u003c/p>\n\u003cp>\u003cb>Farida Jhabvala Romero: \u003c/b>\u003cem>[00:15:50] \u003c/em>Health insurance right.\u003cem> \u003c/em>\u003c/p>\n\u003cp>\u003cb>Ericka Cruz Guevarra: \u003c/b>\u003cem>[00:15:55] \u003c/em>Farida, thank you so much for breaking this down. I appreciate it.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cb>Farida Jhabvala Romero: \u003c/b>\u003cem>[00:15:57] \u003c/em>Thank you, Ericka.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Nearly 31,000 health care workers with the United Nurses Associations of California/Union of Health Care Professionals have been on strike for the last four weeks. Nurses, physicians assistants, pharmacists and other workers at Kaiser Permanente say that their wages have not kept up with inflation and that their workloads have negatively impacted patient care. As the strike drags on and negotiations continue to stall, more patients face canceled surgeries and appointments without an end in sight.\u003c/p>\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=KQINC4078420376\" width=\"100%\" class=\"iframe-class\">\u003c/iframe>\u003c/p>\n\u003cp>\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/p>\n\u003cp>\u003ci>This is a computer-generated transcript. While our team has reviewed it, there may be errors.\u003c/i>\u003c/p>\n\u003cp>\u003cb>Ericka Cruz Guevarra: \u003c/b>\u003cem>[00:00:33] \u003c/em>I’m Ericka Cruz Guevarra and welcome to The Bay, local news to keep you rooted. Outside of Kaiser Oakland on Monday, Kaiser Permanente nurses, physicians assistants, and other workers stood out in the rain to hold the picket line.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cb>Picket Line: \u003c/b>\u003cem>[00:00:53] \u003c/em>Thank you. Be safe in the rain. Let’s get this contract done!\u003cem> \u003c/em>\u003c/p>\n\u003cp>\u003cb>Ericka Cruz Guevarra: \u003c/b>\u003cem>[00:01:03] \u003c/em>It’s been four weeks since tens of thousands of Kaiser workers who make up the backbone of patient care for the company began striking over staffing and pay, including Chris Pyper, a physicians assistant at the Kaiser in San Leandro.\u003c/p>\n\u003cp>\u003cb>Chris Pyper: \u003c/b>\u003cem>[00:01:22] \u003c/em>It just kind of feels like they’ve forgotten the healthcare workers who are doing a lot of the patient care. I’m basically using up savings that I’ve had, hoping that this is going to produce a good contract and I’m willing to stay out as long as we need.\u003c/p>\n\u003cp>\u003cb>Ericka Cruz Guevarra: \u003c/b>\u003cem>[00:01:40] \u003c/em>Workers also have larger concerns over the direction of the company. Kaiser is the largest non-profit health insurer in the country. And employees say that as Kaiser has grown, their work has gotten harder and harder. Today, we talk with KQED labor correspondent, Farida Javala Romero, about the Kaiser strike and what it means for patients.\u003c/p>\n\u003cp>\u003cb>Farida Jhabvala Romero: \u003c/b>\u003cem>[00:02:21] \u003c/em>This is a large strike, even for a very large company like Kaiser.\u003c/p>\n\u003cp>\u003cb>Ericka Cruz Guevarra: \u003c/b>\u003cem>[00:02:29] \u003c/em>Farida Javala-Romero is a labor correspondent for KQED.\u003c/p>\n\u003cp>\u003cb>Farida Jhabvala Romero: \u003c/b>\u003cem>[00:02:33] \u003c/em>So this particular strike involves up to 31,000 employees in California. Most of them are based in Southern California, but there are some happening in Northern California as well. It’s made up of nurses, including nurse anesthetists, physicians assistants, physical therapists, midwives. And then in Southern California, there’s also pharmacists and other very key healthcare workers. They’re key people for operations and surgeries. So we’ve heard of some surgeries being delayed. And so I wanted to speak with Kaiser patients who are facing some of these disruptions in care because of the strike.\u003c/p>\n\u003cp>\u003cb>Kayla Howell: \u003c/b>\u003cem>[00:03:25] \u003c/em>Honestly, when the scheduler first called me and told me about it, I sobbed.\u003c/p>\n\u003cp>\u003cb>Farida Jhabvala Romero: \u003c/b>\u003cem>[00:03:31] \u003c/em>So I spoke with folks like Kayla Howell in San Jose. She was going to have surgery to repair her torn ACL.\u003c/p>\n\u003cp>\u003cb>Kayla Howell: \u003c/b>\u003cem>[00:03:39] \u003c/em>Having that taken away you realize like oh my god i use my leg for everything going to the bathroom taking a shower is extremely difficult and painful\u003c/p>\n\u003cp>\u003cb>Farida Jhabvala Romero: \u003c/b>\u003cem>[00:03:48] \u003c/em>And so she was one of the folks who got a call saying, this thing is gonna be delayed until March.\u003c/p>\n\u003cp>\u003cb>Kayla Howell: \u003c/b>\u003cem>[00:03:55] \u003c/em>I’ve never had surgery before. It’s kind of a big thing. And so in my head, I was like, OK, this is what I’m going to do. I’m ready for it. You know, I’m preparing myself. It’s going to happen on this day. And then to have that, like, snatched away from me just like five days before it’s supposed to happen. I was, like Oh, that’s like a big paradigm shift, you know.\u003c/p>\n\u003cp>\u003cb>Farida Jhabvala Romero: \u003c/b>\u003cem>[00:04:13] \u003c/em>Her mom was gonna travel from abroad to care for her. Her mom couldn’t change her ticket to come to the U.S. To help her and her lodging. It just seemed like there were so many ripple effects just for one patient.\u003c/p>\n\u003cp>\u003cb>Kayla Howell: \u003c/b>\u003cem>[00:04:27] \u003c/em>When Kaiser said they’re canceling non-essential surgeries, like before I would think like, oh, non-essential, like plastic surgery, stuff that like people don’t really like need, you know, but like I need my mobility and I need to my legs.\u003c/p>\n\u003cp>\u003cb>Farida Jhabvala Romero: \u003c/b>\u003cem>[00:04:41] \u003c/em>Some of the people that wrote to us, you know, to tell us about their stories, they had hip replacement surgeries, you know where everything hurts, like it hurts to get in and out of their car. They told me that they’ve been waiting for these surgeries for months already to get on the schedule. So this, you now, additional delay hit really hard.\u003c/p>\n\u003cp>\u003cb>Ericka Cruz Guevarra: \u003c/b>\u003cem>[00:05:02] \u003c/em>I mean, that’s a huge inconvenience for people I can’t imagine. And we are already on week four which feels that feels pretty long to me is that long I guess in comparison to these other strikes that you’ve been talking about?\u003c/p>\n\u003cp>\u003cb>Farida Jhabvala Romero: \u003c/b>\u003cem>[00:05:18] \u003c/em>Yeah, I think so. Since September, this is the third time they’ve gone on strike. But the previous strikes were limited duration, so they lasted one day or five days. And they said ahead of time how long it was going to last, which helps the employer prepare and also for people to know what’s going to happen. With this situation we have now, the stakes are higher because this could go on for a lot longer. It seems like many of these issues, at least from the employee’s perspective, are not getting resolved. And a lot of them have to do with staffing levels.\u003c/p>\n\u003cp>\u003cb>Sanne Jacobsen: \u003c/b>\u003cem>[00:06:06] \u003c/em>I’ve been here for 14 years, I really am honestly at this point feeling like I work for an investment bank that poses as a healthcare organization.\u003c/p>\n\u003cp>\u003cb>Farida Jabvala Romero: \u003c/b>\u003cem>[00:06:17] \u003c/em>Sanne Jacobson, I met her outside of the Oakland Medical Center. It was the first day of this strike on January 26. And she’s part of the bargaining committee. So they’re looking for more input into their scheduling, the number of patients that they see.\u003c/p>\n\u003cp>\u003cb>Sanne Jacobsen: \u003c/b>\u003cem>[00:06:36] \u003c/em>You get providers that are double and triple booked and they can’t adequately provide care for the patients. And they suffer moral injury when they go to work and they can’t practice like they are supposed to be practicing.\u003c/p>\n\u003cp>\u003cb>Farida Jhabvala Romero: \u003c/b>\u003cem>[00:06:50] \u003c/em>What she, and this is echoing what a lot of other folks have told me at Picket Lines, is that increasing pressure to see more and more patients, they feel like they need to rush more to see more patients. They’re seeing their patients have to wait longer to be able to return to come see them for follow-up visits. And then from Kaiser’s perspective, they have been, for months, dismissing any claims that their patient care quality is sliding. And that there aren’t enough staffers to see patients. They say they meet all of the staffing levels that are required. And so, at least from workers’ perspective, the company is focusing on wages and wage increases, but not so much talking about the staffing problems that workers see.\u003c/p>\n\u003cp>\u003cb>\u003c/b>\u003cem>[00:07:38] \u003c/em>So would you say that’s like, the main sticking point for workers in this particular strike? This feeling that they’re just a little overwhelmed with low staffing compared to the number of patients they have to take care of, and that wages maybe actually isn’t the number one issue for them?\u003cem> \u003c/em>\u003c/p>\n\u003cp>\u003cb>Farida Jhabvala Romero: \u003c/b>\u003cem>[00:07:58] \u003c/em>I think it’s all connected. We can say that compensation and staffing levels are the two top issues. And those are nationwide top concerns for nurses and other healthcare workers. And when we’re talking about wages in this particular strike, the union wants a 25% increase over four years and Kaiser has drawn the line at 21.5%.\u003c/p>\n\u003cp>\u003cb>Ericka Cruz Guevarra: \u003c/b>\u003cem>[00:08:31] \u003c/em>Well, I wanna zoom out a little bit from this strike because I feel like I’ve seen a lot of strikes from Kaiser workers lately. Why is that?\u003c/p>\n\u003cp>\u003cb>Farida Jhabvala Romero: \u003c/b>\u003cem>[00:08:39] \u003c/em>We have seen several strikes in the last few years as these contracts expire and Kaiser is in negotiations for a new contract with different unions. This is a company where many of their employees, I think it’s more than 130,000, are unionized. And I think that goes back to this central conflict that we’re seeing for a company like Kaiser, which is. Employees feel like the company is moving away from its mission as a nonprofit, and that instead the company has expanded to new states, building new facilities, buying hospitals, and investing the revenues they’re getting from their health insurance business into growing. Meanwhile, the employees feel like they’ve been sort of left behind.\u003c/p>\n\u003cp>\u003cb>John Logan: \u003c/b>\u003cem>[00:09:36] \u003c/em>What’s happening at Kaiser in some ways reflects what’s happening in terms of the structure of the healthcare industry at the national level.\u003c/p>\n\u003cp>\u003cb>Farida Jhabvala Romero: \u003c/b>\u003cem>[00:09:45] \u003c/em>John Logan chairs the Labor Studies Department at San Francisco State University. He’s a really interesting person to talk to about the strike because he’s kept an eye on Kaiser for a long time.\u003c/p>\n\u003cp>\u003cb>John Logan: \u003c/b>\u003cem>[00:10:01] \u003c/em>You know, the one thing about the Kaiser partnership that’s existed now for over 25 years, nurses, technicians, others had a great deal more say over working conditions, scheduling, and those types of things. And that’s what a lot of the workers say has been eroded in recent years.\u003c/p>\n\u003cp>\u003cb>Farida Jhabvala Romero: \u003c/b>\u003cem>[00:10:22] \u003c/em>The mission of Kaiser is to reinvest all of its revenues into patient care and their facilities. But employees, many of them who’ve worked at Kaiser for more than 10 years, they see the company as changing, they describe it as more corporate, more top-down, and I think that’s some of the conflict that we’re seeing now. It’s making billions of dollars in net income. It has really large reserves. That Kaiser says it needs to deal with long-term commitments, like pensions and building maintenance, and have enough money in case there’s another emergency, like a pandemic. And employees say, hey, this company has a lot of money. How come they’re not investing in their workforce and improving patient care?\u003c/p>\n\u003cp>\u003cb>Ericka Cruz Guevarra: \u003c/b>\u003cem>[00:11:14] \u003c/em>It sounds like employees are feeling like they have to shoulder a lot of this growth that is happening in Kaiser without necessarily getting the support to do that. What is Kaiser saying in response?\u003c/p>\n\u003cp>\u003cb>Farida Jhabvala Romero: \u003c/b>\u003cem>[00:11:28] \u003c/em>What they’ve said in their public statements is that Kaiser is a great health care provider, that they have a really good model benefiting patients, and that they’re trying their best to meet the demand of Kaiser customers or members, which is what they call them. They have not really addressed these employee big concerns about staffing, about scheduling problems. We have not been able to get an interview with like a Kaiser executive or a representative to really dig into you know how they’re thinking about their reality and this you know labor conflict they have now. And then what we talked about earlier that the policies of the federal government are giving health care executives a really uncertain financial picture for the next couple of years. At companies like Kaiser, which is a health insurer and health provider. I mean, this means they could see a lot less money from people not being able to buy insurance or losing their health insurance, at the same time that they could higher costs from uninsured folks coming to hospitals for care.\u003c/p>\n\u003cp>\u003cb>Ericka Cruz Guevarra: \u003c/b>\u003cem>[00:12:42] \u003c/em>Well, I want to come back to Kayla who has the torn ACL. I mean, we’re four weeks into the strike now. I imagine she’s watching this all very, very closely. Do you have any sense of what public support is like from people like Kayla who are directly affected?\u003c/p>\n\u003cp>\u003cb>Farida Jhabvala Romero: \u003c/b>\u003cem>[00:13:03] \u003c/em>Kayla and other patients I spoke with, they all feel like they need the strike to be resolved as soon as possible so that they can get the care that they need.\u003c/p>\n\u003cp>\u003cb>Kayla Howell: \u003c/b>\u003cem>[00:13:15] \u003c/em>We live in one of the richest countries in the world. I pay my health insurance and I pay my premiums and where is that money going to? I just wish they would figure out a way to resolve it.\u003c/p>\n\u003cp>\u003cb>Farida Jhabvala Romero: \u003c/b>\u003cem>[00:13:27] \u003c/em>I think many of these folks sympathize with the employees and they want Kaiser to treat this as a very urgent matter and, you know, come to some deal. I think from both sides, but definitely when you go talk to people at the picket line, they really feel for the patients.\u003c/p>\n\u003cp>\u003cb>Ericka Cruz Guevarra: \u003c/b>\u003cem>[00:13:47] \u003c/em>What is it going to take for this to end and when could it end?\u003c/p>\n\u003cp>\u003cb>Farida Jhabvala Romero: \u003c/b>\u003cem>[00:13:52] \u003c/em>So, there’s a national contract for all of these workers. And then there are locals in each of the regions where workers are represented. And Kaiser, at this point, is refusing to meet with national union negotiators. And there is some bargaining at the local level. What the union folks have told me is that the strike is not going to be resolved without a national contract, or that would be the easiest way for Kaiser to resolve it. The conflict has gone to such a bad place on both sides that you have the employer saying, we’re not going to deal with these national union negotiators anymore. And so we’re just going to try to resolve everything at the local level. And meanwhile, the union is saying, ‘That’s illegal. No, you have to talk to us.’\u003cem> \u003c/em>\u003c/p>\n\u003cp>\u003cb>Ericka Cruz Guevarra: \u003c/b>\u003cem>[00:14:45] \u003c/em>Do you see any parallels between this Kaiser strike and the teacher strike that just ended in San Francisco last week?\u003c/p>\n\u003cp>\u003cb>Farida Jhabvala Romero: \u003c/b>\u003cem>[00:14:53] \u003c/em>Yeah, I mean, so much right now with these big conflicts we’re seeing are about affordability. For example, the Kaiser employees on strike say that during the pandemic, they agreed to much smaller wage increases because Kaiser had some big financial and other challenges, as many health systems did. And so now they feel like it’s a time to catch up and to really try to keep up with inflation and the high prices of everything. And then in San Francisco, with the teachers… It was a similar big issue, which is people feel like they can’t afford to live, you know, where do they work in San Francisco? And so the big topic over all of this is affordability.\u003c/p>\n\u003cp>\u003cb>Ericka Cruz Guevarra: \u003c/b>\u003cem>[00:15:47] \u003c/em>And the teachers were talking about not being able to afford their health care\u003cem> \u003c/em>\u003c/p>\n\u003cp>\u003cb>Farida Jhabvala Romero: \u003c/b>\u003cem>[00:15:50] \u003c/em>Health insurance right.\u003cem> \u003c/em>\u003c/p>\n\u003cp>\u003cb>Ericka Cruz Guevarra: \u003c/b>\u003cem>[00:15:55] \u003c/em>Farida, thank you so much for breaking this down. I appreciate it.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cb>Farida Jhabvala Romero: \u003c/b>\u003cem>[00:15:57] \u003c/em>Thank you, Ericka.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"title": "Trump Administration Sends Pregnant Unaccompanied Minors to Texas Shelter Flagged as Medically Inadequate",
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"headTitle": "Trump Administration Sends Pregnant Unaccompanied Minors to Texas Shelter Flagged as Medically Inadequate | KQED",
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"content": "\u003cp>The \u003ca href=\"https://www.kqed.org/news/tag/donald-trump\">Trump\u003c/a> administration is sending all pregnant unaccompanied minors apprehended by immigration enforcement to a single group shelter in South Texas. The decision was made over urgent objections from the government’s own health and child welfare officials, who say both the facility and the region lack the specialized care the girls need.\u003c/p>\n\u003cp>That’s according to seven sources who work at the Office of Refugee Resettlement within the U.S. Department of Health and Human Services, which handles the custody and care of children who cross the border without a parent or legal guardian, or are separated from family by immigration authorities. All of the sources declined to be named for fear of retaliation.\u003c/p>\n\u003cp>Since late July, more than a dozen pregnant minors have been placed at the Texas facility, which is located in the small border city of San Benito. Some were as young as 13, and at least half of those taken in so far became pregnant as a result of rape, sources said. Their pregnancies are considered\u003ca href=\"https://www.sciencedirect.com/science/article/pii/S1877575625000722\"> high risk\u003c/a> by definition, particularly for the\u003ca href=\"https://utswmed.org/medblog/early-teen-pregnancy-health-risks/\"> youngest\u003c/a> girls.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“This group of kids is clearly recognized as our most vulnerable,” one of the sources said. Rank-and-file staff, the source said, are “losing sleep over it, wondering if kids are going to be placed in programs where they’re not going to have access to the care they need.”\u003c/p>\n\u003cp>The move marks a sharp departure from longstanding federal practice, which placed pregnant, unaccompanied migrant children in ORR shelters or foster homes around the country that are equipped to handle high-risk pregnancies. ORR sources, along with more than a dozen former government officials, health care professionals, migrant advocates and civil rights attorneys, said they worry the Trump administration is putting children in danger at the San Benito shelter to advance an ideological goal: denying them access to abortion by placing them in a state where it’s virtually banned.\u003c/p>\n\u003cfigure id=\"attachment_12073141\" class=\"wp-caption aligncenter\" style=\"max-width: 1600px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-12073141 size-full\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/02/20251104_GlobalX_PL_03.jpg\" alt=\"\" width=\"1600\" height=\"1067\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/02/20251104_GlobalX_PL_03.jpg 1600w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/02/20251104_GlobalX_PL_03-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/02/20251104_GlobalX_PL_03-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 1600px) 100vw, 1600px\">\u003cfigcaption class=\"wp-caption-text\">A Global X plane sits on a runway near Valley International Airport in Harlington, Texas, on Nov. 4, 2025. The Charter airline operates most deportation flights for U.S. Immigration and Customs Enforcement, transporting migrants across the country and abroad. \u003ccite>(Patricia Lim/KUT News)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“This is 100% and exclusively about abortion,” said Jonathan White, a longtime federal health official who ran ORR’s unaccompanied children program for part of President Donald Trump’s first term. White, who recently retired from the government, said the administration tried and failed to restrict abortion access for unaccompanied minors in 2017. “Now they casually roll out what they brutally fought to accomplish last time and didn’t.”\u003c/p>\n\u003cp>Asked via email why the administration is sending pregnant children to San Benito, an HHS spokesperson who asked not to be named wrote that “ORR’s placement decisions are guided by child welfare best practices and are designed to ensure each child is housed in the safest, most developmentally appropriate setting, including for children who are pregnant or parenting.”\u003c/p>\n\u003cp>But several of the ORR officials took issue with the agency’s statement. “ORR is supposed to be a child welfare organization,” one of them said. “Putting pregnant kids in San Benito is not a decision you make when you care about children’s safety.”\u003c/p>\n\u003cp>ORR’s acting director, Angie Salazar, instructed agency staff to send “any pregnant children” to San Benito beginning July 22, 2025, according to an internal email obtained as part of a six-month investigation by The California Newsroom and The Texas Newsroom, public media collaboratives that worked together to produce this story.\u003c/p>\n\u003cfigure id=\"attachment_12073165\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12073165\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/02/KQED-Email-2.jpg\" alt=\"\" width=\"1920\" height=\"700\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/02/KQED-Email-2.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/02/KQED-Email-2-160x58.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/02/KQED-Email-2-1536x560.jpg 1536w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">A screenshot of a July 22, 2025, email notifying ORR supervisors of a directive to send pregnant unaccompanied minors to a single shelter in San Benito, Texas, despite objections from the government’s own health and child welfare officials.\u003c/figcaption>\u003c/figure>\n\u003cp>Several sources said a handful of pregnant girls have mistakenly been placed in other shelters because immigration authorities didn’t know they were pregnant when they were transferred to ORR custody.\u003c/p>\n\u003cp>Since the July order, none of the pregnant girls at the San Benito facility have experienced major medical problems, according to ORR sources and Aimee Korolev, deputy director of ProBAR, an organization that provides legal services to children there. They said several of the girls have given birth and are detained with their infants.\u003c/p>\n\u003cp>But officials interviewed for this story said they worry the shelter is only one high-risk pregnancy away from catastrophe.\u003c/p>\n\u003cp>“I feel like we’re just waiting for something terrible to happen,” one of the ORR sources said.\u003c/p>\n\u003ch2>‘Blown away by the level of risk’\u003c/h2>\n\u003cp>There are dozens of ORR shelters or foster homes across the country that are designated to care for pregnant unaccompanied children, according to ORR officials, with 14 in California alone. None of the officials could recall a time when all of the pregnant minors in the agency’s custody were concentrated in one shelter.\u003c/p>\n\u003cp>Detaining them in San Benito, Texas, doctors and public health experts said, is a dangerous gambit.\u003c/p>\n\u003cfigure id=\"attachment_12073147\" class=\"wp-caption aligncenter\" style=\"max-width: 1600px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-12073147 size-full\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/02/20251105_UrbanStrategy_PL_06.jpg\" alt=\"\" width=\"1600\" height=\"1067\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/02/20251105_UrbanStrategy_PL_06.jpg 1600w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/02/20251105_UrbanStrategy_PL_06-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/02/20251105_UrbanStrategy_PL_06-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 1600px) 100vw, 1600px\">\u003cfigcaption class=\"wp-caption-text\">Parked white vans inside a gated building at Urban Strategies, a facility that holds unaccompanied minor immigrants under contract with the US Office of Refugee Resettlement, in San Benito, Texas, on Nov. 5, 2025. Refugio San Benito is a facility operated by the group Urban Strategies. \u003ccite>(Patricia Lim/KUT News)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“It’s not good to be a pregnant person in Texas, no matter who you are,” said Annie Leone, a nurse midwife who recently spent five years caring for pregnant and postpartum migrant women and girls at a large family shelter not far from San Benito. “So, to put pregnant migrant kids in Texas, and then in one of the worst health care regions of Texas, is not good at all.”\u003c/p>\n\u003cp>The specialized obstetric care that exists in Texas is mostly available \u003ca href=\"https://www.smfm.org/find-an-mfm?MapView=true&Address=San%20Benito%2C%20TX%2C%20USA&Latitude=26.132576&Longitude=-97.6311006&Radius=100\">in its larger cities\u003c/a>, hours from San Benito. And several factors, including \u003ca href=\"https://www.npr.org/sections/shots-health-news/2025/09/16/nx-s1-5542408/health-insurance-obbba-texas-uninsurance-rates\">the high number of uninsured patients\u003c/a>, have eroded the availability of \u003ca href=\"https://www.commonwealthfund.org/publications/scorecard/2024/jul/2024-state-scorecard-womens-health-and-reproductive-care\">health care across the state\u003c/a>.\u003c/p>\n\u003cp>Furthermore, Texas’ near-ban on abortion has been \u003ca href=\"https://www.propublica.org/article/high-risk-pregnancies-chronic-conditions-abortion-bans\">especially devastating to obstetric care\u003c/a>. The law allows an exception in cases where the mother’s life is in danger or one of her bodily functions is at risk, but doctors have been confused as to what that means.\u003c/p>\n\u003cp>Many doctors have \u003ca href=\"https://19thnews.org/2023/06/abortion-gender-affirming-care-bans-doctors-leaving-texas/\">left to practice elsewhere\u003c/a>, and those who’ve stayed are often \u003ca href=\"https://assets-us-01.kc-usercontent.com/9fd8e81d-74db-00ef-d0b1-5d17c12fdda9/34392fc8-1c9a-48a2-be8f-3f79d8a4a7d5/FINAL-TX-OBGYN-Workforce-Study_2024-10_f.pdf\">scared\u003c/a> to perform procedures they worry could come with criminal charges. While Texas passed a law \u003ca href=\"https://www.npr.org/2025/07/19/nx-s1-5445143/texas-abortion-life-of-mother\">clarifying the exceptions\u003c/a> last year, experts \u003ca href=\"https://www.propublica.org/article/texas-medical-board-abortion-training-doctors\">have said\u003c/a> it may not be enough to assuage doctors’ fears.[aside postID=news_12067561 hero='https://cdn.kqed.org/wp-content/uploads/sites/10/2025/12/MexicoBorderChildrenGetty.jpg']Several maternal health experts described a sobering list of dangers for the girls at the San Benito shelter: If one of them develops an \u003ca href=\"https://www.acog.org/advocacy/facts-are-important/understanding-ectopic-pregnancy\">ectopic pregnancy\u003c/a> (where the fertilized egg implants outside the uterus), if she \u003ca href=\"https://www.ncbi.nlm.nih.gov/search/research-news/16798/\">miscarries\u003c/a> or if her \u003ca href=\"https://www.reuters.com/article/fact-check/termination-of-pregnancy-can-be-necessary-to-save-a-womans-life-experts-say-idUSL1N2TC0VD/\">water breaks too early\u003c/a> and she gets an infection, the\u003ca href=\"https://www.acog.org/news/news-releases/2019/09/abortion-can-be-medically-necessary\"> emergency care she needs\u003c/a> could be \u003ca href=\"https://www.propublica.org/series/life-of-the-mother\">delayed or denied by doctors\u003c/a> wary of the abortion ban.\u003c/p>\n\u003cp>Getting the care that is available could take too long to save her life or the baby’s, they added.\u003c/p>\n\u003cp>Adolescents are also more likely to give birth early, which can be life-threatening for both mother and baby. The youngest face complications during labor and delivery because their pelvises aren’t fully developed, said Dr. Anne-Marie Amies Oelschlager, an obstetrician in Washington state who specializes in adolescent pregnancy.\u003c/p>\n\u003cp>“These are young adolescents who are still going through puberty,” she said. “Their bodies are still changing.”\u003c/p>\n\u003cp>Pregnant girls who recently endured the often harrowing journey to the U.S. face even more risk, obstetrics experts said. Many \u003ca href=\"https://pmc.ncbi.nlm.nih.gov/articles/PMC6752644/\">have been raped\u003c/a> along the way and have sexually transmitted infections that can be dangerous during pregnancy. Add to that \u003ca href=\"https://www.projecthope.org/wp-content/uploads/2024/04/Project-Hope-Mexico-NEW-FINAL-1_19_23.pdf\">little to no access to prenatal care\u003c/a> or \u003ca href=\"https://www.borderreport.com/hot-topics/immigration/many-migrants-arriving-at-border-malnourished-health-experts-say/\">proper nourishment\u003c/a>, and then the trauma of \u003ca href=\"https://pmc.ncbi.nlm.nih.gov/articles/PMC8570101/\">being detained\u003c/a>.\u003c/p>\n\u003cp>“You couldn’t set up a worse scenario,” said Dr. Blair Cushing, who runs a women’s health clinic in McAllen, about 45 minutes from San Benito. “I’m kind of blown away by the level of risk that they’re concentrating in this facility.”\u003c/p>\n\u003ch2>A history of problems\u003c/h2>\n\u003cp>The San Benito shelter is owned and operated by Urban Strategies, a for-profit company that has contracted with the federal government to care for unaccompanied children for more than a decade, according to \u003ca href=\"http://usaspending.gov\">USAspending.gov\u003c/a>.\u003c/p>\n\u003cp>The main building, an old tan brick Baptist Church, occupies a city block in downtown San Benito, a quiet town of about 25,000. The church was converted to a migrant shelter in 2015 and was managed by two other contractors before Urban Strategies \u003ca href=\"https://www.federalregister.gov/documents/2021/11/30/2021-25971/announcement-of-intent-to-issue-replacement-award-to-provide-residential-services-shelter\">took it over in 2021\u003c/a>.\u003c/p>\n\u003cp>On a fall day last year, there were no signs of activity at the facility, though children’s lawn toys and playground equipment were visible behind a wooden fence. A guard was stationed at one of the entrances.\u003c/p>\n\u003cfigure id=\"attachment_12073070\" class=\"wp-caption aligncenter\" style=\"max-width: 1600px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12073070\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/02/20251104_MELIZA_PL_01-KQED.jpg\" alt=\"\" width=\"1600\" height=\"1067\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/02/20251104_MELIZA_PL_01-KQED.jpg 1600w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/02/20251104_MELIZA_PL_01-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/02/20251104_MELIZA_PL_01-KQED-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 1600px) 100vw, 1600px\">\u003cfigcaption class=\"wp-caption-text\">Meliza Fonseca lives across the street from the San Benito shelter. She said she occasionally sees children in the yard on weekends, “but for the most part, you don’t see them.” \u003ccite>(Patricia Lim/KUT)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“It’s pretty quiet, just like it is today,” said Meliza Fonseca, who lives nearby. “That’s the way it is every day.”\u003c/p>\n\u003cp>She said she occasionally sees kids playing in the yard on weekends, “but for the most part, you don’t see them.”\u003c/p>\n\u003cp>Reached by email, the founder and president of Urban Strategies, Lisa Cummins, wrote that the company is “deeply committed to the care and well-being of the children we serve,” but directed any questions about ORR-contracted shelters to the federal agency.\u003c/p>\n\u003cp>When asked about the San Benito facility, the ORR spokesperson wrote that “Urban Strategies has a long-standing record of delivering high-quality care to pregnant unaccompanied minors, with a consistently low staff turnover.”\u003c/p>\n\u003cfigure id=\"attachment_12073142\" class=\"wp-caption aligncenter\" style=\"max-width: 1600px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12073142\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/02/20251105_UrbanStrategy_PL_04.jpg\" alt=\"\" width=\"1600\" height=\"1067\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/02/20251105_UrbanStrategy_PL_04.jpg 1600w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/02/20251105_UrbanStrategy_PL_04-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/02/20251105_UrbanStrategy_PL_04-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 1600px) 100vw, 1600px\">\u003cfigcaption class=\"wp-caption-text\">A gated building at Urban Strategies, a facility that holds unaccompanied minor immigrants under contract with the U.S. Office of Refugee Resettlement, in San Benito, Texas, on Nov. 5, 2025. \u003ccite>(Patricia Lim/KUT News)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>But agency sources who spoke with the newsrooms said that as recently as 2024, staff members at the shelter failed to arrange timely medical appointments for pregnant girls or immediately share critical health information with the federal agency and discharged them without arrangements to continue their medical care.\u003c/p>\n\u003cp>ORR temporarily barred the shelter from receiving pregnant girls while Urban Strategies implemented a remediation plan, but the plan did not add staff or enhance their qualifications, the sources said.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Several sources inside the agency said its leadership was provided with a list of shelters that are better prepared to handle children with high-risk pregnancies. All of those shelters are located outside of Texas, in regions where the full range of necessary medical care is available. Yet the directive to place them at San Benito remains.\u003c/p>\n\u003cp>“It’s cruel, it’s just cruel,” one of the officials said. “They don’t care about any of these kids. They’re playing politics with children’s health.”\u003c/p>\n\u003ch2>‘A dress rehearsal’\u003c/h2>\n\u003cp>Jonathan White, who ran ORR’s unaccompanied children program from January of 2017 to March of 2018, said he wasn’t surprised to learn that the new administration is moving pregnant unaccompanied children to Texas.\u003c/p>\n\u003cp>“I’ve been expecting this since Trump returned to office,” White said in an interview.\u003c/p>\n\u003cp>He said he views the San Benito order as a continuation of an anti-abortion policy shift that began in 2017, which “ultimately proved to be a dress rehearsal for the current administration.”\u003c/p>\n\u003cfigure id=\"attachment_12073151\" class=\"wp-caption aligncenter\" style=\"max-width: 1600px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-12073151 size-full\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/02/20251105_RioGrande_PL_02.jpg\" alt=\"\" width=\"1600\" height=\"1067\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/02/20251105_RioGrande_PL_02.jpg 1600w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/02/20251105_RioGrande_PL_02-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/02/20251105_RioGrande_PL_02-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 1600px) 100vw, 1600px\">\u003cfigcaption class=\"wp-caption-text\">The Rio Grande is seen near the Old Hidalgo Pumphouse Museum in Hidalgo, Texas, on Nov. 5, 2025. Migrants often cross the river en route to the United States. \u003ccite>(Patricia Lim/KUT News)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Scott Lloyd, the agency’s director at the time, denied girls in ORR custody permission to end their pregnancies, \u003ca href=\"https://www.acludc.org/cases/jd-v-azar-formerly-garza-v-azar-and-garza-v-hargan-challenging-trump-administrations-refusal/\">court records show\u003c/a>. Lloyd also required the girls to get counseling about the benefits of motherhood and the harms of abortion and personally pleaded with some of them to reconsider.\u003c/p>\n\u003cp>“I worked to treat all of the children in ORR care with dignity, including the unborn children,” Lloyd told the newsrooms in an email.\u003c/p>\n\u003cp>In the fall of 2017, the American Civil Liberties Union filed a \u003ca href=\"https://www.aclu.org/cases/garza-v-hargan-challenge-trump-administrations-attempts-block-abortions-young-immigrant-women\">class action lawsuit\u003c/a> against Lloyd and the Trump administration on behalf of pregnant girls in ORR custody. The ACLU argued that denying the girls abortions violated their constitutional rights, established by the Supreme Court in its 1973 Roe v. Wade decision.[aside postID=news_12071297 hero='https://cdn.kqed.org/wp-content/uploads/sites/10/2026/01/AP26020826398216-KQED.jpg']Not long after the lawsuit was filed, White said he received a late-night phone call from Lloyd, who had a request. He wanted White to transfer an unaccompanied pregnant girl who was seeking an abortion to a migrant shelter in Texas, where, under state law, it would have been too late for her to terminate her pregnancy.\u003c/p>\n\u003cp>White believed following the order would have been unlawful because it might have denied the girl access to legal relief under the lawsuit, so he refused. The girl was not transferred.\u003c/p>\n\u003cp>Lloyd, who has since left the government, told the newsrooms he didn’t believe his request was illegal.\u003c/p>\n\u003cp>The class action lawsuit was \u003ca href=\"https://www.aclu.org/press-releases/result-aclu-litigation-trump-administration-ends-policy-prohibiting-immigrant-minors\">settled in 2020\u003c/a>; the first Trump administration agreed not to interfere with abortion access for migrant youth in federal custody going forward. Four years later, the Biden administration cemented the deal in official\u003ca href=\"https://www.govinfo.gov/content/pkg/FR-2024-04-30/pdf/2024-08329.pdf#page=219\"> regulations\u003c/a>: If a child who wanted to terminate her pregnancy was detained in a state where it was not legal, ORR had to move them to a state where it was.\u003c/p>\n\u003cp>That rule remains in place, and the agency appears to be following it; ORR has transferred two pregnant girls out of Texas since July, though agency sources said one of them chose not to terminate her pregnancy.\u003c/p>\n\u003cp>But now that Trump is back in office, his administration is working to kill the policy.\u003c/p>\n\u003ch2>‘Elegant and simple’\u003c/h2>\n\u003cp>Even before Trump won reelection, policymakers in his circle were planning a renewed attempt to restrict abortion rights for unaccompanied minors.\u003c/p>\n\u003cp>Project 2025, the Heritage Foundation’s blueprint for a politically conservative overhaul of the federal government, \u003ca href=\"https://static.heritage.org/project2025/2025_MandateForLeadership_FULL.pdf#page=510\">called for\u003c/a> ORR to stop facilitating abortions for children in its care. The plan advised the government not to detain unaccompanied children in states where abortion is available.\u003c/p>\n\u003cp>Such a change is now possible, Project 2025 argued, because Roe v. Wade is no longer an obstacle. Since the Supreme Court overturned the landmark decision in 2022, there is no longer a federal right to abortion.\u003c/p>\n\u003cfigure id=\"attachment_11918029\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11918029\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/06/gettyimages-1241510158_wide-618b2eab892ca9097bca6e83bd698df2d7f47782-scaled-e1770775479336.jpg\" alt=\"A sign that reads 'We Dissent' is held up in the foreground. The Supreme Court can be seen in the background.\" width=\"2000\" height=\"1125\">\u003cfigcaption class=\"wp-caption-text\">Abortion rights activists rally outside of the U.S. Supreme Court after the overturning of Roe Vs. Wade, in Washington, D.C., on June 24, 2022. \u003ccite>(Mandel Ngan/AFP/Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Upon returning to office, Trump signed an \u003ca href=\"https://www.whitehouse.gov/presidential-actions/2025/01/enforcing-the-hyde-amendment/\">executive order\u003c/a> “to end the forced use of Federal taxpayer dollars to fund or promote elective abortion.”\u003c/p>\n\u003cp>Then, in early July, the Department of Justice \u003ca href=\"https://www.justice.gov/olc/media/1408241/dl\">reconsidered a longstanding federal law\u003c/a> governing the use of taxpayer money for abortion. The DOJ concluded that the government cannot pay to transport detainees from one state to another to facilitate abortion access, except in cases of rape or incest or to save the life of the mother.\u003c/p>\n\u003cp>And now, ORR is working to rescind the Biden-era requirement that pregnant girls requesting an abortion be moved to states where it’s available. On Jan. 23, the agency \u003ca href=\"https://www.reginfo.gov/public/do/eoDetails?rrid=1252114\">submitted the proposed change\u003c/a> for government approval, though it has not yet published the details.[aside postID=news_12071206 hero='https://cdn.kqed.org/wp-content/uploads/sites/10/2026/01/260122-STEVE-HILTON-ON-PB-MD-04-KQED-1.jpg']Several of the ORR officials who spoke with the newsrooms said it’s unclear whether children in the agency’s custody who have been raped or need emergency medical care will still be allowed to get abortions.\u003c/p>\n\u003cp>“HHS does not comment on pending or pre-decisional rulemaking,” the agency’s spokesperson wrote when asked for details of the regulatory change. “ORR will continue to comply with all applicable federal laws, including requirements for providing necessary medical care to children in ORR custody.”\u003c/p>\n\u003cp>But the day the change was submitted, an unnamed Health and Human Services spokesperson told \u003ca href=\"https://www.dailysignal.com/2026/01/23/exclusive-hhs-advances-rule-ending-taxpayer-funded-abortion-travel-for-alien-children/\">\u003cem>The Daily Signal\u003c/em>\u003c/a>, a conservative news site, “Our goal is to save lives both for these young children that are coming across the border, that are pregnant, and to save the lives of their unborn babies.”\u003c/p>\n\u003cp>Like other experts who spoke with the newsrooms, White, the former head of ORR’s unaccompanied children program, said he thinks the San Benito directive and the anti-abortion rule change are meant to work hand in hand: Once pregnant children are placed at the San Benito shelter, the new regulations could mean they cannot be moved out of Texas to get abortions — even if keeping them there puts them at risk.\u003c/p>\n\u003cp>“It’s so elegant and simple,” White said. “All they have to do is send them to Texas.”\u003c/p>\n\u003cp>\u003cem>Mose Buchele with The Texas Newsroom contributed reporting.\u003c/em>\u003c/p>\n\u003cp>\u003cem>This story was produced by \u003c/em>\u003ca href=\"https://www.kqed.org/californianewsroom\">\u003cem>The California Newsroom\u003c/em>\u003c/a>\u003cem> and \u003c/em>\u003ca href=\"https://www.kut.org/texasnewsroom\">\u003cem>The Texas Newsroom\u003c/em>\u003c/a>\u003cem>. The California Newsroom is a collaboration of public media outlets that includes NPR, CalMatters, KQED (San Francisco), LAist and KCRW (Los Angeles), KPBS (San Diego) and other stations across the state. The Texas Newsroom is a public radio journalism collaboration that includes NPR, KERA (North Texas), Houston Public Media, KUT (Austin), Texas Public Radio (San Antonio) and other stations across the state.\u003c/em>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"title": "Trump Administration Sends Pregnant Unaccompanied Minors to Texas Shelter Flagged as Medically Inadequate | KQED",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>The \u003ca href=\"https://www.kqed.org/news/tag/donald-trump\">Trump\u003c/a> administration is sending all pregnant unaccompanied minors apprehended by immigration enforcement to a single group shelter in South Texas. The decision was made over urgent objections from the government’s own health and child welfare officials, who say both the facility and the region lack the specialized care the girls need.\u003c/p>\n\u003cp>That’s according to seven sources who work at the Office of Refugee Resettlement within the U.S. Department of Health and Human Services, which handles the custody and care of children who cross the border without a parent or legal guardian, or are separated from family by immigration authorities. All of the sources declined to be named for fear of retaliation.\u003c/p>\n\u003cp>Since late July, more than a dozen pregnant minors have been placed at the Texas facility, which is located in the small border city of San Benito. Some were as young as 13, and at least half of those taken in so far became pregnant as a result of rape, sources said. Their pregnancies are considered\u003ca href=\"https://www.sciencedirect.com/science/article/pii/S1877575625000722\"> high risk\u003c/a> by definition, particularly for the\u003ca href=\"https://utswmed.org/medblog/early-teen-pregnancy-health-risks/\"> youngest\u003c/a> girls.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“This group of kids is clearly recognized as our most vulnerable,” one of the sources said. Rank-and-file staff, the source said, are “losing sleep over it, wondering if kids are going to be placed in programs where they’re not going to have access to the care they need.”\u003c/p>\n\u003cp>The move marks a sharp departure from longstanding federal practice, which placed pregnant, unaccompanied migrant children in ORR shelters or foster homes around the country that are equipped to handle high-risk pregnancies. ORR sources, along with more than a dozen former government officials, health care professionals, migrant advocates and civil rights attorneys, said they worry the Trump administration is putting children in danger at the San Benito shelter to advance an ideological goal: denying them access to abortion by placing them in a state where it’s virtually banned.\u003c/p>\n\u003cfigure id=\"attachment_12073141\" class=\"wp-caption aligncenter\" style=\"max-width: 1600px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-12073141 size-full\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/02/20251104_GlobalX_PL_03.jpg\" alt=\"\" width=\"1600\" height=\"1067\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/02/20251104_GlobalX_PL_03.jpg 1600w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/02/20251104_GlobalX_PL_03-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/02/20251104_GlobalX_PL_03-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 1600px) 100vw, 1600px\">\u003cfigcaption class=\"wp-caption-text\">A Global X plane sits on a runway near Valley International Airport in Harlington, Texas, on Nov. 4, 2025. The Charter airline operates most deportation flights for U.S. Immigration and Customs Enforcement, transporting migrants across the country and abroad. \u003ccite>(Patricia Lim/KUT News)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“This is 100% and exclusively about abortion,” said Jonathan White, a longtime federal health official who ran ORR’s unaccompanied children program for part of President Donald Trump’s first term. White, who recently retired from the government, said the administration tried and failed to restrict abortion access for unaccompanied minors in 2017. “Now they casually roll out what they brutally fought to accomplish last time and didn’t.”\u003c/p>\n\u003cp>Asked via email why the administration is sending pregnant children to San Benito, an HHS spokesperson who asked not to be named wrote that “ORR’s placement decisions are guided by child welfare best practices and are designed to ensure each child is housed in the safest, most developmentally appropriate setting, including for children who are pregnant or parenting.”\u003c/p>\n\u003cp>But several of the ORR officials took issue with the agency’s statement. “ORR is supposed to be a child welfare organization,” one of them said. “Putting pregnant kids in San Benito is not a decision you make when you care about children’s safety.”\u003c/p>\n\u003cp>ORR’s acting director, Angie Salazar, instructed agency staff to send “any pregnant children” to San Benito beginning July 22, 2025, according to an internal email obtained as part of a six-month investigation by The California Newsroom and The Texas Newsroom, public media collaboratives that worked together to produce this story.\u003c/p>\n\u003cfigure id=\"attachment_12073165\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12073165\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/02/KQED-Email-2.jpg\" alt=\"\" width=\"1920\" height=\"700\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/02/KQED-Email-2.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/02/KQED-Email-2-160x58.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/02/KQED-Email-2-1536x560.jpg 1536w\" sizes=\"auto, (max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">A screenshot of a July 22, 2025, email notifying ORR supervisors of a directive to send pregnant unaccompanied minors to a single shelter in San Benito, Texas, despite objections from the government’s own health and child welfare officials.\u003c/figcaption>\u003c/figure>\n\u003cp>Several sources said a handful of pregnant girls have mistakenly been placed in other shelters because immigration authorities didn’t know they were pregnant when they were transferred to ORR custody.\u003c/p>\n\u003cp>Since the July order, none of the pregnant girls at the San Benito facility have experienced major medical problems, according to ORR sources and Aimee Korolev, deputy director of ProBAR, an organization that provides legal services to children there. They said several of the girls have given birth and are detained with their infants.\u003c/p>\n\u003cp>But officials interviewed for this story said they worry the shelter is only one high-risk pregnancy away from catastrophe.\u003c/p>\n\u003cp>“I feel like we’re just waiting for something terrible to happen,” one of the ORR sources said.\u003c/p>\n\u003ch2>‘Blown away by the level of risk’\u003c/h2>\n\u003cp>There are dozens of ORR shelters or foster homes across the country that are designated to care for pregnant unaccompanied children, according to ORR officials, with 14 in California alone. None of the officials could recall a time when all of the pregnant minors in the agency’s custody were concentrated in one shelter.\u003c/p>\n\u003cp>Detaining them in San Benito, Texas, doctors and public health experts said, is a dangerous gambit.\u003c/p>\n\u003cfigure id=\"attachment_12073147\" class=\"wp-caption aligncenter\" style=\"max-width: 1600px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-12073147 size-full\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/02/20251105_UrbanStrategy_PL_06.jpg\" alt=\"\" width=\"1600\" height=\"1067\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/02/20251105_UrbanStrategy_PL_06.jpg 1600w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/02/20251105_UrbanStrategy_PL_06-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/02/20251105_UrbanStrategy_PL_06-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 1600px) 100vw, 1600px\">\u003cfigcaption class=\"wp-caption-text\">Parked white vans inside a gated building at Urban Strategies, a facility that holds unaccompanied minor immigrants under contract with the US Office of Refugee Resettlement, in San Benito, Texas, on Nov. 5, 2025. Refugio San Benito is a facility operated by the group Urban Strategies. \u003ccite>(Patricia Lim/KUT News)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“It’s not good to be a pregnant person in Texas, no matter who you are,” said Annie Leone, a nurse midwife who recently spent five years caring for pregnant and postpartum migrant women and girls at a large family shelter not far from San Benito. “So, to put pregnant migrant kids in Texas, and then in one of the worst health care regions of Texas, is not good at all.”\u003c/p>\n\u003cp>The specialized obstetric care that exists in Texas is mostly available \u003ca href=\"https://www.smfm.org/find-an-mfm?MapView=true&Address=San%20Benito%2C%20TX%2C%20USA&Latitude=26.132576&Longitude=-97.6311006&Radius=100\">in its larger cities\u003c/a>, hours from San Benito. And several factors, including \u003ca href=\"https://www.npr.org/sections/shots-health-news/2025/09/16/nx-s1-5542408/health-insurance-obbba-texas-uninsurance-rates\">the high number of uninsured patients\u003c/a>, have eroded the availability of \u003ca href=\"https://www.commonwealthfund.org/publications/scorecard/2024/jul/2024-state-scorecard-womens-health-and-reproductive-care\">health care across the state\u003c/a>.\u003c/p>\n\u003cp>Furthermore, Texas’ near-ban on abortion has been \u003ca href=\"https://www.propublica.org/article/high-risk-pregnancies-chronic-conditions-abortion-bans\">especially devastating to obstetric care\u003c/a>. The law allows an exception in cases where the mother’s life is in danger or one of her bodily functions is at risk, but doctors have been confused as to what that means.\u003c/p>\n\u003cp>Many doctors have \u003ca href=\"https://19thnews.org/2023/06/abortion-gender-affirming-care-bans-doctors-leaving-texas/\">left to practice elsewhere\u003c/a>, and those who’ve stayed are often \u003ca href=\"https://assets-us-01.kc-usercontent.com/9fd8e81d-74db-00ef-d0b1-5d17c12fdda9/34392fc8-1c9a-48a2-be8f-3f79d8a4a7d5/FINAL-TX-OBGYN-Workforce-Study_2024-10_f.pdf\">scared\u003c/a> to perform procedures they worry could come with criminal charges. While Texas passed a law \u003ca href=\"https://www.npr.org/2025/07/19/nx-s1-5445143/texas-abortion-life-of-mother\">clarifying the exceptions\u003c/a> last year, experts \u003ca href=\"https://www.propublica.org/article/texas-medical-board-abortion-training-doctors\">have said\u003c/a> it may not be enough to assuage doctors’ fears.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Several maternal health experts described a sobering list of dangers for the girls at the San Benito shelter: If one of them develops an \u003ca href=\"https://www.acog.org/advocacy/facts-are-important/understanding-ectopic-pregnancy\">ectopic pregnancy\u003c/a> (where the fertilized egg implants outside the uterus), if she \u003ca href=\"https://www.ncbi.nlm.nih.gov/search/research-news/16798/\">miscarries\u003c/a> or if her \u003ca href=\"https://www.reuters.com/article/fact-check/termination-of-pregnancy-can-be-necessary-to-save-a-womans-life-experts-say-idUSL1N2TC0VD/\">water breaks too early\u003c/a> and she gets an infection, the\u003ca href=\"https://www.acog.org/news/news-releases/2019/09/abortion-can-be-medically-necessary\"> emergency care she needs\u003c/a> could be \u003ca href=\"https://www.propublica.org/series/life-of-the-mother\">delayed or denied by doctors\u003c/a> wary of the abortion ban.\u003c/p>\n\u003cp>Getting the care that is available could take too long to save her life or the baby’s, they added.\u003c/p>\n\u003cp>Adolescents are also more likely to give birth early, which can be life-threatening for both mother and baby. The youngest face complications during labor and delivery because their pelvises aren’t fully developed, said Dr. Anne-Marie Amies Oelschlager, an obstetrician in Washington state who specializes in adolescent pregnancy.\u003c/p>\n\u003cp>“These are young adolescents who are still going through puberty,” she said. “Their bodies are still changing.”\u003c/p>\n\u003cp>Pregnant girls who recently endured the often harrowing journey to the U.S. face even more risk, obstetrics experts said. Many \u003ca href=\"https://pmc.ncbi.nlm.nih.gov/articles/PMC6752644/\">have been raped\u003c/a> along the way and have sexually transmitted infections that can be dangerous during pregnancy. Add to that \u003ca href=\"https://www.projecthope.org/wp-content/uploads/2024/04/Project-Hope-Mexico-NEW-FINAL-1_19_23.pdf\">little to no access to prenatal care\u003c/a> or \u003ca href=\"https://www.borderreport.com/hot-topics/immigration/many-migrants-arriving-at-border-malnourished-health-experts-say/\">proper nourishment\u003c/a>, and then the trauma of \u003ca href=\"https://pmc.ncbi.nlm.nih.gov/articles/PMC8570101/\">being detained\u003c/a>.\u003c/p>\n\u003cp>“You couldn’t set up a worse scenario,” said Dr. Blair Cushing, who runs a women’s health clinic in McAllen, about 45 minutes from San Benito. “I’m kind of blown away by the level of risk that they’re concentrating in this facility.”\u003c/p>\n\u003ch2>A history of problems\u003c/h2>\n\u003cp>The San Benito shelter is owned and operated by Urban Strategies, a for-profit company that has contracted with the federal government to care for unaccompanied children for more than a decade, according to \u003ca href=\"http://usaspending.gov\">USAspending.gov\u003c/a>.\u003c/p>\n\u003cp>The main building, an old tan brick Baptist Church, occupies a city block in downtown San Benito, a quiet town of about 25,000. The church was converted to a migrant shelter in 2015 and was managed by two other contractors before Urban Strategies \u003ca href=\"https://www.federalregister.gov/documents/2021/11/30/2021-25971/announcement-of-intent-to-issue-replacement-award-to-provide-residential-services-shelter\">took it over in 2021\u003c/a>.\u003c/p>\n\u003cp>On a fall day last year, there were no signs of activity at the facility, though children’s lawn toys and playground equipment were visible behind a wooden fence. A guard was stationed at one of the entrances.\u003c/p>\n\u003cfigure id=\"attachment_12073070\" class=\"wp-caption aligncenter\" style=\"max-width: 1600px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12073070\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/02/20251104_MELIZA_PL_01-KQED.jpg\" alt=\"\" width=\"1600\" height=\"1067\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/02/20251104_MELIZA_PL_01-KQED.jpg 1600w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/02/20251104_MELIZA_PL_01-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/02/20251104_MELIZA_PL_01-KQED-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 1600px) 100vw, 1600px\">\u003cfigcaption class=\"wp-caption-text\">Meliza Fonseca lives across the street from the San Benito shelter. She said she occasionally sees children in the yard on weekends, “but for the most part, you don’t see them.” \u003ccite>(Patricia Lim/KUT)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“It’s pretty quiet, just like it is today,” said Meliza Fonseca, who lives nearby. “That’s the way it is every day.”\u003c/p>\n\u003cp>She said she occasionally sees kids playing in the yard on weekends, “but for the most part, you don’t see them.”\u003c/p>\n\u003cp>Reached by email, the founder and president of Urban Strategies, Lisa Cummins, wrote that the company is “deeply committed to the care and well-being of the children we serve,” but directed any questions about ORR-contracted shelters to the federal agency.\u003c/p>\n\u003cp>When asked about the San Benito facility, the ORR spokesperson wrote that “Urban Strategies has a long-standing record of delivering high-quality care to pregnant unaccompanied minors, with a consistently low staff turnover.”\u003c/p>\n\u003cfigure id=\"attachment_12073142\" class=\"wp-caption aligncenter\" style=\"max-width: 1600px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12073142\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/02/20251105_UrbanStrategy_PL_04.jpg\" alt=\"\" width=\"1600\" height=\"1067\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/02/20251105_UrbanStrategy_PL_04.jpg 1600w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/02/20251105_UrbanStrategy_PL_04-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/02/20251105_UrbanStrategy_PL_04-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 1600px) 100vw, 1600px\">\u003cfigcaption class=\"wp-caption-text\">A gated building at Urban Strategies, a facility that holds unaccompanied minor immigrants under contract with the U.S. Office of Refugee Resettlement, in San Benito, Texas, on Nov. 5, 2025. \u003ccite>(Patricia Lim/KUT News)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>But agency sources who spoke with the newsrooms said that as recently as 2024, staff members at the shelter failed to arrange timely medical appointments for pregnant girls or immediately share critical health information with the federal agency and discharged them without arrangements to continue their medical care.\u003c/p>\n\u003cp>ORR temporarily barred the shelter from receiving pregnant girls while Urban Strategies implemented a remediation plan, but the plan did not add staff or enhance their qualifications, the sources said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Several sources inside the agency said its leadership was provided with a list of shelters that are better prepared to handle children with high-risk pregnancies. All of those shelters are located outside of Texas, in regions where the full range of necessary medical care is available. Yet the directive to place them at San Benito remains.\u003c/p>\n\u003cp>“It’s cruel, it’s just cruel,” one of the officials said. “They don’t care about any of these kids. They’re playing politics with children’s health.”\u003c/p>\n\u003ch2>‘A dress rehearsal’\u003c/h2>\n\u003cp>Jonathan White, who ran ORR’s unaccompanied children program from January of 2017 to March of 2018, said he wasn’t surprised to learn that the new administration is moving pregnant unaccompanied children to Texas.\u003c/p>\n\u003cp>“I’ve been expecting this since Trump returned to office,” White said in an interview.\u003c/p>\n\u003cp>He said he views the San Benito order as a continuation of an anti-abortion policy shift that began in 2017, which “ultimately proved to be a dress rehearsal for the current administration.”\u003c/p>\n\u003cfigure id=\"attachment_12073151\" class=\"wp-caption aligncenter\" style=\"max-width: 1600px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-12073151 size-full\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/02/20251105_RioGrande_PL_02.jpg\" alt=\"\" width=\"1600\" height=\"1067\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/02/20251105_RioGrande_PL_02.jpg 1600w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/02/20251105_RioGrande_PL_02-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/02/20251105_RioGrande_PL_02-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 1600px) 100vw, 1600px\">\u003cfigcaption class=\"wp-caption-text\">The Rio Grande is seen near the Old Hidalgo Pumphouse Museum in Hidalgo, Texas, on Nov. 5, 2025. Migrants often cross the river en route to the United States. \u003ccite>(Patricia Lim/KUT News)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Scott Lloyd, the agency’s director at the time, denied girls in ORR custody permission to end their pregnancies, \u003ca href=\"https://www.acludc.org/cases/jd-v-azar-formerly-garza-v-azar-and-garza-v-hargan-challenging-trump-administrations-refusal/\">court records show\u003c/a>. Lloyd also required the girls to get counseling about the benefits of motherhood and the harms of abortion and personally pleaded with some of them to reconsider.\u003c/p>\n\u003cp>“I worked to treat all of the children in ORR care with dignity, including the unborn children,” Lloyd told the newsrooms in an email.\u003c/p>\n\u003cp>In the fall of 2017, the American Civil Liberties Union filed a \u003ca href=\"https://www.aclu.org/cases/garza-v-hargan-challenge-trump-administrations-attempts-block-abortions-young-immigrant-women\">class action lawsuit\u003c/a> against Lloyd and the Trump administration on behalf of pregnant girls in ORR custody. The ACLU argued that denying the girls abortions violated their constitutional rights, established by the Supreme Court in its 1973 Roe v. Wade decision.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Not long after the lawsuit was filed, White said he received a late-night phone call from Lloyd, who had a request. He wanted White to transfer an unaccompanied pregnant girl who was seeking an abortion to a migrant shelter in Texas, where, under state law, it would have been too late for her to terminate her pregnancy.\u003c/p>\n\u003cp>White believed following the order would have been unlawful because it might have denied the girl access to legal relief under the lawsuit, so he refused. The girl was not transferred.\u003c/p>\n\u003cp>Lloyd, who has since left the government, told the newsrooms he didn’t believe his request was illegal.\u003c/p>\n\u003cp>The class action lawsuit was \u003ca href=\"https://www.aclu.org/press-releases/result-aclu-litigation-trump-administration-ends-policy-prohibiting-immigrant-minors\">settled in 2020\u003c/a>; the first Trump administration agreed not to interfere with abortion access for migrant youth in federal custody going forward. Four years later, the Biden administration cemented the deal in official\u003ca href=\"https://www.govinfo.gov/content/pkg/FR-2024-04-30/pdf/2024-08329.pdf#page=219\"> regulations\u003c/a>: If a child who wanted to terminate her pregnancy was detained in a state where it was not legal, ORR had to move them to a state where it was.\u003c/p>\n\u003cp>That rule remains in place, and the agency appears to be following it; ORR has transferred two pregnant girls out of Texas since July, though agency sources said one of them chose not to terminate her pregnancy.\u003c/p>\n\u003cp>But now that Trump is back in office, his administration is working to kill the policy.\u003c/p>\n\u003ch2>‘Elegant and simple’\u003c/h2>\n\u003cp>Even before Trump won reelection, policymakers in his circle were planning a renewed attempt to restrict abortion rights for unaccompanied minors.\u003c/p>\n\u003cp>Project 2025, the Heritage Foundation’s blueprint for a politically conservative overhaul of the federal government, \u003ca href=\"https://static.heritage.org/project2025/2025_MandateForLeadership_FULL.pdf#page=510\">called for\u003c/a> ORR to stop facilitating abortions for children in its care. The plan advised the government not to detain unaccompanied children in states where abortion is available.\u003c/p>\n\u003cp>Such a change is now possible, Project 2025 argued, because Roe v. Wade is no longer an obstacle. Since the Supreme Court overturned the landmark decision in 2022, there is no longer a federal right to abortion.\u003c/p>\n\u003cfigure id=\"attachment_11918029\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11918029\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2022/06/gettyimages-1241510158_wide-618b2eab892ca9097bca6e83bd698df2d7f47782-scaled-e1770775479336.jpg\" alt=\"A sign that reads 'We Dissent' is held up in the foreground. The Supreme Court can be seen in the background.\" width=\"2000\" height=\"1125\">\u003cfigcaption class=\"wp-caption-text\">Abortion rights activists rally outside of the U.S. Supreme Court after the overturning of Roe Vs. Wade, in Washington, D.C., on June 24, 2022. \u003ccite>(Mandel Ngan/AFP/Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Upon returning to office, Trump signed an \u003ca href=\"https://www.whitehouse.gov/presidential-actions/2025/01/enforcing-the-hyde-amendment/\">executive order\u003c/a> “to end the forced use of Federal taxpayer dollars to fund or promote elective abortion.”\u003c/p>\n\u003cp>Then, in early July, the Department of Justice \u003ca href=\"https://www.justice.gov/olc/media/1408241/dl\">reconsidered a longstanding federal law\u003c/a> governing the use of taxpayer money for abortion. The DOJ concluded that the government cannot pay to transport detainees from one state to another to facilitate abortion access, except in cases of rape or incest or to save the life of the mother.\u003c/p>\n\u003cp>And now, ORR is working to rescind the Biden-era requirement that pregnant girls requesting an abortion be moved to states where it’s available. On Jan. 23, the agency \u003ca href=\"https://www.reginfo.gov/public/do/eoDetails?rrid=1252114\">submitted the proposed change\u003c/a> for government approval, though it has not yet published the details.\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>Several of the ORR officials who spoke with the newsrooms said it’s unclear whether children in the agency’s custody who have been raped or need emergency medical care will still be allowed to get abortions.\u003c/p>\n\u003cp>“HHS does not comment on pending or pre-decisional rulemaking,” the agency’s spokesperson wrote when asked for details of the regulatory change. “ORR will continue to comply with all applicable federal laws, including requirements for providing necessary medical care to children in ORR custody.”\u003c/p>\n\u003cp>But the day the change was submitted, an unnamed Health and Human Services spokesperson told \u003ca href=\"https://www.dailysignal.com/2026/01/23/exclusive-hhs-advances-rule-ending-taxpayer-funded-abortion-travel-for-alien-children/\">\u003cem>The Daily Signal\u003c/em>\u003c/a>, a conservative news site, “Our goal is to save lives both for these young children that are coming across the border, that are pregnant, and to save the lives of their unborn babies.”\u003c/p>\n\u003cp>Like other experts who spoke with the newsrooms, White, the former head of ORR’s unaccompanied children program, said he thinks the San Benito directive and the anti-abortion rule change are meant to work hand in hand: Once pregnant children are placed at the San Benito shelter, the new regulations could mean they cannot be moved out of Texas to get abortions — even if keeping them there puts them at risk.\u003c/p>\n\u003cp>“It’s so elegant and simple,” White said. “All they have to do is send them to Texas.”\u003c/p>\n\u003cp>\u003cem>Mose Buchele with The Texas Newsroom contributed reporting.\u003c/em>\u003c/p>\n\u003cp>\u003cem>This story was produced by \u003c/em>\u003ca href=\"https://www.kqed.org/californianewsroom\">\u003cem>The California Newsroom\u003c/em>\u003c/a>\u003cem> and \u003c/em>\u003ca href=\"https://www.kut.org/texasnewsroom\">\u003cem>The Texas Newsroom\u003c/em>\u003c/a>\u003cem>. The California Newsroom is a collaboration of public media outlets that includes NPR, CalMatters, KQED (San Francisco), LAist and KCRW (Los Angeles), KPBS (San Diego) and other stations across the state. The Texas Newsroom is a public radio journalism collaboration that includes NPR, KERA (North Texas), Houston Public Media, KUT (Austin), Texas Public Radio (San Antonio) and other stations across the state.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>Carrie Esqueda’s injured knee has hurt since last summer, sometimes agonizingly so. It hurts when she tries to walk in her hilly Riverside County neighborhood and show homes to real estate clients. The 57-year-old misses the regular one-hour strolls with friends that kept her healthy and fit.\u003c/p>\n\u003cp>After months waiting for a high-demand surgery at Kaiser Permanente to repair her torn meniscus, Esqueda said the procedure was scheduled for Jan. 29. But the night before, the nonprofit health care organization called with bad news: Her operation was canceled due to \u003ca href=\"https://www.kqed.org/news/12071014/kaiser-strike-sees-thousands-walk-out-in-california-this-time-with-no-end-in-sight\">an employee strike\u003c/a>.\u003c/p>\n\u003cp>“I was absolutely devastated. I literally wanted to cry,” Esqueda said. “I am in constant pain. I cannot really walk without a knee brace because it always feels like it’s going to buckle. So I’ve been in a bad situation. And now, who knows how long it’ll take.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Esqueda is one of a growing number of patients reporting delays in care as a labor conflict intensifies at Kaiser, rippling across California and Hawaii, with no contract deal in sight. Meanwhile, the ranks of up to 31,000 nurses, physician assistants, physical therapists and other health care workers striking for a third week over staffing levels and compensation swelled on Monday, as thousands more employees walked off pharmacy and laboratory jobs.\u003c/p>\n\u003cp>The Oakland-based health care giant, which has kept most of its facilities open, declined requests for more information on how many procedures it has postponed since the strike began on Jan. 26.\u003c/p>\n\u003cp>The company has relocated staffers to affected hospitals and medical offices, and hired temporary workers, a mounting expense that could add up to millions of dollars per week. Some pharmacies will close.\u003c/p>\n\u003cfigure id=\"attachment_12072988\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12072988\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/02/020926_KAISERSTRIKE_8239B-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/02/020926_KAISERSTRIKE_8239B-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/02/020926_KAISERSTRIKE_8239B-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/02/020926_KAISERSTRIKE_8239B-KQED-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Carrie Esqueda wears a knee brace at home in Wildomar on Feb. 9, 2026. \u003ccite>(Lauren Justice for KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“Kaiser Permanente remains committed to its nurses, employees, and patients and focused on reaching a fair agreement that recognizes employees’ value while protecting access to affordable, quality care for the members and patients who rely on us every day,” a company statement said.\u003c/p>\n\u003cp>While Kaiser said its doctors, nurses and contingency personnel are working to meet members’ needs, the nurse anesthetists and other highly specialized professionals who are on the picket lines can be hard to replace. Disruptions are especially affecting patients in Southern California, where most of the workers on strike are based.\u003c/p>\n\u003cp>Dozens of cancer patients have said on social media that their chemotherapy treatments were canceled or moved with little warning to non-Kaiser facilities that required further travel, while others described deserted hospital halls and long pharmacy wait lines. Several patients told KQED that their postponed hip replacement and other surgeries due to the staffing shortages left them depressed and struggling.\u003c/p>\n\u003cp>“I feel angry and hopeless because my surgery has been delayed by five weeks, and that’s five more weeks of my life waiting to get back to normal,” said Kayla Howell, whose Jan. 27 operation to repair a torn ACL was rescheduled to March. “Having that taken away, you realize, ‘Oh my God, I use my leg for everything, even taking a shower is extremely difficult and painful.’”[aside postID=news_12070141 hero='https://cdn.kqed.org/wp-content/uploads/sites/10/2026/01/Emmas-room-2.jpg']The 27-year-old kindergarten teacher assistant in San José had enlisted her mother to travel from Ireland to help with post-surgery recovery, including the weeks Howell must spend on crutches. But the setback upended those plans, as rebooking her mother’s flight and lodging would cost hundreds more dollars.\u003c/p>\n\u003cp>“It’s just so frustrating because we just want care, and we deserve care. I pay my health insurance, and I pay my premiums, and where is that money going?” she said, adding that she wants Kaiser executives to work urgently to resolve the strike. “Help people get care, because that’s what their company is supposed to be for. But instead, people are suffering.”\u003c/p>\n\u003cp>Meanwhile, labor negotiations are at a standstill, with both parties accusing each other of halting progress. Kaiser is refusing to meet with national union negotiators, saying it is shifting unresolved contract issues to local bargaining tables. The union, which has called that move illegal, filed a federal unfair labor practices complaint against Kaiser.\u003c/p>\n\u003cp>Union-represented employees want a 25% raise over a four-year contract, with no cuts to pensions and other benefits, as well as more input on scheduling and staffing ratios. The company, which has dismissed claims of chronic understaffing or declining patient care, has stuck for months to its offer to increase wages by 21.5%.\u003c/p>\n\u003cp>“I’ve put all of these years into this company, and to see that it has come to this, it’s very overwhelming and it’s heartbreaking,” said Christina Thomas, a 40-year-old pharmacy technician with the United Food and Commercial Workers who walked off the job this week.\u003c/p>\n\u003cp>The mother of two said wages have not kept up with inflation, while she and co-workers struggle to fill thousands of prescriptions daily at a Lancaster pharmacy.\u003c/p>\n\u003cfigure id=\"attachment_11963409\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11963409\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231004-KAISER-STRIKE-MD-10-KQED.jpg\" alt='A large modern building with the words \"Kaiser Permanente\" across the top.' width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231004-KAISER-STRIKE-MD-10-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231004-KAISER-STRIKE-MD-10-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231004-KAISER-STRIKE-MD-10-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231004-KAISER-STRIKE-MD-10-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231004-KAISER-STRIKE-MD-10-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231004-KAISER-STRIKE-MD-10-KQED-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">The Kaiser Permanente Oakland Medical Center in Oakland on Oct. 4, 2023. \u003ccite>(Martin do Nascimento/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“At the end of the day, we are striking for our patients, and so that Kaiser can wake up and come back to the table,” she said.\u003c/p>\n\u003cp>As a nonprofit health plan and care provider, Kaiser reinvests its revenue into facilities and services for patients. The organization, founded in 1945, has grown to serve more than 12 million people in eight states and the District of Columbia, emphasizing preventive care.\u003c/p>\n\u003cp>Company executives argue that greater wage raises are unsustainable and would increase members’ premiums at a time when massive budget cuts to Medicaid and other federal policies could make insurance unaffordable for millions of Americans. Under the Trump administration, Kaiser and other health care systems face an uncertain financial forecast with potential revenue losses and increased costs.\u003c/p>\n\u003cp>As the work stoppage drags on in California, where most Kaiser customers are located, the company risks increasing reputational damage among not only its patients but also its workforce, resulting in longer-term costs, according to health care business experts.\u003c/p>\n\u003cfigure id=\"attachment_12073048\" class=\"wp-caption alignleft\" style=\"max-width: 1333px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-12073048 size-full\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/02/020926_KAISERSTRIKE_8223B-KQED.jpg\" alt=\"\" width=\"1333\" height=\"2000\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/02/020926_KAISERSTRIKE_8223B-KQED.jpg 1333w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/02/020926_KAISERSTRIKE_8223B-KQED-160x240.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/02/020926_KAISERSTRIKE_8223B-KQED-1024x1536.jpg 1024w\" sizes=\"auto, (max-width: 1333px) 100vw, 1333px\">\u003cfigcaption class=\"wp-caption-text\">Carrie Esqueda at home in Wildomar, California, on Monday, Feb. 9, 2026. \u003ccite>(Lauren Justice for KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“The bigger economic risk isn’t what the strike costs this week, but it’s what happens if workforce distrust becomes structural at Kaiser, because you will get higher turnover, you’re going to have higher recruitment costs,” said Michael Skolnik, academic director of the Dominican University of California’s health care executive MBA program.\u003c/p>\n\u003cp>Patients like Alice Gallagher sympathize with the strikers but fear further disruptions. Last week, the San Diego County clarinetist said she was temporarily unable to order her medication for epilepsy via the Kaiser app. She tried calling her local pharmacy and then a regional number, she said, but nobody would help her.\u003c/p>\n\u003cp>Gallagher, 46, started to panic.\u003c/p>\n\u003cp>“If I don’t have my medication, I end up in the hospital… because my seizures are so bad once they get out of control,” she said, adding that, as she can’t drive, it would take her hours to travel on paratransit to visit her pharmacy.\u003c/p>\n\u003cp>Gallagher was later able to order her prescriptions online. But the experience left her wondering about other vulnerable patients in need of timely care.\u003c/p>\n\u003cp>“I had my moment of panic,” she said. “But for someone who’s just been diagnosed with something and feels overwhelmed, or someone who has cancer and then they are at the mercy of this stalemate in the negotiations, that’s who’s really suffering. That’s what’s really tough here.”\u003c/p>\n\u003cp>Esqueda, the real estate agent with a torn meniscus, said that she’s watching the news daily, hoping that Kaiser ends the strike so that she can get the surgery she needs to heal.\u003c/p>\n\u003cp>“I’m just praying that they get to some resolution,” Esqueda said. “I hope they listen and take into consideration that there are people’s lives that are being turned upside down.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Carrie Esqueda’s injured knee has hurt since last summer, sometimes agonizingly so. It hurts when she tries to walk in her hilly Riverside County neighborhood and show homes to real estate clients. The 57-year-old misses the regular one-hour strolls with friends that kept her healthy and fit.\u003c/p>\n\u003cp>After months waiting for a high-demand surgery at Kaiser Permanente to repair her torn meniscus, Esqueda said the procedure was scheduled for Jan. 29. But the night before, the nonprofit health care organization called with bad news: Her operation was canceled due to \u003ca href=\"https://www.kqed.org/news/12071014/kaiser-strike-sees-thousands-walk-out-in-california-this-time-with-no-end-in-sight\">an employee strike\u003c/a>.\u003c/p>\n\u003cp>“I was absolutely devastated. I literally wanted to cry,” Esqueda said. “I am in constant pain. I cannot really walk without a knee brace because it always feels like it’s going to buckle. So I’ve been in a bad situation. And now, who knows how long it’ll take.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Esqueda is one of a growing number of patients reporting delays in care as a labor conflict intensifies at Kaiser, rippling across California and Hawaii, with no contract deal in sight. Meanwhile, the ranks of up to 31,000 nurses, physician assistants, physical therapists and other health care workers striking for a third week over staffing levels and compensation swelled on Monday, as thousands more employees walked off pharmacy and laboratory jobs.\u003c/p>\n\u003cp>The Oakland-based health care giant, which has kept most of its facilities open, declined requests for more information on how many procedures it has postponed since the strike began on Jan. 26.\u003c/p>\n\u003cp>The company has relocated staffers to affected hospitals and medical offices, and hired temporary workers, a mounting expense that could add up to millions of dollars per week. Some pharmacies will close.\u003c/p>\n\u003cfigure id=\"attachment_12072988\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-12072988\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/02/020926_KAISERSTRIKE_8239B-KQED.jpg\" alt=\"\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/02/020926_KAISERSTRIKE_8239B-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/02/020926_KAISERSTRIKE_8239B-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/02/020926_KAISERSTRIKE_8239B-KQED-1536x1024.jpg 1536w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">Carrie Esqueda wears a knee brace at home in Wildomar on Feb. 9, 2026. \u003ccite>(Lauren Justice for KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“Kaiser Permanente remains committed to its nurses, employees, and patients and focused on reaching a fair agreement that recognizes employees’ value while protecting access to affordable, quality care for the members and patients who rely on us every day,” a company statement said.\u003c/p>\n\u003cp>While Kaiser said its doctors, nurses and contingency personnel are working to meet members’ needs, the nurse anesthetists and other highly specialized professionals who are on the picket lines can be hard to replace. Disruptions are especially affecting patients in Southern California, where most of the workers on strike are based.\u003c/p>\n\u003cp>Dozens of cancer patients have said on social media that their chemotherapy treatments were canceled or moved with little warning to non-Kaiser facilities that required further travel, while others described deserted hospital halls and long pharmacy wait lines. Several patients told KQED that their postponed hip replacement and other surgeries due to the staffing shortages left them depressed and struggling.\u003c/p>\n\u003cp>“I feel angry and hopeless because my surgery has been delayed by five weeks, and that’s five more weeks of my life waiting to get back to normal,” said Kayla Howell, whose Jan. 27 operation to repair a torn ACL was rescheduled to March. “Having that taken away, you realize, ‘Oh my God, I use my leg for everything, even taking a shower is extremely difficult and painful.’”\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>The 27-year-old kindergarten teacher assistant in San José had enlisted her mother to travel from Ireland to help with post-surgery recovery, including the weeks Howell must spend on crutches. But the setback upended those plans, as rebooking her mother’s flight and lodging would cost hundreds more dollars.\u003c/p>\n\u003cp>“It’s just so frustrating because we just want care, and we deserve care. I pay my health insurance, and I pay my premiums, and where is that money going?” she said, adding that she wants Kaiser executives to work urgently to resolve the strike. “Help people get care, because that’s what their company is supposed to be for. But instead, people are suffering.”\u003c/p>\n\u003cp>Meanwhile, labor negotiations are at a standstill, with both parties accusing each other of halting progress. Kaiser is refusing to meet with national union negotiators, saying it is shifting unresolved contract issues to local bargaining tables. The union, which has called that move illegal, filed a federal unfair labor practices complaint against Kaiser.\u003c/p>\n\u003cp>Union-represented employees want a 25% raise over a four-year contract, with no cuts to pensions and other benefits, as well as more input on scheduling and staffing ratios. The company, which has dismissed claims of chronic understaffing or declining patient care, has stuck for months to its offer to increase wages by 21.5%.\u003c/p>\n\u003cp>“I’ve put all of these years into this company, and to see that it has come to this, it’s very overwhelming and it’s heartbreaking,” said Christina Thomas, a 40-year-old pharmacy technician with the United Food and Commercial Workers who walked off the job this week.\u003c/p>\n\u003cp>The mother of two said wages have not kept up with inflation, while she and co-workers struggle to fill thousands of prescriptions daily at a Lancaster pharmacy.\u003c/p>\n\u003cfigure id=\"attachment_11963409\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11963409\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231004-KAISER-STRIKE-MD-10-KQED.jpg\" alt='A large modern building with the words \"Kaiser Permanente\" across the top.' width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231004-KAISER-STRIKE-MD-10-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231004-KAISER-STRIKE-MD-10-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231004-KAISER-STRIKE-MD-10-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231004-KAISER-STRIKE-MD-10-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231004-KAISER-STRIKE-MD-10-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/10/231004-KAISER-STRIKE-MD-10-KQED-1920x1280.jpg 1920w\" sizes=\"auto, (max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">The Kaiser Permanente Oakland Medical Center in Oakland on Oct. 4, 2023. \u003ccite>(Martin do Nascimento/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“At the end of the day, we are striking for our patients, and so that Kaiser can wake up and come back to the table,” she said.\u003c/p>\n\u003cp>As a nonprofit health plan and care provider, Kaiser reinvests its revenue into facilities and services for patients. The organization, founded in 1945, has grown to serve more than 12 million people in eight states and the District of Columbia, emphasizing preventive care.\u003c/p>\n\u003cp>Company executives argue that greater wage raises are unsustainable and would increase members’ premiums at a time when massive budget cuts to Medicaid and other federal policies could make insurance unaffordable for millions of Americans. Under the Trump administration, Kaiser and other health care systems face an uncertain financial forecast with potential revenue losses and increased costs.\u003c/p>\n\u003cp>As the work stoppage drags on in California, where most Kaiser customers are located, the company risks increasing reputational damage among not only its patients but also its workforce, resulting in longer-term costs, according to health care business experts.\u003c/p>\n\u003cfigure id=\"attachment_12073048\" class=\"wp-caption alignleft\" style=\"max-width: 1333px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-12073048 size-full\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/02/020926_KAISERSTRIKE_8223B-KQED.jpg\" alt=\"\" width=\"1333\" height=\"2000\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2026/02/020926_KAISERSTRIKE_8223B-KQED.jpg 1333w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/02/020926_KAISERSTRIKE_8223B-KQED-160x240.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2026/02/020926_KAISERSTRIKE_8223B-KQED-1024x1536.jpg 1024w\" sizes=\"auto, (max-width: 1333px) 100vw, 1333px\">\u003cfigcaption class=\"wp-caption-text\">Carrie Esqueda at home in Wildomar, California, on Monday, Feb. 9, 2026. \u003ccite>(Lauren Justice for KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“The bigger economic risk isn’t what the strike costs this week, but it’s what happens if workforce distrust becomes structural at Kaiser, because you will get higher turnover, you’re going to have higher recruitment costs,” said Michael Skolnik, academic director of the Dominican University of California’s health care executive MBA program.\u003c/p>\n\u003cp>Patients like Alice Gallagher sympathize with the strikers but fear further disruptions. Last week, the San Diego County clarinetist said she was temporarily unable to order her medication for epilepsy via the Kaiser app. She tried calling her local pharmacy and then a regional number, she said, but nobody would help her.\u003c/p>\n\u003cp>Gallagher, 46, started to panic.\u003c/p>\n\u003cp>“If I don’t have my medication, I end up in the hospital… because my seizures are so bad once they get out of control,” she said, adding that, as she can’t drive, it would take her hours to travel on paratransit to visit her pharmacy.\u003c/p>\n\u003cp>Gallagher was later able to order her prescriptions online. But the experience left her wondering about other vulnerable patients in need of timely care.\u003c/p>\n\u003cp>“I had my moment of panic,” she said. “But for someone who’s just been diagnosed with something and feels overwhelmed, or someone who has cancer and then they are at the mercy of this stalemate in the negotiations, that’s who’s really suffering. That’s what’s really tough here.”\u003c/p>\n\u003cp>Esqueda, the real estate agent with a torn meniscus, said that she’s watching the news daily, hoping that Kaiser ends the strike so that she can get the surgery she needs to heal.\u003c/p>\n\u003cp>“I’m just praying that they get to some resolution,” Esqueda said. “I hope they listen and take into consideration that there are people’s lives that are being turned upside down.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"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. ",
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"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. ",
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"marketplace": {
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"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",
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"mindshift": {
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"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>",
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"order": 12
},
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"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM1NzY0NjAwNDI5",
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"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.",
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"onourwatch": {
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"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?",
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"perspectives": {
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"planet-money": {
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"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.",
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"title": "Political Breakdown",
"tagline": "Politics from a personal perspective",
"info": "Political Breakdown is a new series that explores the political intersection of California and the nation. Each week hosts Scott Shafer and Marisa Lagos are joined with a new special guest to unpack politics -- with personality — and offer an insider’s glimpse at how politics happens.",
"airtime": "THU 6:30pm-7pm",
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"possible": {
"id": "possible",
"title": "Possible",
"info": "Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. Together in Possible, Hoffman and Finger lead enlightening discussions about building a brighter collective future. The show features interviews with visionary guests like Trevor Noah, Sam Altman and Janette Sadik-Khan. Possible paints an optimistic portrait of the world we can create through science, policy, business, art and our shared humanity. It asks: What if everything goes right for once? How can we get there? Each episode also includes a short fiction story generated by advanced AI GPT-4, serving as a thought-provoking springboard to speculate how humanity could leverage technology for good.",
"airtime": "SUN 2pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Possible-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.possible.fm/",
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"source": "Possible"
},
"link": "/radio/program/possible",
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},
"pri-the-world": {
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"title": "PRI's The World: Latest Edition",
"info": "Each weekday, host Marco Werman and his team of producers bring you the world's most interesting stories in an hour of radio that reminds us just how small our planet really is.",
"airtime": "MON-FRI 2pm-3pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/The-World-Podcast-Tile-360x360-1.jpg",
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},
"radiolab": {
"id": "radiolab",
"title": "Radiolab",
"info": "A two-time Peabody Award-winner, Radiolab is an investigation told through sounds and stories, and centered around one big idea. In the Radiolab world, information sounds like music and science and culture collide. Hosted by Jad Abumrad and Robert Krulwich, the show is designed for listeners who demand skepticism, but appreciate wonder. WNYC Studios is the producer of other leading podcasts including Freakonomics Radio, Death, Sex & Money, On the Media and many more.",
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},
"reveal": {
"id": "reveal",
"title": "Reveal",
"info": "Created by The Center for Investigative Reporting and PRX, Reveal is public radios first one-hour weekly radio show and podcast dedicated to investigative reporting. Credible, fact based and without a partisan agenda, Reveal combines the power and artistry of driveway moment storytelling with data-rich reporting on critically important issues. The result is stories that inform and inspire, arming our listeners with information to right injustices, hold the powerful accountable and improve lives.Reveal is hosted by Al Letson and showcases the award-winning work of CIR and newsrooms large and small across the nation. In a radio and podcast market crowded with choices, Reveal focuses on important and often surprising stories that illuminate the world for our listeners.",
"airtime": "SAT 4pm-5pm",
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"officialWebsiteLink": "https://www.revealnews.org/episodes/",
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},
"link": "/radio/program/reveal",
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"rss": "http://feeds.revealradio.org/revealpodcast"
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