healthcare

SAN FRANCISCO — It was speed dating: Eight suitors with less than four minutes each, pitching the woo to thousands of Democratic Party faithful.

The race for California governor has been a low-boil, late-developing affair, noteworthy mostly for its lack of a whole lot that has been noteworthy.

That changed a bit on a sunny Saturday in San Francisco, the contest assuming a smidgen of campaign heat — chanting crowds, sign-waving supporters, call-and-response from the audience — as the state party held its annual convention in this bluest of cities.

Delegates had the chance to officially endorse a party favorite, providing a major lift in a contest with the distinct lack of any obvious front-runner. But with an overstuffed field of nine major Democratic contenders — San José Mayor Matt Mahan was said to have entered the contest too late for consideration — the vote proved to be a mere formality.

No candidate came remotely close to winning the required 60% support.

That left the contestants, sans Mahan, to offer their best distillation of the whys and wherefore of their campaigns, before one of the most important and influential audiences they will face between now and the June 2 primary.

There was, unsurprisingly, a great deal of Trump-bashing and much talk of affordability, or rather, the excruciating lack of it in this priciest of states.

The candidates vied to establish their relatability, that most valuable of campaign currencies, by describing their own hardscrabble experiences.

Former Los Angeles Mayor Antonio Villaraigosa — the first speaker, as drawn by lot — spoke of his upbringing in a home riven by alcoholism and domestic violence. State Supt. of Public Instruction Tony Thurmond described his childhood subsistence on food stamps, free school lunches and surplus government cheese.

Former state Controller Betty Yee told how she shared a bedroom with four siblings. Katie Porter, the single mom of three kids, said she knows what it’s like to push a grocery cart and fuel her minivan and watch helplessly as prices “go up and up” while dollars don’t stretch far enough.

Michele Reed of Los Angeles cheers at the state Democratic Party convention.

(Christina House/Los Angeles Times)

When it came to lambasting Trump, the competition was equally fierce.

“His attacks on our schools, our healthcare and his politics of fear and bullying has to stop now,” Villaraigosa said.

Rep. Eric Swalwell (D-Dublin) called him “the worst president ever” and boasted of the anti-Trump battles he’s fought in Congress and the courts. Xavier Becerra, a former California attorney general, spoke of his success suing the Trump administration.

Porter may have outdone them all, at least in the use of profanity and props, by holding up one of her famous whiteboards and urging the crowd to join her in a chant of its inscription: “F—- Trump.”

“Together,” the former Orange County congresswoman declared, “we’re going to kick Trump’s ass in November.”

Porter was also the most extravagant in her promises, pledging to deliver universal healthcare to California — a years-old Democratic ambition — free childcare, zero tuition at the state’s public universities and elimination of the state income tax for those earning less than $100,000.

Unstated was how, precisely, the cash-strapped state would pay for such a bounty.

Former Assemblyman Ian Calderon offered a more modest promise to provide free child care to families earning less than $100,000 annually and to break up PG&E, California’s largest utility, “and literally take California’s power back.” (Another improbability.)

Becerra, in short order, said he was “not running on inflated promises” but rather his record as a congressman, former attorney general and health secretary in President Biden’s cabinet.

Rachel Pickering, right, vice chair of the San Luis Obispo County Democratic Party, stands with others wearing pins supporting Democratic causes at the party’s state convention.

(Christina House/Los Angeles Times)

It was one of several jabs that could be heard if one listened closely enough. (No candidate called out any other by name.) “You’re not going to vote for a Democrat who voted for the border wall, are you?” Thurmond demanded, a jab at Porter who supported a major funding bill that included money for Trump’s pet project.

“You’re not going to vote for a Democrat who praises ICE, are you?” Thurmond asked, a poke at Swalwell, who thanked the department for its work last year in a case of domestic terrorism.

“You’re not going to vote for a Democrat who made money off ICE detention centers,” Thurmond went on, targeting Tom Steyer and his former investment firm, which had holdings in the private prison industry.

Yee seemed to take aim at Mahan and his rich Silicon Valley backers, suggesting grassroots Democrats “will not be pushed aside by the billionaire boys club that wants to rule California.”

The barb was part of a full-on assault on the state’s monied class, which includes Steyer, who made his fortune as a hedge fund manager.

In a bit of billionaire jujitsu, he sought to turn the attack around by saying his vast wealth — which has allowed him to richly fund his political endeavors — made him immune to the blandishments of plutocrats and corporate interests.

“Here’s the thing about big donors,” Steyer said. “If you take their money, you have to take their calls. And I don’t owe them a thing. In a world where politicians serve special interests, I can’t be bought.”

There were no breakout moments Saturday. Nothing was said or done in the roughly 35 minutes the candidates devoted to themselves that seemed likely to change the dynamic or trajectory of a race that remains stubbornly ill-defined and, to an unprecedented degree in modern times, wide open.

And there was certainly no sign any of the gubernatorial candidates plan to give up, bowing to concerns their large number could divide the Democratic vote and allow a pair of Republicans to slip through and emerge from California’s top-two primary.

But for at least a little while, within the confines of San Francisco’s Moscone Center, there was a glimmer of a life in a contest that has seemed largely inert. That seemed a portent of more to come as the June primary inches ever closer.

Hannatu Charles* carried her pregnancy to full term. She attended all antenatal sessions and was eager to meet her baby. 

In January, when she was due, she went into labour around 7 p.m. Unfortunately, the primary healthcare centre in Kirchinga, a community in Madagali local government area of Adamawa state in northeastern Nigeria, closes around 6 p.m. Her family immediately called one of the traditional birth attendants in the community.

Hannatu laboured for hours, yet her baby did not emerge despite the efforts of the traditional birth attendant. By 10 p.m., warning bells began to ring in her mind, as by that time, all doors in Kirchinga had been shut and all access routes deserted. 

“We decided to try to see if we could at least meet one person at the primary healthcare centre, so my husband and my neighbour took me there that night, but we didn’t meet any midwife or any healthcare staff,” she told HumAngle. 

The centre was closed. All the healthcare staff had gone and would only return the next morning. Night shifts no longer hold. These changes were made due to the scale of insecurity. 

Hannatu told HumAngle they returned home, where she continued to push, but despite her efforts, she was unable to deliver. The birth attendant noted that the baby was in breech position and, therefore, an experienced midwife or a gynaecologist was required. The only way they could access such care was by travelling to the Cottage Hospital in Gulak Local Government or the General Hospital in Michika Local Government, both many hours away. 

Hannatu said they would have made the journey that night on a regular day, but now,  it was too risky. Movement in Kirchinga was restricted after dark as Boko Haram terrorists roamed the area, especially at night. There was also no way to access vehicles or get a driver to take the,m as all routes were closed. 

She said she was willing to persevere until dawn when the roads would reopen, but by midnight, the pain intensified, and the midwife doubled her efforts. A stillborn was delivered. 

“I’m not the first to lose a child because of the security situation in this region,” Hannatu said as she talked about how insecurity destroys healthcare. “In fact, I’m lucky to be alive,” she added, stressing that several women and their babies had died.

According to Hannatu, the women who went into labour during the day in Kirchinga are considered lucky. 

The healthcare crisis 

Kyauta Ibrahim, a community health extension worker, spends her days at the primary school in Limankara, another community in the same Madagali that has, since the past decade, been repurposed as the community’s healthcare centre. Since residents began returning to Madagali in 2016 — two years after Boko Haram attacks displaced them — she and her colleagues have provided medical services from this makeshift facility.

“We are yet to move to the permanent site. We were asked to stay here to perform our duties,” she said. When the insurgents struck, they torched several structures, including the original primary healthcare centre where she worked.

For Limankara residents, this temporary facility remains the only nearby source of medical care. With few doctors remaining in the region, patients are often forced to travel long distances to better-equipped centres in Shuwa, Michika, or Gulak, particularly in emergencies.

Before the insurgency, the primary healthcare centre in Limankara served the local population and neighbouring communities such as Sakur and Lakundi, providing antenatal care, deliveries, and basic medical services. After peace was gradually restored in 2016, the state government converted one of the primary schools into a modest healthcare facility to meet the community’s needs.

A decade later, the school still functions as the healthcare centre. The situation worsened as medical doctors and other professionals began withdrawing, leaving indigenous community health extension workers to manage the facility. In 2016, most health centres in Madagali and Michika were closed because many professionals had either been killed or fled permanently.

As of 2019, the World Health Organisation’s Health Resources Availability Monitoring System (HeRAMS) highlighted that only 45 per cent of health centres in Adamawa were fully functional after 12 per cent had been destroyed and 34 per cent severely damaged by Boko Haram attacks. 

Kyauta told HumAngle that, aside from staff shortages, inadequate healthcare equipment continues to affect healthcare delivery in the area. The temporary primary healthcare centre now closes by late evening due to recurring Boko Haram attacks, leaving pregnant women and children most vulnerable.

“When a woman starts labour at night, she can’t even go to the primary healthcare centre and has to give birth at home,” she said. Complicated cases are referred to Shuwa, and if necessary, to the General Hospital in Michika or the Gulak cottage hospital, all of which are some distance away. 

Esther Markus, a mother of six from Wagga, another community in Madagali, travels six hours for a round trip to Gulak for medical care. Emergencies are further complicated by a 6 p.m. curfew. Traditional birth attendants handle routine deliveries, but high-risk cases, like breech births or sudden illness at night, go untreated until morning.

“Once it’s 6 p.m., we can’t take sick people to the hospital, so we leave them till the next day in the hands of God, and if the person dies, then we accept it,” said Hamidu Ahmadu, Limankara’s community leader.

Residents said security remains precarious. “A few days ago, the soldiers guarding us were attacked, so since then, they leave once it is 5 p.m. and head back to their headquarters in town. Our youths guard us all through the night,” Esther added. 

Hamidu told HumAngle that the community has a population of about 3,000. He acknowledged the efforts of some humanitarian organisations that have visited the area in the past to treat malnourished children and provide basic healthcare services to residents, but the gap remains. 

In 2024, the International Committee of the Red Cross (ICRC) resumed operations in Madagali after being unable to operate since 2018. The following year, the organisation provided basic healthcare and nutrition services to residents and also renovated the existing healthcare facility in Madagali town, which has become a haven for displaced persons in villages around the area. This has helped mitigate how insecurity affects healthcare in Madagali. 

Despite these humanitarian efforts to restore healthcare access in conflict-prone communities in Madagali, however, factors like the curfew, abductions, and the absence of medical professionals continue to limit access to services. 

Medical professionals are fleeing 

Kirchinga, the community in Madagali where Halima had the stillbirth, faces a similar plight. Although it has a functional primary healthcare centre, the lack of medical professionals severely affects service delivery.  

“Since the insecurity started, the doctors have stopped staying. They no longer live in the community but only show up from time to time,” said Bitrus Kwada, a Kirchinga resident.

Boko Haram terrorists have abducted, killed, or threatened several health and humanitarian workers in the northeastern region. In 2018, some medical workers were kidnapped and later killed in Borno. The following year, Boko Haram attacked Kirchinga and Shuwa communities, burning houses, shops, and clinics after killing three people. 

By 2020, Bitrus explained, healthcare workers, including doctors, who once lived in Kirchinga had either been transferred or fled, leaving them only occasionally available and unable to respond to emergencies.

“We suffer when it comes to emergency treatment at night,” Bitrus stated.  

Over the years, several women with complicated pregnancies have died during childbirth, along with their babies, due to the absence of doctors and surgeons. 

Blessing Dingami, another resident of Kirchinga, told HumAngle that before the insurgency started in 2014, the primary healthcare centre in the community was staffed by a medical doctor, two nurses, and another healthcare provider who ran the facility round the clock, with support from community health extension workers.

Following the attacks, the centre collapsed, forcing the professionals to flee. Although the government has since renovated it, community health extension workers now manage the facility, and the quality of services has declined.

Even though movement in Kirchinga is unrestricted until 10 p.m., accessing medical care is increasingly difficult. “There was a time when people from our community were involved in a ghastly accident at night, and we rushed them to the centre, but there was no professional to handle their case,” Blessing recounted. 

She noted that the healthcare centre no longer provides scanning, surgery, and other services it previously offered. Residents now have to travel for over half an hour to Shuwa and sometimes to Gulak, where there is a cottage hospital.

In Wagga Lawan, another community in Madagali, the primary healthcare centre was destroyed during Boko Haram attacks in 2014 but was recently rebuilt and commissioned by the state government.

Despite the renovation, many Madagali residents remain unable or afraid to use the facility. People from Wagga Mongoro, Thidakwa, and even Limankara travel there, yet fear of kidnapping, its remote location, and the surrounding bushes keep many away, particularly at night.

“The centre is located on the outskirts of the town, and bushes surround it, so people are afraid to go there for services, especially at night, due to fear of kidnapping,” said Cyril Ezra, a resident. Travel to the facility takes over an hour by bike. 

In 2025, Boko Haram attacked Wagga Mongoro, killing four people, injuring many others, and razing property—underscoring why many remain hesitant to use even the newly rebuilt facility.

Uncertainty 

Peace Ijanada Simon, a midwife at Shuwa’s primary healthcare centre, said the facility is overburdened with deliveries and emergencies from surrounding communities, as theirs lack night services. Although staff work night shifts, service is inconsistent due to recent kidnappings and a lack of reliable electricity. 

“There is no power supply. We use torchlights for most deliveries. If we can’t handle it, we refer immediately to Gulak or Michika,” she said.

In Kirchinga, locals have lost hope for the return of professional healthcare workers. “From 2014 to today, we’ve been facing security challenges because Boko Haram can attack at any time and destroy our things. Some of our people have been killed. Two years back, the situation changed into kidnappings,” he said. 

Bitrus explained that the terrorists mostly show up at night when locals are sleeping and carry out these abductions. “Ransoms have been paid, and some have been released. We have soldiers here, but I don’t think they are taking strong action,” he added.

Maradi, a community near Kirchinga, was attacked on Jan. 23. One resident who resisted capture was killed in his home, while a hunter who confronted the attackers that night was also killed, and another person was abducted that night. 

“We don’t sleep. From midnight, we stay awake till 3 a.m. because that’s the time they normally come. We have to stay conscious,” he said. 

It’s one thing most everyone agrees on: federal funding cuts have left the Los Angeles County health system teetering toward financial collapse.

But the supervisors’ chosen antidote — a half-cent sales tax to replenish county coffers — is being condemned by a slew of cities as its own form of financial catastrophe.

“I heard from every city in my district,” said Kathryn Barger, the only supervisor who voted against putting the sales tax on the June ballot.

The resounding reaction? “Absolutely not,” she says.

“People are fatigued,” Barger said. “I’m not convinced that it’s going to pass.”

Observers wouldn’t have sensed that fatigue from the rowdy crowd of supporters that filled the board meeting Tuesday, along with seldom-used overflow rooms. The supervisors voted 4-1 at the meeting to put the tax on the ballot.

“There really are no other viable and timely options,” said Supervisor Holly Mitchell, who introduced the measure along with Supervisor Hilda Solis. “Trust me, I looked high and low.”

The goal, supervisors say, is to generate $1 billion per year to backfill the dwindling budgets of local hospitals and clinics battered by federal funding cuts.

The county’s already bracing for impact. The Department of Public Health announced Friday it would shutter seven clinics. Officials say it’s just the beginning, with the county poised to lose more than $2 billion in funding for health services over the next three years. Hospitals could be down the road, they warn.

But many cities, some of which could have local sales tax hit more than 11%, are revolting on the plan.

“I have been getting calls and texts and letters like honestly I have not gotten in a long time,” Supervisor Janice Hahn told the audience as a message from Jeff Wood — the vice mayor of Lakewood — pinged on her phone. “They are really diving in on this one.”

In a series of opposition letters, the cities unleashed a torrent of criticism. Norwalk called the tax “rushed.” Palmdale said it had “significant flaws.” Glendale found it “deeply troubling and fundamentally unfair.”

Some bristled at the cost to consumers. Palmdale and Lancaster — some of the poorest cities in the county — could wind up with some of the highest sales tax rates in the state if the measure passes.

Some cities say the bigger issue is they don’t trust the county. They point to its checkered history of pushing ballot measures that don’t live up to their promises.

Measure B, a special parcel tax, was passed in 2002 to fund the county’s trauma center network. An audit more than a decade later found the county couldn’t prove it used the money for emergency medical services.

Measure H, the homelessness services tax measure, was passed in 2017 as a temporary tax. Voters agreed in 2024 to make the tax permanent and to double the rate — though some cities insist they’ve never gotten their fair share of the funds.

“It’s a historical issue,” said Glendora mayor David Fredendall, whose city opposes the sales tax. “We don’t trust it.”

The county decided to put the sales tax on the ballot as a general tax, meaning the money goes into the general fund. Legally, supervisors could use the money for whatever services they desire.

“They say ‘No, this is our plan’, but we’re going to expand from five to nine supervisors over the next few years before this tax expires,” said Marcel Rodarte, the head of the California Contract Cities Assn., a coalition of cities inside the county. “They may say we need to use these funds for something else.”

A general tax also is easier to pass, since it needs only a majority vote. Special taxes — levies earmarked for a specific purpose — need two-thirds of the vote.

The measure also asks voters to approve the creation of an oversight group that would monitor where the money goes. The supervisors also voted on a spending plan for the tax money, which would dedicate the largest portion of funds for uninsured residents over the next five years.

Some opponents predict the tax will stick around longer than advertised.

“A temporary tax is like Bigfoot,” said Jon Coupal, president of the Howard Jarvis Taxpayers Assn., a group that advocates for lower taxes. “It exists in fantasy.”

State of play

— FRIENDLY FIRE: Three hours before the filing deadline, L.A. City Councilmember Nithya Raman jumped into the race for mayor, challenging her former ally Karen Bass. Her candidacy will be Bass’ most serious threat.

— DEFUND DETOUR: Shortly after, Raman staked out her position on cops, saying she doesn’t want the LAPD to lose more police. Raman called for department downsizing when she first ran for city council in 2020.

— LOYAL LABOR: The head of the AFL-CIO, the county’s powerful labor federation, blasted Raman as an “opportunist.” Federation president Yvonne Wheeler said her organization will “use every tool” at its disposal to get Bass reelected.

— PETITION PUSH: Scores of candidates for L.A. city offices picked up their petitions Feb. 7, launching their effort to collect the signatures they need to qualify for the ballot. The first to turn in a petition was Councilmember Traci Park, who is facing two challengers while running for reelection in a coastal district.

— EYES ON ICE: Los Angeles police officers must turn on their body cameras if they’re at the scene of federal immigration enforcement operations, according to a new executive directive issued by Bass. LAPD officers also must document the name and badge number of the agents’ on-scene supervisor.

— CONTESTING CLEANUPS: A federal judge ruled this week that the city of L.A. violated the constitutional rights of homeless people by seizing and destroying their personal property during encampment cleanups. Lawyers for the plaintiffs want U.S. District Judge Dale S. Fischer to issue an injunction requiring the city to give homeless people the opportunity to contest the seizure of their property.

— HOTEL HIKE: Voters in the June 2 election will be asked to hike the city’s tax on nightly hotel stays — increasing it to 16% from 14% — for the next three years. The tax would then drop to 15% in 2029.

— PAYDAY POLITICS: The county is considering a proposal that would remove supervisors’ final decision-making power in contract disputes involving sheriff’s deputies and firefighters. Supporters say it’ll take politics out of labor negotiations while opponents warn of bloated labor costs.

QUICK HITS

• Where is Inside Safe? The mayor’s signature homelessness program went to Los Angeles City Council District 13, bringing 50 unhoused Angelenos indoors from an encampment.
• On the docket next week: The county’s back to its marathon budget briefings. Tune in Tuesday for presentations from the sheriff, district attorney and probation department.

Stay in touch

That’s it for this week! Send your questions, comments and gossip to LAontheRecord@latimes.com. Did a friend forward you this email? Sign up here to get it in your inbox every Saturday morning.

Sen. Bernie Sanders, a political hero among liberals and populists, next week will formally kick off the campaign to place a new tax on billionaires on California’s November ballot.

The controversial proposal, which would impose a one-time 5% tax on the assets of the state’s wealthiest residents, is critical to backfilling federal funding cuts to healthcare enacted by the Trump administration, Sanders said in a statement.

“This initiative would provide the necessary funding to prevent over 3 million working-class Californians from losing the healthcare they currently have — and would help prevent the closures of California hospitals and emergency rooms,” he said. “It should be common sense that the billionaires pay just slightly more so that entire communities can preserve access to life-saving medical care. Our country needs access to hospitals and emergency rooms, not more tax breaks for billionaires.”

The independent senator from Vermont, who caucuses with Democrats in the nation’s Capitol, will appear Feb. 18 at the Wiltern in Los Angeles alongside prominent musical acts. Sanders has a deep base of support among California Democrats, winning the state’s 2020 presidential primary over Joe Biden by eight points, and narrowly losing the 2016 primary to Hillary Clinton. In both elections, he won the votes of more than 2 million Californians, who were also a major source of the small-dollar donations that fueled his insurgent campaigns.

The tax proposal, which Sanders previously endorsed on social media, is proposed by the Service Employees International Union-United Healthcare Workers West. The supporters need to gather the signatures of nearly 875,000 registered voters and submit them to county elections officials by June 24 for the measure to qualify for the November ballot. They began gathering signatures in January.

Supporters of the tax argue it is one of the few ways the state can backfill major federal cuts to healthcare services for California’s most vulnerable residents. Opponents warn it would kill the innovation that has made the state rich and prompt an exodus of wealthy entrepreneurs.

More than 200 billionaires in Californians would be affected if the proposal qualifies for the ballot and is approved. Some prominent billionaires have already left the state, notably PayPal co-founder Peter Thiel and venture capitalist David Sacks.

Both men were major supporters of President Trump.

Democrats are divided about the issue. Notably, Gov. Gavin Newsom and San Jose Mayor Matt Mahan, who is among a dozen candidates running in November to replace the termed-out governor, oppose the proposal.

SACRAMENTO — California lawmakers on Monday approved a one-time infusion of $90 million for Planned Parenthood and other women’s health clinics, a direct respond to the Trump administration’s cuts to reproductive healthcare and access to abortion providers.

“Trump is tearing down healthcare and increasing costs,” Assembly Speaker Robert Rivas (D-Hollister) said in a statement. “Democrats are building it up — investing millions in women’s health and maternal care, because families come first in California.”

The legislation providing the funding, SB 106, carried by Sen. John Laird (D-Santa Cruz), is intended to help offset the losses from federal cuts that targeted abortion providers. The Republican-backed One Big Beautiful Bill Act, signed last year by President Trump, prohibited federal Medicaid funding from going to Planned Parenthood.

The bill now heads to Gov. Gavin Newsom.

California and a coalition of other Democrat-led states filed a lawsuit against the Trump administration last year over the provision. More than 80% of the nearly 1.3 million annual patient visits to Planned Parenthood in California previously were reimbursed by Medi-Cal, the state’s version of Medicaid, which provides healthcare coverage to low-income Americans.

Assemblyman David Tangipa (R-Clovis) voiced opposition to the legislation Monday.

“Why does Planned Parenthood get a $90-million grant when right now over 60 hospitals in the state of California are on the verge of shutting down?” Tangipa asked, speaking on the Assembly floor. “Hospitals across our state that deliver high quality care to women are on the brink of closure.”

Planned Parenthood offers a range of services, including abortions, birth control and cancer screenings.

Reporting from Sacramento — Soda companies got a respite last week from battling local taxes on sugary beverages, after California lawmakers grudgingly passed a 12-year ban on cities and counties imposing the levies.

That reprieve might be short-lived.

Major healthcare groups announced Monday that they will pursue a statewide soda tax initiative on the 2020 ballot to pay for public health programs. And in another jab at the beverage industry, the initiative would enshrine in the California Constitution the right of local governments to impose soda taxes.

“Big Soda has been a major contributor to the alarming rise in obesity and diabetes,” said Dustin Corcoran, chief executive of the California Medical Assn., a principal backer of the initiative. “We need to address this crisis now, and this initiative gives voters a real opportunity to do that.”

The proposed 2-cents-per-fluid-ounce tax would mean an additional 24 cents tacked onto the cost of a 12-ounce can, or an extra $1.34 for a 2-liter bottle sold in the state.

The proposal sets the stage for a marquee statewide battle between health groups and the soda industry — a feud that has been simmering in California’s cities and counties for years and burst into full view in the state Capitol last week.

California bans local soda taxes »

With the battle lines forming for 2020, the soda industry has had little time to savor its recent victory.

The companies won a 12-year ban on local soda taxes from legislators in exchange for a promise from business groups to withdraw a ballot initiative that would have required cities and counties to get supermajority approval from voters to raise any new taxes. That initiative, which had qualified for the November ballot, panicked mayors and labor groups representing local government workers with the prospect of a higher vote threshold that could stymie efforts to collect new tax revenue for cities and counties.

Minutes after Gov. Jerry Brown signed the bill that contained the soda tax ban, proponents pulled their broader tax initiative from the ballot.

The eleventh-hour deal infuriated public health groups and a number of legislative Democrats, who likened the soda industry’s leverage play to “extortion.”

“We were disappointed that the American Beverage Assn., and their member companies, went to such great lengths to take away the right of Californians to vote for better health,” said Nancy Brown, chief executive of the American Heart Assn.

But the maneuver prodded the California medical and dental associations to respond. The initiative, according to proponents, would raise between $1.7 billion and $1.9 billion in a statewide levy on soda and other sugary beverages, with money going toward programs to combat and prevent diabetes and obesity — both commonly linked to consumption of those drinks.

The tax would not apply to diet sodas, fruit and vegetable juices with no added sugar and drinks in which milk is the primary ingredient.

“Big Soda may have won a cynical short-term victory but, for the sake of our children’s health, we cannot and will not allow them to undermine California’s long-term commitment to healthcare and disease prevention,” Corcoran and Carrie Gordon, chief strategy officer of the California Dental Assn., said in a statement.

Brown of the American Heart Assn. said her group backs a statewide tax and efforts to roll back the local ban.

“We will be relentless in our work with communities across the state to improve public health through a statewide tax, and to restore the rights of Californians to vote for what they believe best supports health in their state,” she said.

The two organizations partnered with other public health groups, along with the Service Employees International Union, to successfully raise tobacco taxes by $2 per pack in 2016.

“Everyday grocery shoppers in California are struggling with affordability in the state — from housing to transportation to taxes. Rather than further driving up costs at the supermarket, we believe there is a better way for health advocates, government and California’s beverage companies to work together to help people reduce sugar consumption while at the same time protecting consumers’ pocketbooks and the small businesses that are so vital to our communities,” said William M. Dermody Jr., spokesman for the American Beverage Assn.

The soda industry has long fended off taxes at the state and local level. Berkeley became the first to pass a tax in November 2014 and since then, three other Bay Area cities — San Francisco, Oakland, and Albany — have imposed their own levies.

Until recently, the battle over a statewide soda tax had been fought — and won — by the industry in the Legislature. A recent legislative analysis counted proposals dating back to 1983 that had fizzled at some point during negotiations in Sacramento.

One recent effort was a 2013 bill by state Sen. Bill Monning (D-Carmel) to impose a penny-per-ounce tax, half the size of the tax under the proposed initiative. Assemblyman Richard Bloom (D-Santa Monica) sought a 2 cent-per-ounce tax in two successive bills in 2015 and 2016; both measures failed to advance.

“These products are dangerous,” Monning said last week during Senate debate over the bill that now bans local soda taxes. “We label and tax tobacco because we know what it does. We should label and tax these products and let people have informed choice.”

Times staff writer John Myers contributed to this report.

Coverage of California politics »

melanie.mason@latimes.com

Follow @melmason on Twitter for the latest on California politics.

SACRAMENTO — As massive federal cuts are upending the healthcare system in California, analysts and healthcare professionals are urging state lawmakers to soften the blow by creating new revenue streams and helping residents navigate through the newly-imposed red tape.

“It impacts not only uninsured but also Medicare and commercially insured patients who rely on the same system,” said Dolly Goel, a physician and chief officer for the Santa Clara Valley Healthcare Administration. “People will die.”

Goel was among more than a dozen speakers this week at a state Assembly Health Committee hearing held to collect input on how to address cuts enacted by a Republican-backed tax and spending bill signed last year by President Trump. The committee’s Republican members — Assemblymembers Phillip Chen of Yorba Linda, Natasha Johnson of Lake Elsinore, Joe Patterson of Rockin, and Kate Sanchez of Trabuco Canyon — did not attend.

The so-called “Big, Beautiful Bill” passed by Republicans shifts federal funding away from safety-net programs and toward tax cuts and immigration enforcement. A recent report from the Legislative Analyst’s Office, which advises the state Legislature on budgetary issues, estimated this will reduce funding for healthcare by “tens of billions of dollars” in California and warned about 1.2 million people could lose coverage through Medi-Cal, the state’s version of the federal Medicaid program providing healthcare coverage to low-income Americans.

Congress allowed enhanced Affordable Care Act subsidies to expire, which is dramatically increasing the cost of privately-purchased health insurance. Covered California, the state’s Affordable Care Act health insurance marketplace, estimates hundreds of thousands of Californians will either be stripped of coverage or drop out due to increased cost.

Sandra Hernández, president of the California Health Care Foundation, said the federal legislation creates administrative hurdles, requiring Medicaid beneficiaries to meet new work or income requirements and to undergo the eligibility re-determination process every six months instead of annually.

“We are looking at a scenario where otherwise eligible working parents lose their coverage simply because they aren’t able to navigate a complex verification process in a timely way,” she said.

California should move aggressively to automate verification instead of putting the burden of proof on beneficiaries, Hernández said. She advised legislators to center new healthcare strategies around technology, like artificial intelligence and telehealth services, to improve efficiency and keep costs down.

“While the federal landscape has shifted, California has enormous power to mitigate the damage,” said Hernández. “California has had a long tradition of taking care of its own.”

Hannah Orbach-Mandel, an analyst with the California Budget and Policy Center, said legislators should establish new revenue sources.

“A common sense place to start is by eliminating corporate tax loopholes and ensuring that highly profitable corporations pay their fair share in state taxes,” she said, adding that California loses out on billions annually because of the “water’s edge” tax provision, which allows multinational corporations to exclude the income of their foreign subsidiaries from state taxation.

One proposal to raise money for state healthcare benefits already is raising controversy. Under the Billionaire Tax Act, Californians worth more than $1 billion would pay a one-time 5% tax on their total wealth. The Service Employees International Union-United Healthcare Workers West, the union behind the act, said the measure would raise much-needed money for healthcare, education and food assistance programs. It is opposed by Gov. Gavin Newsom, among others.

During last week’s legislative hearing in Sacramento, other speakers stressed the importance of communicating clearly with the public, collaborating with nonprofits and county governments and bracing for an influx of hospital patients.

Those who lose health insurance will skip medications and primary care and subsequently get sicker and end up in the emergency room, explained Goel. She said this will strain hospital staff and lead to longer wait times and delayed care for all patients.

The federal cuts come at a time when California is struggling with its own budgetary woes. The Legislative Analyst’s Office estimates the state will have an $18-billion budget shortfall in the upcoming fiscal year.

At the start of the hearing, Assemblymember Mia Bonta (D-Alameda) criticized the federal government for leaving states in the lurch and prioritizing immigration enforcement over healthcare.

The Republican-led Congress and the president provided a staggering funding increase to Immigration and Customs Enforcement, known as ICE. The agency’s annual budget has ballooned to $85 billion.

“The federal dollars which once supported healthcare for working families are now being funneled into mass deportation operations,” said Bonta, who chairs the committee. “Operations that resulted in tragic murders — this is where our healthcare funding is going.”

SACRAMENTO — California lawmakers will consider bolstering funding for Planned Parenthood and other providers of reproductive health with a one-time infusion of $90 million, leaders of the state Legislature announced Friday.

Assembly Speaker Robert Rivas (D-Hollister) and Senate President Monique Limón (D-Goleta) said the money would give grants to providers that were affected by recent federal cuts passed by President Trump and the Republican-led Congress that targeted abortion providers. The funding is included in a proposed bill being considered by state lawmakers.

“Trump and his Republican enablers have waged an all-out assault on women — attacking abortion access, family-planning and reproductive health,” Rivas said in a Friday statement. “Outrage alone won’t stop it. When Trump strips funding, California will continue to act.”

The Republican-backed “One Big Beautiful Bill Act,” signed last year by Trump, prohibited federal Medicaid funding from going to Planned Parenthood. California and a coalition of other Democrat-led states filed a lawsuit against the Trump administration last year over the provision.

More than 80% of the nearly 1.3 million annual patient visits to Planned Parenthood in California were previously reimbursed by Medi-Cal, the state’s version of Medicaid, which provides healthcare coverage to low-income Americans.

In his recent budget proposal, Gov. Gavin Newsom allotted $60 million for reproductive healthcare. His proposal serves as a starting point for state budget negotiations.

Planned Parenthood offers a range of services, including abortions, birth control, cancer screenings and testings for sexually transmitted diseases.

The beautiful country has been named the best retirement destination for 2026, beating Spain with affordable living and excellent healthcare

If you’ve been considering spending your golden years overseas, there’s no shortage of things to weigh up. Thankfully, International Living’s yearly report analysed everything from living costs to how easy it is for Britons to make the move.

Crucial factors include visa stipulations, access to medical services, and the country’s weather conditions. After putting 195 nations under the microscope, the research crowned Greece as the ultimate retirement haven for 2026.

Greece boasts great weather, a thriving expat scene, and remarkably, pensioners can get a three-bedroom property with coastal vistas for just £900 a month.

International Insurance notes that Greece operates both state-funded healthcare and private medical facilities. Retirees can shell out roughly £220 monthly for private cover to access “consistently good” treatment.

“There are also high ratios of medical specialists for the population, and basic emergency care is free for everyone, even foreigners. Pharmacies, after-hours clinics, and community health centers provide more care options. In small towns and on remote islands, pharmacies are equipped to provide many medical services, including helping with small emergencies.”

Coming in at second place for 2026 relocations is Panama. The Central American nation features a bustling British community abroad, whilst healthcare comes in both public and private forms, with the latter boasting cutting-edge facilities and English-fluent medical professionals.

Favourite retirement hotspots like Spain, Portugal, and Italy also secured spots in the top 10.

Top countries to retire in 2026

1. Greece
2. Panama
3. Costa Rica
4. Portugal
5. Mexico
6. Italy
7. France
8. Spain
9. Thailand
10. Malaysia

For years, 64-year-old Ibrahim Zira lived with high blood pressure, managing the condition at Jigalambu Primary Healthcare Centre (PHC) in the Michika area of Adamawa State, northeastern Nigeria. When his condition worsened, he was referred to the Michika General Hospital, where he faced a familiar struggle: incomplete medical records and repeated tests.

“When I got there, they asked for my records, and the file I had contained very little information. I was asked questions and told to repeat tests I had already done. I had to pay again. It was painful because I don’t have a steady income,” Ibrahim complained.

In Nigeria, about 77 per cent of health spending is paid out of pocket, so each additional test adds a financial burden that many patients can barely afford. But the challenge is not only financial. Without digital medical records, patients like Ibrahim are often made to reconstruct their medical histories whenever they move between facilities, relying on memory of dates, drug names, and test results. 

“Sometimes I forget dates or drug names,” he said. “When that happens, the health workers think I’m not serious. It’s stressful explaining the same sickness again and again, especially when you’re not feeling well.”

The same experience surfaced for Pwavira Akami during her first pregnancy. She began antenatal care (ANC) at Gweda Mallam PHC in her hometown of Numan but later relocated to Jimeta, Yola—more than an hour’s journey away—to stay with her sister. There, she registered for antenatal care at Damilu PHC. 

The transition exposed the same fault line in the absence of digital patient records.

“They asked me many questions that were already written in my ANC card, but some pages were missing,” she recalled. As a result, Pwavira was asked to repeat basic lab tests. “I had to spend more money. It’s tiring; you keep answering the same questions about your last period, past illnesses, and tests. Sometimes you’re not even sure if you’re saying it correctly.” 

In both cases, the problem was not medical knowledge or staff competence. It was the absence of a shared system that allowed patient information to follow people as they moved between facilities.

Frontline workers show concerns

This gap, healthcare workers say, affects patients across Adamawa every day.

Mercy Dakko, a midwife at General Hospital, Michika, said she works almost every month without patient files and that internally displaced persons (IDPs) and pregnant women often arrive with incomplete or fragmented medical histories. 

“It slows everything down,” she told HumAngle. “In emergencies, lack of history can be risky. You may not know past complications or drug reactions.” 

Mercy recalled the case of a woman who came into labour, only for the staff to later learn that she was diagnosed with high blood pressure in a previous clinic. “We found out late, and it almost caused serious complications,” the midwife explained.

Sam Alex, another medical practitioner, agreed that due to a lack of well-documented medical history, they rely only on what the patient remembers, which is not always accurate. “Very often we repeat tests. It’s not ideal, but sometimes it’s the only safe option,” Sam said, noting that the stakes are even higher for chronic diseases.  “It increases the risk of wrong medication, delayed care and poor outcomes, especially for conditions like diabetes or hypertension.” 

He acknowledged that patients often bear additional burdens, spending more time and money, and some even refuse to come to the hospital because they are tired of having to repeat medical procedures. 

‘Everything is paper-based’

At the root of the problem is a paper-based system that requires patients to carry physical files. Emmanuel Somotochukwu, a Nigerian pharmacist, told HumAngle that in his hospital, about one in ten patients are sent back simply because a prescription is illegible or an old lab result is missing. 

Studies in Nigeria have found that illegible or incomplete prescriptions are a leading cause of medical error. In most hospitals across Adamawa, record officers are overwhelmed by paperwork. Bewo Gisilanbe, a record officer at the General Hospital in Michika, described how patient histories are stored. 

“Everything is paper-based. Files are created manually and stored in cabinets,” he said, admitting that old files or files from busy clinic days could get torn, misplaced, and slow to retrieve. “Once a patient leaves, their record ends here. There’s no connection to other facilities.”

Bewo stressed that searching for a lost history wastes time and distorts continuity of care. “We don’t know what happened to a patient’s prior care after they leave,” he said. If systems were linked, he argued, everything would change. “It would reduce workload, improve accuracy, and make record tracking easier.”

Why digitalised medical records matter

Experts say the solution to the flawed health system in Adamawa lies in Digital Public Infrastructure (DPI). In the health sector, DPI refers to shared, secure information systems that allow “medical histories, prescriptions, insurance status, and laboratory results to move electronically between units, without requiring patients to act as messengers”. 

The cornerstone of this system is a dependable digital identity. By mid-2025, Nigeria’s National Identity Management Commission (NIMC) had issued 123.5 million National Identity Numbers (NIN). These IDs, if utilised, can act as a digital passport, enabling the connection of patient records across various healthcare facilities.

Recently, the National Health Insurance Authority (NHIA) and NIMC signed an MoU to establish a unified framework linking citizens’ national identity data with health insurance records. This integration is meant to streamline verification, reduce fraud, and expand access to healthcare, especially for underserved communities.

Beyond identity, DPI seems to require an interoperable health information record system. In 2024, the government launched the Nigeria Digital in Health Initiative (NDHI) to build a national health information exchange and patient registry. The goal is for health facilities to securely and seamlessly share information. 

Nzadon David, a digital innovations specialist working with the African Union, and Asor Ahura, a Nigerian-based AI engineer and digital health expert, highlighted several key requirements for success in digital health systems. Nzadon emphasised that “every system needs a way to recognise each person. In Nigeria, this means using the NIN or similar IDs in health records.” Asor also stated that “clinics must agree on data formats and coding systems to ensure that one hospital’s notes can be understood at another. He stressed that privacy laws, such as Nigeria’s 2023 Data Protection Act and clear guidelines about who can access information are essential for building trust. 

Across Africa, early DPI projects show what’s possible. Rwanda has an integrated e-health platform (Irembo) that links digital IDs to patient records and lab results. Kenya’s Afya Kenya initiative likewise allows a clinic in Kisumu to retrieve the same information as a clinic in Nairobi, eliminating duplicate efforts. The payoff is clear: fewer medical errors, faster diagnosis, and better continuity of care, according to the DPI Africa platform. Even India’s Aadhaar ID system now covers 1.4 billion people and is tied into programs including health insurance.

Nzadon noted that these countries didn’t digitise everything at once. They started small, created shared standards, scaling gradually. “States that succeed focus on shared standards and simple, open systems more than expensive software,” he added.

The road map

In 2025, Nigeria joined the UN’s Digital Public Goods Alliance, pledging that government systems, including health, should be open, inclusive, and interoperable. These moves seem to reflect lessons from around the world. Rwanda, Kenya and other countries show that with a national ID, electronic medical records, and a clear privacy framework, health services can become seamless. In Nigeria’s case, there is no shortage of data on why it matters. Aside from the human toll of broken care, inefficiency has economic consequences. According to McKinsey Global Institute’s digital identification report, scaling digital ID systems worldwide could add $5 trillion to global GDP. 

Frontline healthcare workers, seeing the impact firsthand, have a clear wish list. 

With connected records, Mercy said, “we can focus more on care instead of paperwork.” Bewo admitted that a shared system would “reduce mistakes” and free up resources for patients. Perhaps most pointedly, patients themselves feel the difference. Reflecting on his own experience, Ibrahim says a digitalised health system would make life easier. 

This report is produced under the DPI Africa Journalism Fellowship Programme of the Media Foundation for West Africa and Co-Develop.

Democrats Jasmine Crockett and James Talarico differed more on style than substance in their first debate for U.S. Senate in heavily Republican Texas, though they distinguished themselves somewhat on the future of ICE and impeachment of President Trump.

Crockett, an outspoken second-term U.S. House member, and Talarico, a more soft-spoken four-term state representative, generally echoed each other on economic issues, healthcare and taxes.

Both called for a “fighter” in the role. Crockett, who is Black, said she was better positioned to attract disaffected Black voters, while Talarico, a Presbyterian seminarian who often discusses his Christian faith, suggested he could net rural voters unhappy with Republicans.

The hourlong discussion, before hundreds of labor union members and their families at the Texas AFL-CIO political convention, served as an early preview for themes Democrats hoping to overtake the Republican majority in the Senate in November are likely to stress throughout the midterm campaign.

The nominee chosen in the March 3 primary will face the winner of a Republican contest between four-term Sen. John Cornyn, Rep. Wesley Hunt and state Atty. Gen. Ken Paxton.

Impeachment of Trump

Crockett said she would support impeachment proceedings against Trump, beginning with investigating his use of tariffs. Crockett has supported impeachment measures in the House.

“I think that there is more than enough to impeach Donald Trump,” Crockett said. “Ultimately, do I think we should go through the formal process? Absolutely.”

Talarico stopped short of suggesting whether he would support impeachment proceedings, except to say, “I think the administration has certainly committed impeachable offenses.”

Instead, Talarico said he would, as a senator, weigh any evidence presented during an impeachment trial fairly, given that the Senate does not bring impeachment charges but votes to convict or acquit. “I’m not going to articulate articles of impeachment here at a political debate,” he said.

Both candidates address ICE funding

Both candidates condemned the shooting of a man in Minneapolis by federal immigration officers Saturday, and ICE’s heavy presence in the city, though Talarico was more adamant about cutting funding to the agency.

Both said they support bringing impeachment proceedings against Department of Homeland Security Secretary Kristi Noem, under whom ICE serves. But Crockett was less specific about cutting their funding.

“We absolutely have to clean house,” she said. “Whatever that looks like, I’m willing to do it.”

Talarcio more specifically said of ICE funding, “We should take that money back and put it in our communities where it belongs.”

Differences of style

While both candidates said the position requires “a fighter,” Crockett cast herself as a high-profile adversarial figure while Talarico said he had been confronting Republicans in the Texas Statehouse.

“I am here to fight the system, the system that is holding so many of us down,” said Crockett, a 44-year-old Dallas civil rights lawyer and former public defender who has built her national profile with a candid style marked by viral moments.

“It is about tapping into the rawness of this moment,” Crockett said of what Democratic primary voters are seeking.

Talarico, a former public school teacher, cast himself as someone who had been actively opposing the Republican-controlled state legislature.

He pointed to his opposition to Texas’ Republican Gov. Greg Abbott’s agenda in Austin, notably on tax credits for Texans who choose private schools for their children.

“We need a proven fighter for our schools, for our values, for our constituents in the halls of power,” he said. “I think we need a teacher in the United States Senate.”

Taxes, healthcare and economy

Crockett and Talarico generally aligned on domestic policy, including support for higher taxes.

Both candidates proposed ending tariffs as a way of lowering consumer prices.

“We have to roll back these tariffs,” Crockett said. “It’s hurting farmers and ranchers who are filing a record number of bankruptcies.”

Talarico was more direct about his support for higher taxes on the nation’s wealthiest earners.

“What I will not compromise on is making sure these billionaires pay for all that they have gotten from this country,” Talarico said, though he stopped short of suggesting how much he would seek to raise taxes.

Crockett voted last summer against the tax-cut and spending-reduction bill passed by the Republican-controlled Congress and signed by Trump. The bill extended tax cuts enacted during Trump’s first administration.

She also said she supported Medicare for all, a government-backed health insurance plan for all Americans.

“If we truly believe that everyone should have access to healthcare, we can make that a reality with bold leadership,” she said.

Talarico supports the concept, and spoke favorably about universal basic income, without suggesting he would specifically support it in the Senate.

“I’m very encouraged by some pilot programs of universal basic income,” he said.

Beaumont writes for the Associated Press.