healthcare

Israel is holding captive 95 Palestinian healthcare workers in its prisons. They include doctors, nurses and paramedics detained without charge. Healthcare Workers Watch recorded 80 medical workers taken from Gaza and 15 from the occupied West Bank.

SACRAMENTO — Top California health officials warned that federal cuts will deliver a devastating blow to public health, even as the state grapples with ways to mitigate the damage.

“These changes will impact our emergency departments, rural hospitals, private and public hospitals, community health centers, ambulance providers and the broader health care system that serves every community,” said Michelle Baass, director of the California Department of Health Care Services.

Baass was among several experts who spoke Monday at a briefing about the effects of HR 1, a massive tax and spending bill passed by the Republican-led Congress and signed by President Trump that shifts federal funding away from safety-net programs for the vulnerable and toward tax cuts and immigration enforcement. She said the legislation makes sweeping changes to Medi-Cal, as Medicaid is known in California.

It “will cause widespread harm by making massive reductions in federal funding and potentially cripple the health care safety net,” Baass said. “These changes put tens of billions of dollars of federal funding at risk for California and could result in a loss of coverage for millions of Californians.”

Roughly 15 million Californians — a third of the state — are on Medi-Cal, with some of the highest percentages being in rural counties. More than half of the children in California receive healthcare coverage through Medi-Cal, healthcare coverage provided to eligible, low-income residents, according to the state Department of Health Care Services.

California officials expect the state to lose billions of dollars in federal funding for Medi-Cal and other essential healthcare programs. Given that California is facing an ongoing budget deficit, it is highly unlikely that the state will be able to raise enough money to make up for the loss in funding to continue the current level of services to residents, according to a report by the state Legislative Analyst’s Office.

Baass explained the federal legislation creates new eligibility requirements for Medicaid. Starting in 2027, many individuals ages 19 to 64 will need to work for at least 80 hours a month, or perform 80 hours of community service or be enrolled in an educational program, to qualify. The law allows various exemptions, including pregnancy, disabilities, or caring for children under the age of 19.

She estimated 3 million Medi-Cal recipients could lose coverage as a result.

“This would significantly drive up the uninsured rate that raises cost for hospitals treating uninsured patients,” Baass said.

Baass said HR 1, which Republicans labeled the “Big, Beautiful Bill,” also bans abortion providers from receiving federal Medicaid funding — even for healthcare services they offer that are not related to the procedure — and reduces federal dollars for emergency medical care for undocumented immigrants. It additionally limits state funding mechanisms, such as taxes paid by managed care providers, and establishes federal penalties for improper payments.

CalFresh, the state name for the Supplemental Nutrition Assistance Program, is expecting cuts of at least $1.7 billion annually, said Jennifer Troia, director of the California Department of Social Services. About 395,000 people could lose their benefits for government food assistance.

SNAP benefits are also being hit by the current government shutdown, with payments halting in November.

At the heart of the shutdown is a political standoff in Washington over the expiring tax credits for people who get health insurance through the Affordable Care Act, also known as Obamacare. Democrats said they will not vote to reopen the government until Republicans agree to renew the expanded subsidies. Republican leaders refused to negotiate until Democrats vote to reopen the government.

Covered California, the state’s Affordable Care Act health insurance marketplace, estimated over the summer that as many as 660,000 of the roughly 2 million people in the program will either be stripped of coverage or drop out because of increased cost and the onerous new mandates to stay enrolled.

Impacts from the new federal cuts and policies are already being felt across the state and nation.

A Planned Parenthood program in Orange and San Bernardino counties announced its imminent closure earlier this month due to being federally defunded. Los Angeles County’s health system has implemented a hiring freeze and is bracing to lose $750 million per year for the county Department of Health Services, which oversees four public hospitals and roughly two dozen clinics. Meanwhile, food banks nationwide are seeking donations and preparing for longer lines.

Kim Johnson, secretary of the state Health and Human Services Agency, discussed how California is fighting back.

Gov. Gavin Newsom recently announced he is deploying the National Guard and fast-tracking $80 million to support food banks, she said. This came alongside the governor’s decision to allocate $140 million in state funding to Planned Parenthood.

Johnson said Atty. Gen. Rob Bonta has filed more than two dozen lawsuits related to HR 1.

“Here in California,” she said, “we will continue to mitigate the harm of these federal changes wherever we can.”

WASHINGTON — The first caller on a telephone town hall with Maryland Rep. Andy Harris, leader of the House’s conservative Freedom Caucus, came ready with a question about the Affordable Care Act. Her cousin’s disabled son is at risk of losing the insurance he gained under that law, the caller said.

“Now she’s looking at two or three times the premium that she’s been paying for the insurance,” said the woman, identified as Lisa from Harford County, Md. “I’d love for you to elucidate what the Republicans’ plan is for health insurance?”

Harris, a seven-term Republican, didn’t have a clear answer. “We think the solution is to try to do something to make sure all the premiums go down,” he said, predicting Congress would “probably negotiate some off-ramp” later.

His uncertainty reflected a familiar Republican dilemma: Fifteen years after the Affordable Care Act was enacted, the party remains united in criticizing the law but divided on how to move forward. That tension has come into sharp focus during the government shutdown as Democrats seize on rising premiums to pressure Republicans into extending expiring subsidies for the law, often referred to as Obamacare.

President Trump and GOP leaders say they’ll consider extending the enhanced tax credits that otherwise expire at year’s end — but only after Democrats vote to reopen the government. In the meantime, people enrolled in the plans are already being notified of hefty premium increases for 2026.

As town halls fill with frustrated voters and no clear Republican plan emerges, the issue appears to be gaining political strength heading into next year’s midterm elections.

“Premiums are going up whether it gets extended or not,” said GOP Sen. Rick Scott. “Premiums are going up because healthcare costs are going up. Because Obamacare is a disaster.”

‘Concepts of a plan’

At the center of the shutdown — now in its fourth week with no end in sight — is a Democratic demand that Affordable Care Act subsidies passed in 2021 be extended.

Trump has long promised an alternative. “The cost of Obamacare is out of control, plus, it’s not good Healthcare,” he wrote on Truth Social in November 2023. “I’m seriously looking at alternatives.”

Pressed on healthcare during a September 2024 presidential debate, Trump said he had “concepts of a plan.”

But nearly 10 months into his presidency, that plan has yet to come. Dr. Mehmet Oz, administrator of the Centers for Medicare and Medicaid Services, told NBC on Wednesday, “I fully believe the president has a plan,” but didn’t go into details.

Republicans say they want a broader overhaul of the healthcare system, though such a plan would be difficult to advance before next year. Party leaders have not outlined how they’ll handle the expiring tax credits, insisting they won’t negotiate on the issue until Democrats agree to end the shutdown.

A September analysis from the nonpartisan Congressional Budget Office estimated that permanently extending the tax credits would increase the deficit by $350 billion from 2026 to 2035. The number of people with health insurance would rise by 3.8 million in 2035 if the credits are kept, CBO projected.

House Speaker Mike Johnson told a news conference Monday that the tax credits are “subsidizing bad policy.” Republicans “have a long list of ideas” to address healthcare costs, he said, and are “grabbing the best ideas that we’ve had for years to put it on paper and make it work.”

“We believe in the private sector and the free market and individual providers,” he added.

A growing political issue

With notices of premium spikes landing in mailboxes now and the open enrollment period for Affordable Care Act health plans beginning Nov. 1, the political pressure has been evident in Republican town halls.

In Idaho, Rep. Russ Fulcher told concerned callers that “government-provided healthcare is the wrong path” and that “private healthcare is the right path.” In Texas, freshman Rep. Brandon Gill responded to a caller facing a sharp premium increase by saying Republicans are focused on cutting waste, fraud and abuse.

Harris echoed a message shared by many in his party during his Maryland town hall, saying costs are “just going back to what it was like before COVID.”

But the number of people who rely on Affordable Care Act health insurance has increased markedly since before the pandemic. More than 24 million people were enrolled in the marketplace plans in 2025, up from about 11 million in 2020, according to an analysis from the health care research nonprofit KFF.

Sara from Middleville, Mich., told Rep. John Moolenaar during his town hall that if health insurance premiums go up by as much as 75%, most people will probably go without healthcare. “So how do you address that?” she asked.

Moolenaar, who represents a district he handily won last year, responded: “We have time to negotiate, figure out a plan going forward and I think that’s something that could occur.”

Some Republicans have shown urgent concern. In a letter sent to Johnson, a group of 13 battleground House Republicans wrote that the party must “immediately turn our focus to the growing crisis of health care affordability” once the shutdown ends.

“While we did not create this crisis, we now have both the responsibility and the opportunity to address it,” the lawmakers wrote.

Some Republicans dismiss projections that ACA premiums will more than double without the subsidies, calling them exaggerated and arguing the law has fueled fraud and abuse that must be curbed.

Many Democrats credited their ability to flip the House in 2018 during Trump’s first term to the GOP’s attempt at repealing Obamacare, and they’re forecasting a similar outcome this time.

About 4 in 10 U.S. adults say they trust the Democrats to do a better job handling healthcare, compared with about one-quarter who trust the Republicans more, a recent AP-NORC poll found. About one-quarter trust neither party, and about 1 in 10 trust both equally, according to the poll.

A looming internal GOP fight

Even as GOP leaders pledge to discuss ending the subsidies when the government opens, it’s clear that many Republican lawmakers are adamantly opposed to an extension.

“At least among Republicans, there’s a growing sense that just maintaining the status quo is very destructive,” said Brian Blase, the president of Paragon Health Institute and a former health policy advisor to Trump during his first term.

Michael Cannon, director of health policy studies at the libertarian Cato Institute, said he’s working with multiple congressional offices on alternatives that would let the subsidies end. For example, he wants to expand the Affordable Care Act exemption given to U.S. territories to all 50 states and reintroduce a first-term Trump policy that gave Americans access to short-term health insurance plans outside the Affordable Care Act marketplace.

Cannon declined to name the lawmakers he’s working with, but said he hopes they act on his ideas “sooner than later.”

David McIntosh, president of the influential conservative group Club For Growth, told reporters Thursday that the group has “urged the Republicans not to extend those COVID-era subsidies.”

“We have a big spending problem,” McIntosh said.

“I think most people are going to say, OK, I had a great deal during COVID,” he said. “But now it’s back to business as usual, and I should be paying for healthcare.”

Cappelletti and Swenson write for the Associated Press. Swenson reported from New York.

WASHINGTON — Twenty-two days into the government shutdown, California Rep. Kevin Kiley spent an hour of his morning in Washington guiding a group of middle school students from Grass Valley through the empty corridors of the U.S. Capitol.

Normally, one of his staff members would have led the tour. But the Capitol is closed to all tours during the shutdown, unless the elected member is present. So the schoolchildren from Lyman Gilmore Middle School ended up with Kiley, a Republican from Rocklin, as their personal tour guide.

“I would have visited with these kids anyway,” Kiley said in his office after the event. “But I actually got to go on the whole tour of the Capitol with them as well.”

Kiley’s impromptu tour is an example of how members of California’s congressional delegation are improvising their routines as the shutdown drags on and most of Washington remains at a standstill.

Some are in Washington in case negotiations resume, others are back at home in their districts meeting with federal workers who are furloughed or working without pay, giving interviews or visiting community health centers that rely on tax credits central to the budget negotiations. One member attended the groundbreaking of a flood control project in their district. Others are traveling back and forth.

“I’ve had to fly back to Washington for caucus meetings, while the opposition, the Republicans, don’t even convene and meet,” Rep. Maxine Waters, a longtime Los Angeles Democrat, said in an interview. “We will meet anytime, anyplace, anywhere, with [House Speaker Mike] Johnson, with the president, with the Senate, to do everything that we can to open up the government. We are absolutely unified on that.”

The shutdown is being felt across California, which has the most federal workers outside the District of Columbia. Food assistance benefits for millions of low-income Californians could soon be delayed. And millions of Californians could see their healthcare premiums rise sharply if Affordable Care Act subsidies are allowed to expire.

For the California delegation, the fallout at home has become impossible to ignore. Yet the shutdown is in its fourth week with no end in sight.

In the House, Johnson has refused to call members back into session and prevented them from doing legislative work. Many California lawmakers — including Kiley, one of the few GOP lawmakers to openly criticize him — have been dismayed by the deadlock.

“I have certainly emphasized the point that the House needs to be in session, and that canceling a month’s worth of session is not a good thing for the House or the country,” Kiley said, noting that he had privately met with Johnson.

Kiley, who represented parts of the Sacramento suburbs and Lake Tahoe, is facing political uncertainty as California voters weigh whether to approve Proposition 50 on Nov. 4. The measure would redraw the state’s congressional districts to better favor Democrats, leaving Kiley at risk, even though the Republican says he believes he could still win if his right-leaning district is redrawn.

The Senate has been more active, holding a series of votes on the floor and congressional hearings with Atty. Gen. Pam Bondi and CIA Director John Ratcliffe. The chamber, however, has been unable to reach a deal to reopen the government. On Thursday, the 23rd day of the shutdown, the Senate failed to advance competing measures that would have paid federal employees who have been working without compensation.

The Republicans’ plan would have paid active-duty members of the military and some federal workers during the shutdown. Democrats backed a bill that would have paid all federal workers and barred the Trump administration from laying off any more federal employees.

“California has one of the largest federal workforces in the country, and no federal worker or service member should miss their paychecks because Donald Trump and Republicans refused to come to the table to protect Americans’ health care,” Sen. Alex Padilla said in a statement.

Working conditions get harder

The strain on federal employees — including those who work for California’s 54 delegation members — are starting to become more apparent.

Dozens of them have been working full time without pay. Their jobs include answering phone calls and requests from constituents, setting the schedules for elected officials, writing policy memos and handling messaging for their offices.

House Speaker Mike Johnson speaks about the shutdown at a news conference Thursday with other Republican House members.

(Eric Lee / Getty Images)

At the end of October, House staffers — who are paid on a monthly basis — are expected to miss their first paycheck.

Some have been quietly told to consider borrowing money from the U.S. Senate Federal Credit Union, which is offering a “government shutdown relief loan program” that includes a no-interest loan of up to $5,000 to be repaid in full after 90 days.

The mundane has also been disrupted. Some of the cafeterias and coffee carts that are usually open to staffers are closed. The lines to enter office buildings are long because fewer entrances are open.

The hallways leading to the offices of California’s elected officials are quiet, except for the faint sound of occasional elevator dings. Many of their doors are adorned with signs that show who they blame for the government shutdown.

“Trump and Republicans shut down the government,” reads a sign posted on the door that leads into Rep. Norma Torres’ (D-Pomona) office. “Our office is OPEN — WORKING for the American people.”

Rep. Ted Lieu, a Democrat from Torrance, posted a similar sign outside his office.

A sign is posted outside of the office of Rep. Ted Lieu, a California Democrat, in Washington on Wednesday.

(Ana Ceballos / Los Angeles Times)

Rep. Vince Fong, a Republican who represents the Central Valley, has been traveling between Washington and his district. Two weeks into the shutdown, he met with veterans from the Central Valley Honor Flight and Kern County Honor Flight to make sure that their planned tour of the Capitol was not disrupted by the shutdown. Like Kiley’s tour with the schoolchildren, an elected member needed to be present for the tour to go on.

“His presence ensured the tour could continue as planned,” Fong’s office said.

During the tour, veterans were able to see Johnson as well, his office said.

Shutdown highlights deep divisions

California’s congressional delegation mirrors the broader stalemate in Washington, where entrenched positions have kept both parties at a negotiation impasse.

Democrats are steadfast in their position that they will not agree to a deal unless Republicans extend the Affordable Care Act tax credits expiring at the end of the year, while Republicans are accusing Democrats of failing to reopen the government for political gain.

Kiley is one of the few Republicans who has called on Johnson to negotiate with Democrats on healthcare. Kiley said he thinks there is a “a lot of room to negotiate” because there is concern on both sides of the aisle if the tax credits expire.

“If people see a massive increase in their premiums … that’s not a good thing,” he said. “Especially in California, where the cost of living is already so high, and you’re suddenly having to pay a lot more for healthcare.”

Rep. Robert Garcia, the chair of the House Democratic Caucus, in a press event Wednesday with five other California Democrats talked about the need to fight for the healthcare credits.

Garcia, of Long Beach, said he recently visited a healthcare center in San Bernardino County that serves seniors with disabilities. He said the cuts would be “devastating” and would prompt the center to close.

“That’s why we are doing everything in our power to negotiate a deal that reopens the federal government and saves healthcare,” he said.

As the shutdown continues, many Democrats are digging their heels on the issue.

At an Oct. 3 event outside of Hollywood Presbyterian Medical Center, for instance, Rep. Laura Friedman held a news conference with nurses and hospital staff and said she would not vote for a bill to reopen the government unless there is a deal on healthcare.

Last week, the Glendale Democrat said her position hasn’t changed.

“I will not support a shutdown deal that strips healthcare from tens of thousands of my constituents,” she said.

Pregnancy centers in the U.S. that discourage women from getting abortions have been adding more medical services — and could be poised to expand further.

The expansion — including testing and treatment for sexually transmitted infections (STIs) and even providing primary medical care — has been unfolding for years. It gained steam after the Supreme Court overturned Roe vs. Wade three years ago, clearing the way for states to ban abortion.

The push could get more momentum with Planned Parenthood closing some clinics and considering shutting others after changes to Medicaid. Planned Parenthood is not just the nation’s largest abortion provider, but also offers cancer screenings, sexually transmitted infection testing and treatment, and other reproductive health services.

“We ultimately want to replace Planned Parenthood with the services we offer,” said Heather Lawless, founder and director of Reliance Center in Lewiston, Idaho. She said about 40% of patients at the antiabortion center are there for reasons unrelated to pregnancy, including some who use the nurse practitioner as a primary caregiver.

The changes have frustrated abortion rights groups, who, in addition to opposing the centers’ antiabortion messaging, say they lack accountability; refuse to provide birth control; and offer only limited ultrasounds that cannot be used for diagnosing fetal anomalies because the people conducting them don’t have that training. A growing number also offer unproven abortion-pill reversal treatments.

Because most of the centers don’t accept insurance, the federal law restricting release of medical information doesn’t apply to them, though some say they follow it anyway. They also don’t have to follow standards required by Medicaid or private insurers, though those offering certain services generally must have medical directors who comply with state licensing requirements.

“There are really bedrock questions about whether this industry has the clinical infrastructure to provide the medical services it’s currently advertising,” said Jennifer McKenna, a senior advisor for Reproductive Health and Freedom Watch, a project funded by liberal policy organizations that researches the pregnancy centers.

Post-Roe world opened new opportunities

Perhaps best known as “crisis pregnancy centers,” these mostly privately funded and religiously affiliated centers were expanding services such as diaper banks ahead of the Supreme Court’s 2022 Dobbs vs. Jackson Women’s Health Organization ruling, which overturned Roe.

As abortion bans kicked in, the centers expanded medical, educational and other programs, said Moira Gaul, a scholar at the Charlotte Lozier Institute, the research arm of SBA Pro-Life America. “They are prepared to serve their communities for the long term,” she said in a statement.

In Sacramento, for instance, Alternatives Pregnancy Center in the last two years has added family practice doctors, a radiologist and a specialist in high-risk pregnancies, along with nurses and medical assistants. Alternatives — an affiliate of Heartbeat International, one of the largest associations of pregnancy centers in the U.S. — is some patients’ only health provider.

When the Associated Press asked to interview a patient who had received only non-pregnancy services, the clinic provided Jessica Rose, a 31-year-old woman who took the rare step of detransitioning after spending seven years living as a man, during which she received hormone therapy and a double mastectomy.

For the last two years, she’s received all her medical care at Alternatives, which has an OB-GYN who specializes in hormone therapy. Few, if any, pregnancy centers advertise that they provide help with detransitioning. Alternatives has treated four similar patients over the last year, though that’s not its main mission, director Heidi Matzke said.

“APC provided me a space that aligned with my beliefs as well as seeing me as a woman,” Rose said. She said other clinics “were trying to make me think that detransitioning wasn’t what I wanted to do.”

Pregnancy centers expand as health clinics decline

As of 2024, more than 2,600 antiabortion pregnancy centers operated in the U.S., up 87 from 2023, according to the Crisis Pregnancy Center Map, a project led by University of Georgia public health researchers who are concerned about aspects of the centers. According to the Guttmacher Institute, 765 clinics offered abortions last year, down more than 40 from 2023.

Over the years, pregnancy centers have received a boost in taxpayer funds. Nearly 20 states, largely Republican-led, now funnel millions of public dollars to these organizations. Texas alone sent $70 million to pregnancy centers this fiscal year, while Florida dedicated more than $29 million for its “Pregnancy Support Services Program.”

This boost in resources is unfolding as Republicans have barred Planned Parenthood from receiving Medicaid funds under the tax and spending law President Trump signed in July. While federal law already blocked the use of taxpayer funds for most abortions, Medicaid reimbursements for other health services were a big part of Planned Parenthood’s revenue.

Planned Parenthood said its affiliates could be forced to close up to 200 clinics.

Some already had closed or reorganized. They have cut abortion in Wisconsin and eliminated Medicaid services in Arizona. An independent group of clinics in Maine stopped primary care for the same reason. The uncertainty is compounded by pending Medicaid changes expected to result in more uninsured Americans.

Some abortion rights advocates worry that will mean more healthcare “deserts” where the pregnancy centers are the only option for more women.

Kaitlyn Joshua, a founder of abortion rights group Abortion in America, lives in Louisiana, where Planned Parenthood closed its clinics in September.

She’s concerned that women seeking health services at pregnancy centers as a result of those closures won’t get what they need. “Those centers should be regulated,” she said. “They should be providing information which is accurate, rather than just getting a sermon that they didn’t ask for.”

Thomas Glessner, founder and president of the National Institute of Family and Life Advocates, a network of 1,800 centers, said the centers do have government oversight through their medical directors. “Their criticism,” he said, “comes from a political agenda.”

In recent years, five Democratic state attorneys general have issued warnings that the centers, which advertise to people seeking abortions, don’t provide them and don’t refer patients to clinics that do. And the Supreme Court has agreed to consider whether a state investigation of an organization that runs centers in New Jersey stifles its free speech.

Different services than Planned Parenthood

Choices Medical Services in Joplin, Mo., where the Planned Parenthood clinic closed last year, moved from focusing solely on discouraging abortion to a broader sexual health mission about 20 years ago when it began offering STI treatment, said its executive director, Karolyn Schrage.

The center, funded by donors, works with law enforcement in places where authorities may find pregnant adults, according to Schrage and Arkansas State Police.

Schrage estimates that more than two-thirds of its work isn’t related to pregnancy.

Hayley Kelly first encountered Choices volunteers in 2019 at a regular weekly dinner they brought to dancers at the strip club where she worked. Over the years, she went to the center for STI testing. Then in 2023, when she was uninsured and struggling with drugs, she wanted to confirm a pregnancy.

She anticipated the staff wouldn’t like that she was leaning toward an abortion, but she says they just answered questions. She ended up having that baby and, later, another.

“It’s amazing place,” Kelly said. “I tell everybody I know, ‘You can go there.’”

The center, like others, does not provide contraceptives — standard offerings at sexual health clinics that experts say are best practices for public health.

“Our focus is on sexual risk elimination,” Schrage said, “not just reduction.”

Mulvihill and Kruesi write for the Associated Press.

The scary thing about retirement is that it’s hard to know exactly how much money you’ll need to cover your costs until that period of life begins. Sure, you can estimate a budget based on certain assumptions, like where you’ll live and how you’ll spend your days. But nailing down an exact budget is pretty difficult.

Meanwhile, one of the most tricky retirement expenses to estimate is none other than healthcare. That’s because the cost there will hinge on factors like:

• How long you live
• What health issues you end up experiencing
• What Medicare plan you choose

Image source: Getty Images.

Still, it’s important to have a basic handle on what healthcare might cost you down the line. And recent data reveals that a good chunk of Americans are clueless in that regard.

Do you know what you might spend on healthcare in retirement?

In a recent report, Fidelity found that the typical 65-year-old today can expect to spend $172,500 on healthcare costs during retirement. But it also found that 20% of Americans have never thought about what healthcare might cost them down the line.

There are two reasons it’s important to plan for healthcare costs in retirement. First, it’s one expense that’s non-negotiable.

You can downsize your home if the costs of maintaining it are too high. And you can move to a state that’s cheaper if it helps you stretch your income and Social Security benefits. But you can’t not pay for healthcare. If you need a certain medication to function, you may not have a choice about taking it.

Secondly, healthcare has, for many years, outpaced broad inflation. When Fidelity first started estimating healthcare costs for retirement back in 2002, it found that the typical senior would spend $80,000 throughout their senior years. In the past two decades and change, that projection has more than doubled. And chances are, it’ll continue to climb.

Have a plan for tackling healthcare expenses

There are steps you can take to make healthcare in retirement more affordable, like going to your scheduled physicals and screening appointments to get ahead of potential issues and choosing the right Medicare plan. But there may be only so much you can do to keep your costs down.

That’s why it’s so important to save well for healthcare specifically. And while you could always boost your IRA or 401(k) plan contributions, you may want to allocate funds in a separate account specifically for healthcare.

In that regard, a health savings account, or HSA, is a great option to look at. The nice thing about HSAs is that they’re triple tax-advantaged, which means:

• Contributions go in tax-free
• Investment gains are tax-free
• Withdrawals are tax-free when used to cover qualifying healthcare expenses

Plus, HSAs are extremely flexible. You can withdraw your money at any time, and your money will never expire.

Also, if you end up in the enviable position of having lower healthcare costs in retirement than expected, your HSA won’t go to waste. When you’re under age 65, HSA withdrawals for non-medical expenses incur a steep penalty. But that penalty is waived once you turn 65, at which point an HSA can function like a traditional IRA or 401(k) plan.

Between Medicare premiums, deductibles, copays, and other expenses, you may find that healthcare in retirement costs more than expected. Read up on healthcare costs so you’re not caught off guard once your career comes to an end. Better yet, make sure you’re saving for your future healthcare needs so you never have to be in a position where you have to skimp on care because of the price tag attached to it.

U.S. House Minority Leader Hakeem Jeffries (D-N.Y.) visited three Black churches in Los Angeles on Sunday morning to campaign for California’s redistricting effort, which could add five or six Democratic representatives to his ranks.

Amid a congressional deadlock over healthcare subsidies that has left the government shut down for more than two weeks, the minority leader returned to the Golden State to campaign for Proposition 50. The ballot measure would give his party more power against Republicans, who Jeffries said have refused to negotiate in the shutdown and otherwise.

“This is trouble all around us,” Jeffries told the congregation at First African Methodist Episcopal Church of Los Angeles in West Adams — after poking fun at President Trump’s 2016 gaffe misspronouncing a book of the Bible. “Folks in the government who would rather shut the government down than give healthcare to everyday Americans. Wickedness in high places. And now they want to gerrymander the congressional maps all across the country to try to rig the midterm elections.”

The packed congregation — most wearing pink to support Breast Cancer Awareness Month — were receptive to his message.

“This is a way of trying to keep things equal,” said Kim Balogun, who was in Sunday’s crowd. “A level playing field.”

For many of its members, First AME is more than just a church. As the city’s oldest African American congregation, it has been at the forefront of the fight for civil rights since its founding in 1872.

“This is family,” said Toni Scott, a retired special-education teacher who has been with First AME for 52 years. “As one of the church’s previous ministers used to say, ‘This is a hospital. People are sick; we come to be healed,’” she said.

When news reached L.A. that Nelson Mandela would be released from prison, South African immigrants and anti-apartheid activists flocked to the church, anxiously awaiting the first sights of Mandela walking free. During the 1992 riots, First AME was a bastion of hope amid a sea of chaos.

“We thank you, God, for bringing us through dark times and chaotic times,” the Rev. Charolyn Jones said to the congregation on Sunday, “knowing that our church, the African Methodist Episcopal Church, was born out of protest.”

House Minority Leader Hakeem Jeffries, left, greets parishioners at First African Methodist Episcopal Church of Los Angeles. “It’s an honor and a privilege to spend time worshiping at Black churches here with Congresswoman Sydney Kamlager-Dove to reinforce the message of the importance of voting yes on Proposition 50,” Jeffries said.

(Ethan Swope / For The Times)

For Jeffries, the first Black person to lead a major political party in Congress, the West Coast trip amid a congressional impasse was important.

“The African American churchgoing community has always been the foundation of the Black experience in the United States of America,” Jeffries said, who also visited the congregations of Mt. Sinai Missionary Baptist Church in South L.A. and Resurrection Church of Los Angeles in Carson. “It’s an honor and a privilege to spend time worshiping at Black churches here with Congresswoman Sydney Kamlager-Dove to reinforce the message of the importance of voting yes on Proposition 50.”

The state’s redistricting effort, Proposition 50, is part of a national fight over control of the U.S. House of Representatives, instigated by President Trump. Republicans hold a slim majority in the House, but in June, Trump began pushing Texas Republicans to redraw the state’s congressional maps to yield five more likely GOP seats.

In response, Newsom proposed California temporarily depose of its independent redistricting commission, led by 14 citizens, to redraw the state’s maps and add five Democratic seats, effectively canceling out Texas’s move.

The Democratic-controlled state Legislature quickly produced redrawn maps and scheduled a Nov. 4 special election to put them up for a vote. Mail-in ballots are already in the hands of voters.

California Republicans, including former governor Arnold Schwarzenegger, have slammed the initiative as a “big scam.” Schwarzenegger called Democrats hypocritical, arguing that while they call Trump a “threat to democracy,” they want to “tear up the Constitution of California” and “take the power away from the people and give it back to the politicians.”

Jeffries noted that California was letting its citizens ultimately decide — unlike some Republican-led states.

“We said from the very beginning that we want to find bipartisan common ground whenever possible, but unfortunately, Republicans, from the beginning of this presidency, have adopted a take-it-or-leave-it, go-at-it-alone strategy,” he said, which is part of why, he added, Proposition 50 is so important.

In the current shutdown, Democrats said they will not vote for a funding bill unless it extends tax credits in the Affordable Care Act that are set to expire for many Americans at the end of the year and reverses cuts to Medicaid that Republicans passed in July’s so-called Big Beautiful Bill.

If the ACA credits expire, premiums would on average more than double for Americans on the enhanced tax credit, one health policy research firm found. But Republicans point out they come with a price: The Congressional Budget Office estimates they would cost the government $350 billion over the next decade.

The bill, which is now law, will cut Medicaid spending by $793 billion, the CBO estimated, and lead to 7.8 million Americans losing their insurance.

On the government shutdown, Richard Balogun, a member of Sunday’s First AME congregation, thinks fighting for healthcare is a worthwhile cause.

“Isn’t it amazing that in England, Australia … you can have national healthcare? Maybe you don’t get treated within the first hour, but you get treated,” he said. In America, “you have to ask yourself sometimes, if I’m going to the emergency room, can I afford that thousands of dollars I’m going to have to pay? That should not be the case in this country.”

A government shutdown has consequences: 2.3 million civilian federal employees are going without pay — roughly 750,000 of whom are furloughed. When the employees are back-paid after the government reopens, that’ll correspond to roughly $400 million of taxpayer money spent every day of the shutdown to pay employees who were not working, the CBO estimates.

Beyond National Park closures and air travel delays, food programs for low-income families could run dry without a funding bill. The Women, Infants and Children Program (WIC) can see effects as soon as one week after a shutdown, the CEO of the National WIC Assn. said. Meanwhile, SNAP (formerly known as food stamps) could also run out of funding further down the line.

Republicans blame Democrats for shutting down the government over their healthcare concerns, but Jeffries pinned it on Republicans, who’ve refused to negotiate.

To Scott, the pink her congregation was wearing to support breast cancer survivors only emphasized the importance of access to healthcare. (Jeffries sported a pink tie.)

“More people need to know what’s going on, so just having him go from church to church, mostly in the Black neighborhoods — that’s where we have the most people: in our churches,” Scott said. “Some may hear the word, see something on fake news, but we know in the church you’re going to hear truth.”

WASHINGTON — Senate Democrats are poised for the 10th time Thursday to reject a stopgap spending bill that would reopen the government, insisting they won’t back away from demands that Congress take up healthcare benefits.

The repetition of votes on the funding bill has become a daily drumbeat in Congress, underscoring how intractable the situation has become. It has been at times the only item on the agenda for the Senate floor, while House Republicans have left Washington altogether. The standoff has lasted over two weeks, leaving hundreds of thousands of federal workers furloughed, even more without a guaranteed payday and Congress essentially paralyzed.

“Every day that goes by, there are more and more Americans who are getting smaller and smaller paychecks,” said Senate Majority Leader John Thune, adding that there have been thousands of flight delays across the country as well.

Thune, a South Dakota Republican, again and again has tried to pressure Democrats to break from their strategy of voting against the stopgap funding bill. It hasn’t worked. And while some bipartisan talks have been ongoing about potential compromises on healthcare, they haven’t produced any meaningful progress toward reopening the government. Thune has also offered to hold a later vote on extending subsidies for health plans offered under Affordable Care Act marketplaces, but said he would not “guarantee a result or an outcome.”

Democrats say they won’t budge until they get a guarantee on extending the tax credits for the health plans. They warn that millions of Americans who buy their own health insurance — such as small business owners, farmers and contractors — will see large increases when premium prices go out in the coming weeks. Looking ahead to a Nov. 1 deadline in most states, they think voters will demand that Republicans enter into serious negotiations.

“The ACA crisis is looming over everyone’s head, and yet Republicans seem ready to let people’s premiums spike,” said Senate Democratic leader Chuck Schumer in a floor speech.

Still, Thune was also trying a different tack Thursday with a vote to proceed to appropriations bills — a move that could grease the Senate’s gears into some action or just deepen the divide between the two parties.

A deadline for subsidies on health plans

Democrats have rallied around their priorities on healthcare as they hold out against voting for a Republican bill that would reopen the government. Yet they also warn that the time to strike a deal to prevent large increases for many health plans is drawing short.

When they controlled Congress during the pandemic, Democrats boosted subsidies for Affordable Care Act health plans. It pushed enrollment under President Obama’s signature healthcare law to new levels and drove the rate of uninsured people to a historic low. Nearly 24 million people currently get their health insurance from subsidized marketplaces, according to healthcare research nonprofit KFF.

Democrats — and some Republicans — are worried that many of those people will forgo insurance if the price rises dramatically. While the tax credits don’t expire until next year, health insurers will soon send out notices of the price increases. In most states, they go out Nov. 1.

Sen. Patty Murray, the top Democrat on the Senate Appropriations Committee, said she has heard from “families who are absolutely panicking about their premiums that are doubling.”

“They are small business owners who are having to think about abandoning the job they love to get employer-sponsored healthcare elsewhere or just forgoing coverage altogether,” she added.

Murray also said that if many people decide to leave their health plan, it could have an effect across medical insurance because the pool of people under health plans will shrink. That could result in higher prices across the board, she said.

Some Republicans have acknowledged that the expiration of the tax credits could be a problem and floated potential compromises to address it, but there is hardly a consensus among the GOP.

House Speaker Mike Johnson (R-La.) this week called the COVID-era subsidies a “boondoggle,” adding that “when you subsidize the healthcare system and you pay insurance companies more, the prices increase.”

President Trump has said he would “like to see a deal done for great healthcare,” but has not meaningfully weighed in on the debate. And Thune has insisted that Democrats first vote to reopen the government before entering any negotiations on healthcare.

If Congress were to engage in negotiations on significant changes to healthcare, it would likely take weeks, if not longer, to work out a compromise.

Votes on appropriations bills

Meanwhile, Senate Republicans are setting up a vote Thursday to proceed to a bill to fund the Defense Department and several other areas of government. This would turn the Senate to Thune’s priority of working through spending bills and potentially pave the way to paying salaries for troops, though the House would eventually need to come back to Washington to vote for a final bill negotiated between the two chambers.

It could also put a crack in Democrats’ resolve. Thune said Thursday, “If they want to stop the defense bill, I don’t think it’s very good optics for them.”

It wasn’t clear whether Democrats would give the support needed to advance the bills. They discussed the idea at their luncheon Wednesday and emerged saying they wanted to review the Republican proposal and make sure it included appropriations that are priorities for them.

While the votes will not bring the Senate any closer to an immediate fix for the government shutdown, it could at least turn their attention to issues where there is some bipartisan agreement.

Still, there was a growing sense on Capitol Hill that an end to the stasis is nowhere in sight.

“So many of you have asked all of us, how will it end?” said House Speaker Johnson. “We have no idea.”

Groves and Jalonick write for the Associated Press.

Eli Lilly (LLY -0.82%) has been one of the best-performing healthcare giants over the past decade. It now stands as the largest in the sector by market cap.

Even with headwinds it has encountered this year, the drugmaker is arguably one of the top stocks in its industry to buy right now. Here’s why.

Image source: Getty Images.

Innovation pays off

It’s hard to find a drugmaker that has proven more innovative than Eli Lilly in recent years. Within its core areas of diabetes and weight management, Lilly launched tirzepatide, marketed as Mounjaro for diabetes and Zepbound for obesity. Tirzepatide was a significant breakthrough, as the first dual GLP-1 (glucagon-like peptide-1) and GIP (gastric inhibitory polypeptide) agonist, a medicine that mimics the action of these two gut hormones.

That’s one of the reasons tirzepatide has proved more effective than traditional GLP-1 drugs, and is racking up sales the likes of which have almost never been seen in the history of the industry. That’s not hyperbole. Most compounds never reach $1 billion in annual sales. Most of those that do, never get to $5 billion, and those that do, typically take years on the market to get there. In its third full year on the market, tirzepatide will generate well over $20 billion this year.

The next chapter

Last year, Eli Lilly earned approval for Kisunla, a medicine indicated to treat Alzheimer’s disease, an area that had long been considered the graveyard of investigational medications. So Lilly’s innovative prowess extends beyond its core markets. And the company is leveraging its success in weight management and obesity to establish a strong foundation for the future.

Thanks to acquisitions and licensing deals, it has significantly expanded its pipeline, which should power clinical and regulatory success over the next few years and strong financial results well into the next decade. That’s why Eli Lilly is one of the top healthcare stocks to buy right now.

It’s not my habit to preface my columns with “trigger alerts,” so this is a first:

If talking about circumcision makes you cringe, feel free to move along.

If, on the other hand, you wish to understand what Robert F. Kennedy Jr. was talking about during a White House meeting Oct. 9 when he tried to connect circumcision with autism, follow along with me.

The offhand reference to circumcision’s possible role in autism by Kennedy, Trump’s secretary of Health and Human Services, is part and parcel of Kennedy’s documented assault on science-based medicine.

His campaign encompasses attacks on COVID-19 vaccines, which have been shown over the years to have saved millions of people from death, hospitalization or long-term disability; his firing members of professional advisory boards at his agency and replacing them with anti-vaccine activists; his promotion of unproven “cures” for vaccine-preventable diseases; and his inaction in the face of a nationwide surge in cases of measles, a disease that was declared eliminated in the U.S. in 2000.

Let’s pause for a few words about the broader consequences of the erosion of our public health infrastructure. It not only exposes Americans to more disease and more serious disease, but has profound economic effects.

That’s true worldwide, but especially in the U.S., which spends much more per capita on healthcare than other developed countries, for lower results. Undermining the existing system for partisan ends won’t make the picture look any lovelier.

“The U.S. health disadvantage threatens the country’s global competitiveness and national security, as well as the hopes and prospects of future generations,” according to a 2021 paper from the Department of Health and Human Services, the agency that Kennedy now leads.

“U.S. employers depend on a healthy workforce to maximize productivity and minimize healthcare costs,” the paper stated. “Population health also affects the consumer market, whereby the demand for nonessential products and services suffers when families are struggling with illnesses and much of their disposable income is required for medical expenses.”

The chaos imposed on our public health system under the Trump administration only intensifies the damage.

On Friday, hundreds of employees at Kennedy’s agency, including the Centers for Disease Control and Prevention, abruptly received layoff notices. Some were hastily informed that their firings were erroneous, but the experience rattled the CDC, an agency tasked with overseeing the national response to seasonal respiratory illnesses at a time when those illnesses typically spike.

“The damage is beyond repair,” Demetre Daskalakis, who resigned as director of the National Center for Immunization and Respiratory Diseases, a unit of the National Institutes of Health, over conflicts with Kennedy, told CNN. “Crippling CDC, even as a ploy to create political pressure to end the government shutdown, means America is even less prepared for outbreaks and infectious disease security threats.”

That brings us back to Kennedy’s preoccupation with autism. He has claimed that the autism rate is on the rise due to “environmental toxins” such as childhood vaccinations and the use of Tylenol — or acetaminophen, its generic name — by mothers during pregnancy.

As I’ve reported, however, the roots of the increase in reported autism rates in recent decades are well understood: They have much to do with a broader definition of autism, which is widely described today as “autism spectrum disorder,” and with improved access to screening and diagnostic services by formerly overlooked groups such as Blacks, Hispanics and other nonwhite cohorts.

Kennedy’s comment about circumcision came during a White House Cabinet meeting. At first, he and Trump traded misconceptions they had previously aired about Tylenol use by pregnant women — Trump asserting that “obviously,” the rise in autism rates is “artificially induced” and adding, “I would say don’t take Tylenol if you’re pregnant, and … when the baby is born don’t give it Tylenol.”

That advice dismayed physicians, who say that fevers during pregnancy are a greater risk for the unborn and that acetaminophen is safer than alternative fever-reducing medicines.

Kennedy then injected circumcision into the discussion. “There’s two studies that show children who were circumcised early have double the rate of autism,” he said. “It’s highly likely because they were given Tylenol.”

Unsurprisingly, Kennedy’s remark got extensive play in the news media, prompting him to try walking it back via a tweet on X. Rather than accept responsibility for his confusing words, he responded with Bondi-esque truculence, writing: “As usual, the mainstream media attacks me for something I didn’t say in order to distract from the truth of what I did say.”

He even took arms against the Murdoch-owned New York Post, which posted its story with the headline, “RFK Jr. says Tylenol after circumcisions linked to autism,” and proceeded to debunk the claim.

In trying to clarify his point, however, Kennedy dug himself a deeper hole. According to his tweet, the two studies he was referring to at the cabinet meeting were a Danish study from 2015 and a non-peer-reviewed preprint posted online in August, which refers to the Danish paper. Kennedy mischaracterizes both.

Contrary to Kennedy’s implication, the Danish study did not address the use of acetaminophen (called “paracetamol” in the paper) in connection with circumcision. The reason, its authors wrote, was that “we had no data available on analgesics or possible local anesthetics used during ritual circumcisions in our cohort, so we were unable to address the paracetamol hypothesis directly.”

They did note, however, that the acetaminophen theory had only “limited empirical support.” In other words, evidence was lacking. Anyway, the Danish study was criticized — in the same journal that had published it — for its reliance on a very small sample of children.

As for the preprint, contrary to Kennedy’s description, it did not identify the Danish paper as offering “the most compelling ‘standalone’ evidence” for an autism-acetaminophen link. That language referred to three studies, one of which was the Danish paper. Of the other papers, one was based on later interviews with parents. The other was a study of the effects of acetaminophen on 10-day-old mice, not human children.

I asked Kennedy’s agency to clarify his claim and to explain the discrepancies between his words and the papers themselves, but received no reply.

To summarize, Robert F. Kennedy Jr., the nation’s top federal healthcare official, conjured up a connection between circumcision and autism via a relationship between circumcision and Tylenol that is unsupported by the research he cited. Indeed, the Danish paper describes the idea that boys undergoing circumcision invariably are given acetaminophen for pain as “a questionable assumption.”

In searching for empirical support for the acetaminophen theory, moreover, the Danish paper cited a 2010 paper funded by NIH that cautioned: “No evidence is presented here that acetaminophen in any way causes autism. … This hypothesis is largely based on multiple lines of often weak evidence.” Anyway, the paper was focused on a possible link between acetaminophen use and asthma, not autism.

Sadly, this sort of mischaracterization of research described as “a rigorous scientific framework” (RFK Jr.’s words) isn’t surprising coming from today’s Department of Health and Human Services. This is the agency, it may be recalled, that in May issued an “assessment” of the health of America’s children that cited at least seven sources that did not exist.

Nothing can stop unwary parents from relying on the judgment of Donald Trump or Robert F. Kennedy Jr. to make healthcare decisions for their infants and children. But they should be warned: They do so at their own and their offsprings’ risk.

SACRAMENTO — Though raging thousands of miles to the east, the entrenched stalemate in Washington over federal spending and the ensuing government shutdown has thrust California’s expansive healthcare policies into the center of the pitched, partisan debate.

The Trump administration and the Republican leaders in Congress continue to use California, and the benefits the state has extended to eligible immigrants regardless of their legal status, as a cudgel against Democrats trying to extend federal subsidies for taxpayer-funded healthcare coverage.

President Trump claimed recently that Democrats “want to have illegal aliens come into our country and get massive healthcare at the cost to everybody else.” Democrats called Trump’s assertion an absolute lie, accusing Republicans of wanting to slash federal healthcare benefits to Americans in need to pay for tax breaks for the wealthy.

“California has led the nation in expanding access to affordable healthcare, but Donald Trump is ripping it away,” California Gov. Gavin Newsom said.

In return for their votes to reopen the government, Democratic leaders in Congress want to reverse Medicaid cuts made in Republicans’ tax and spending bill passed this summer and continue subsidies through the Affordable Care Act, a program long targeted by Republicans. The subsidies, which come in the form of a tax credit, help lower health insurance costs for millions of Americans.

Can immigrants in the country illegally enroll in federal healthcare programs?

No. Undocumented immigrants are ineligible for Medicaid, Children’s Health Insurance Program or Medicare, or coverage through the Affordable Care Act, according to KFF, an independent health research organization.

Rep. Kevin Mullin (D-South San Francisco) held a virtual town hall last week in which he highlighted the “misinformation” about immigrants and healthcare.

“I just want to be completely clear that federal funding does not pay for health insurance for undocumented immigrants, period,” Mullin said.

Jessica Altman, executive director of Covered California, said the debate is really over “who can benefit from the federal dollars that are flowing to all states, including California,” to help lower costs for health insurance.

Covered California serves as a marketplace exchange for state residents seeking healthcare insurance under the Affordable Care Act, widely known as Obamacare, allowing them to select from name-brand insurance providers and choose from a variety of coverage plans. The vast majority of Californians receive federal subsidies to lower their premiums, including many middle-income families who had become eligible when Congress expanded the financial assistance in 2021.

Those expanded subsidies will expire at the end of the year, and Democrats are demanding that they be extended as part of any deal to reopen the government before they vote in favor of what is known as a continuing resolution, or a temporary funding bill to keep the federal government running.

“From the very beginning, undocumented or illegal — whatever terminology you want to use — individuals were never eligible for those tax credits, never eligible for those cost-sharing reductions, and in fact, and not even eligible to come onto a marketplace and buy coverage if they paid the full costs,” Altman said.

California does offer state healthcare coverage for undocumented immigrants

Through Medi-Cal, the state’s version of the federal Medicaid program, some medical coverage is offered, regardless of immigration status. The majority of that money comes from the state.

H.D. Palmer, deputy director for external affairs at the California Department of Finance, said the cost to provide Medi-Cal to undocumented immigrants in the current fiscal year is just over $12.5 billion.

State money accounts for $11.2 billion and the remaining difference is reimbursed with federal funding because it’s used to cover emergency services, Palmer explained.

“Under current law, hospitals that receive Medicaid are required to provide emergency care, including labor and delivery, to individuals regardless of their citizenship status,” he said. “That goes back to a budget law that was approved by Congress in 1986 and signed by President Ronald Reagan.”

The 1986 law is called the Emergency Medical Treatment and Active Labor Act, and allows for emergency healthcare for all persons.

Some Republicans have raised other concerns about the state’s use of managed care organization taxes.

The MCO tax is a federally allowable Medicaid funding mechanism that imposes a tax on health insurance providers that charge fixed monthly payments for services and is based on the number of people enrolled in plans each month. The revenue from the tax can then be used to support Medicaid expenditures with federal matching funds.

Critics say California exploits a so-called loophole: By increasing the MCO tax, and subsequently bringing in more matching federal funds, California can then put more of its own state money toward healthcare for undocumented immigrants.

“We are bringing in all those additional federal dollars and then reallocating other money away so that we can provide about $9.6 billion for Medi-Cal for undocumented and illegal immigrants,” said Assemblymember David J. Tangipa (R-Fresno). “The MCO tax was never supposed to be weaponized in that process.”

White House officials also contend that California could not afford to put resources toward benefits for undocumented immigrants if it had not received the extra federal money — a claim Newsom disputes.

“What the president is saying, he’s lying,” Newsom said at a recent event. “Speaker [Mike] Johnson’s lying. They’re lying to the American people. It’s shameful. … I guess they’re trying to connect their displeasure with what California and many other states do with state resources in this space, and that is a very separate conversation.”

California is not alone in offering such healthcare to immigrants in the country illegally

A “small but growing” number of states offer state-funded coverage to certain groups of low-income people regardless of immigration status, according to KFF.

California became the first state in the nation last year to offer healthcare to all low-income undocumented immigrants, an expansion spearheaded by Newsom.

Newsom has since partially walked back that policy after the costs exceeded expectations. Starting in January, most adult Medi-Cal applications will be blocked — although current enrollees can continue to renew — and some adults will be required to pay monthly premiums. Undocumented minors under age 19, who became eligible for Medi-Cal nearly a decade ago, will not be affected by the changes.

The upcoming changes to the state’s policies and the enrollment freeze will help decrease the overall costs, which are projected to fall to about $10.1 billion during the next fiscal year, according to the California Department of Finance.

While the governor’s shift angered his most progressive allies and renewed speculation that he is tacking to the political middle ahead of his expected run for president in 2028, the Democratic-led Legislature approved the Medi-Cal eligibility changes in June.

Public opinion on the issue may also be changing.

Fifty-eight percent of adults in California were opposed to providing healthcare for undocumented immigrants, according to a poll released in June from the nonpartisan Public Policy Institute of California. This was a notable shift, as previous surveys from the institute conducted between 2015 to 2023 showed the majority approved.

Who would lose coverage if the tax credits end and Medicaid cuts aren’t reversed?

Trump’s One Big Beautiful Bill Act, passed by Republicans this summer, ends healthcare subsidies that were extended during the pandemic and makes other cuts to programs. According to the White House, the bill “contains the most important America First healthcare reforms ever enacted.”

“The policies represent a comprehensive effort to address waste, fraud, and abuse to strengthen the healthcare system for the most vulnerable Americans, ensuring that taxpayer dollars are focused on American citizens and do not subsidize healthcare for illegal immigrants,” the White House said in a statement on Oct. 1.

Among other things, the law limits Medicare and other program eligibility to certain groups, including green card holders, effective July 2025. Other lawfully present immigrants, including refugees and asylees, are no longer eligible, according to KFF.

It’s estimated that the eligibility restrictions will result in about 1.4 million lawfully present immigrants becoming uninsured, reduce federal spending by about $131 billion and increase federal revenue by $4.8 billion as of 2034, according to the Congressional Budget Office.

At the same time, a broader group of lawfully present immigrants, including refugees, will lose access to subsidized coverage through the ACA marketplace by January 2027.

Covered California’s Altman estimated that there are about 119,000 immigrants in California who are covered and would lose eligibility for financial assistance.

More broadly, Altman and other healthcare experts predict that healthcare premiums will skyrocket if the ACA tax credits expire.

Healthcare stocks have struggled since interest rates began climbing in 2022. Rising yields pulled capital away from speculative biotech and drug development, pushing valuations lower even as research pipelines advanced. Many promising companies now trade at a fraction of their previous highs, while investors pour money into artificial intelligence (AI) names trading at record multiples.

That gap creates opportunity. Several healthcare innovators are approaching pivotal stages of development, yet their share prices still reflect caution rather than potential. These four healthcare stocks stand out as timely buys in a market that has overlooked their progress.

Image source: Getty Images.

Commercial momentum building

Crispr Therapeutics (CRSP -2.44%) and Vertex Pharmaceuticals (VRTX -1.68%) developed Casgevy, the first gene-editing treatment approved for sickle cell disease and beta-thalassemia, two inherited blood disorders.

Vertex reported $30 million in Casgevy sales in the second quarter of 2025, a sharp uptick from prior quarters, showing the drug is starting to gain traction in the marketplace. Crispr receives 40% of the program’s profits through its partnership with Vertex.

By mid-2025, 75 hospitals and clinics worldwide had been cleared to administer Casgevy, and approximately 115 patients had begun the treatment process. As more centers gain experience, patient numbers and sales are expected to grow through 2025 and 2026.

Outside of Casgevy, Crispr is working on several new treatments it fully owns, such as CTX112, a cell-based therapy in early testing for cancer and immune diseases. Results from CTX112 or other key pipeline candidates in late 2025 could provide a boost to the stock if the data show clear progress.

Late-stage catalysts approaching

Intellia Therapeutics (NTLA -3.81%) is advancing two CRISPR gene-editing programs toward key readouts. It recently completed enrollment in its Phase 3 study for hereditary angioedema, a rare disease that causes sudden swelling attacks, using a treatment called lonvoguran ziclomeran (NTLA-2002). Topline results are expected in the first half of 2026, with a regulatory filing planned later that year.

Intellia is also pushing forward with its program for ATTR amyloidosis, a disease in which abnormal proteins build up and damage the heart and nerves, using a treatment called nex-z (NTLA-2001). A pivotal trial is underway, and earlier testing showed that a single dose can reduce the TTR protein by approximately 91% in many patients, with data showing sustained reductions over time.

If both programs succeed, Intellia could become one of the first companies to win approval for a single-dose, in vivo CRISPR therapy (where gene editing happens directly inside the body) — a potential breakthrough that could lift investor expectations and reset how gene-editing companies are valued.

Platform plays with pharma validation

Recursion Pharmaceuticals (RXRX -10.24%) runs a drug discovery platform powered by AI and backed by big pharma partnerships such as Sanofi, Roche, and Bayer. In its latest results, the company pulled in $19.2 million in revenue — primarily from collaborations.

Several clinical trial updates are expected later in 2025. If those trials show its AI-discovered drugs perform well in patients, the market may begin valuing its individual programs more favorably — and that could unlock significant upside for the stock.

Viking Therapeutics (VKTX -4.00%) is advancing VK2735, a dual GLP-1/GIP agonist, through late-stage development for obesity. In its mid-stage study, the injectable version produced up to 14.7% average weight loss after 13 weeks and is now being tested in a large late-stage trial across obesity and type 2 diabetes populations.

The stock declined in August 2025 after results from the oral formulation showed higher dropout rates caused by gastrointestinal side effects from rapid dose escalation. The findings reflected how the drug was given, not an underlying problem with the compound.

With a slower titration schedule, tolerability could improve meaningfully. Both the injectable and oral versions remain key to Viking’s obesity strategy, positioning the company to compete in a market expected to exceed $100 billion in annual sales.

California Sen. Alex Padilla is among the highest-ranking Latinos in U.S. politics today, but it took a pair of handcuffs to make him famous.

How’s that for a comment on America 2025?

Padilla, you may remember, was tackled and cuffed by federal officers after attempting to ask a question of Homeland Security Czarina Kristi Noem at an L.A. news conference in June, when the National Guard first made its appearance on our streets. Noem later claimed Padilla “lunged” at her — which he did not — using the classic Trumpian technique of erasing reality with blame, especially when it comes to brown people.

Padilla told me that “from day one of this administration, I have tried to speak truth to power,” and if getting tackled forced people to “have no choice but to now start paying attention … that could be helpful, because the general public knows it’s wrong.”

U.S. Atty. Gen. Pam Bondi recycled the incident on Tuesday when Padilla attempted to question her during a congressional hearing, voicing concern about the weaponization of the Department of Justice. Bondi refused to answer multiple questions, instead invoking the Noem defense.

“I find it interesting that you want order … in this proceeding now,” Bondi said. “You sure didn’t have order when you stormed Secretary Noem at a press conference in California, did you?”

Again, no storming, no lunging, not even a feint. Really, if anything can be said of Padilla, it’s that he’s a guy who likes order. An MIT-trained engineer, he’s known for being calm to the point of boring — in the best of ways. Who wouldn’t want a bit of boring in their politics today, if it’s seasoned with compassion and common sense?

Calm, of course, does not mean a lack of conviction. As the government shutdown limps to the end of its first full week, Padilla took a few minutes to fill me in on why Democrats shouldn’t back down, and why he won’t — whether the issue is healthcare, immigration or the collision of the two, which is at the heart of this shutdown.

Republicans would like voters to believe that undocumented immigrants are throwing parties in our emergency rooms, racking up free services while shoving U.S. citizens out to the sidewalk. In reality, there’s not a lot of good data on how many ER visits involve undocumented folks because doctors are more focused on saving lives than checking immigration status. But one Texas study found that about 2% of all hospital visits in a three-month period involved people without documentation. That’s in a state with a high number of undocumented folks, so take it for what it’s worth — hardly a scourge.

Padilla and Democrats would like to stay focused on an actual crisis — healthcare premiums for low- and middle-income folks are about to skyrocket in coming weeks if Congress doesn’t keep the Obama-era subsidies that make the premiums affordable. Padilla wants voters to understand how dire this is.

“This is not a what-might-happen-next-year concern … this is a now concern,” Padilla told me.

“Open enrollment is opening,” he said. “People are setting their premiums and have to make choices of where to sign up for healthcare and at the cost right now, and so it does need to be immediately addressed.”

In case you think this is partisan show, far-right MAGA cheerleader Rep. Marjorie Taylor Greene (R-Ga.) agrees with Padilla. That’s when you know things are getting weird.

“Not a single Republican in leadership talked to us about this or has given us a plan to help Americans deal with their health insurance premiums DOUBLING!!!” Greene wrote on social media, breaking with her party on the issue.

That’s about the only thing that Padilla and Greene may ever agree on. Padilla is the son of immigrants who met in L.A. and later obtained legal status. He was born in Southern California, making birthright citizenship core to his identity at a moment when Trump is asking the Supreme Court to end it. His isn’t just an immigrant story, it’s a California story, and it’s never far from his mind.

He was recently asked if he regretted fighting with the Biden administration over proposed immigration reform that lacked pathways for immigrants, especially Dreamers and others who have been in the United States for years if not decades, to become citizens. Would it have been better to sell them out, leave them in limbo, but fix the border before Trump could exploit it?

“Of course not,” Padilla told me. Rather than shrink under attack, Padilla said he’s holding his ground.

California is one of a handful of states that does in fact offer healthcare to undocumented people, though budget shortfalls forced Gov. Gavin Newsom to scale back that plan.

No federal dollars are used for that undocumented healthcare — it’s solely state money. And Padilla supports it.

“There are some states that choose to use state funding to provide that care, and I agree with that, because it’s much smarter, from a public health standpoint, to help prevent people from getting sick or treat people early on, not administer healthcare, certainly not primary care, through emergency rooms,” he said.

Padilla said it’s rich that the very workers deemed essential during the coronavirus pandemic, the workers who kept food on tables, deliveries going, and cared for our young and our elderly, are now “the primary target of Trump’s massive deportation agenda. So whether it’s in the vein of the healthcare question, whether it’s in the vein of the indiscriminate raids by ICE and other federal agencies, that’s the cruel irony.”

The Trump administration raised Padilla’s profile inadvertently, but the newfound fame has had a somewhat unexpected consequence: Frequent speculation that he may run for governor when Newsom terms out in 2026.

Padilla said he hasn’t “made a decision on that and not making any announcements right now.”

Instead, he’s focusing on helping to pass California’s Proposition 50, which would rig election maps to potentially create five more Democratic seats in the midterm elections, with the hopes of taking control of at least one house of Congress, an effort he says is “critical to reining in this out-of-control administration.”

WASHINGTON — Democrats believe healthcare is an issue that resonates with a majority of Americans as they demand an extension of subsidies for their votes to reopen the shuttered U.S. government. But it is also one of the most intractable issues in Congress — and a real compromise is unlikely to be easy, or quick.

There are some Republicans in Congress who want to extend the higher subsidies, which were first put in place in 2021 amid the COVID-19 pandemic, as millions of people who receive their insurance through the Affordable Care Act marketplaces are set to receive notices that their premiums will increase at the beginning of the year. But many GOP lawmakers are strongly opposed to any extension — and see the debate as a new opportunity to cut back on the program altogether.

“If Republicans govern by poll and fail to grab this moment, they will own it,” wrote Texas Rep. Chip Roy, a Republican, in a letter published in the the Wall Street Journal over the weekend. He encouraged senators not to go “wobbly” on the issue.

“The jig is up, the pandemic is over and my colleagues shouldn’t blink in any other direction,” Roy wrote.

Republicans have been railing against the Affordable Care Act, former President Obama’s signature healthcare law, since it was enacted 15 years ago. But while they have been able to chip away at it, they have not been able to substantially alter it as a record 24 million people are now signed up for insurance coverage through the ACA, in large part because billions of dollars in subsidies have made the plans more affordable for many people.

Now, some of them see the Democrats’ fight as their chance to revisit the issue — putting Republican congressional leaders and President Trump in a complicated position as the government shutdown enters its seventh day and hundreds of thousands of federal workers are going unpaid.

“I am happy to work with Democrats on their Failed Healthcare Policies, or anything else, but first they must allow our Government to reopen,” Trump wrote on social media Monday night, walking back earlier comments saying there were ongoing negotiations with Democrats.

Waiting for the other side to blink

Senate Majority Leader John Thune (R-S.D.) has repeatedly indicated that Republicans are open to extending the subsidies, with reforms, if Democrats would reopen the government. But he has refused to negotiate until that happens — and has suggested Trump will be key to the eventual outcome.

Thune told reporters Monday “there may be a path forward” on ACA subsidies, but stressed, “I think a lot of it would come down to where the White House lands on that.”

Many GOP senators argue the only path forward is to overhaul the law. “The whole problem with all of this is Obamacare,” said Florida Sen. Rick Scott.

Most House Republicans agree, and House Speaker Mike Johnson has been noncommittal on discussions.

“Obamacare is not working,” Johnson said Sunday on NBC’s “Meet the Press.” “We’re trying to fix it.”

Democrats believe that public sentiment is on their side and argue that Trump and Republicans will have to come to the negotiating table as people who are enrolled in the program, many of whom live in Republican districts and states, are notified that their rates will increase.

“All I can tell you is the American people feel very deeply about solving this healthcare crisis,” Schumer said after the Senate rejected a House-passed bill to reopen the government for the fifth time Monday evening. “Every poll we have seen shows they want us to do it, and they feel that the Republicans are far more responsible for the shutdown than we are.”

Bipartisan talks face difficulties

With leaders at odds, some rank-and-file senators in both parties have been in private talks to try to find a way out of the shutdown. Republican Sen. Mike Rounds of South Dakota has suggested extending the subsidies for a year and then phasing them out. Senate Appropriations Committee Chairwoman Susan Collins (R-Maine) has suggested pushing ahead with a group of bipartisan spending bills that are pending and a commitment to discuss the healthcare issue.

But many Democrats say a commitment isn’t good enough, and Republicans say they need deeper reforms — leaving the talks, and the U.S. government, at a standstill.

Maine Sen. Angus King, an Independent who caucuses with Democrats, voted with Republicans to keep the government open. But he said Monday that he might switch his vote to “no” if Republicans do not “offer some real solid evidence that they are going to help us with this crisis” on healthcare.

Republican Sen. Markwayne Mullin of Oklahoma said his party is “not budging,” however. “First and foremost, before we can talk about anything, they need to reopen the government.”

Some Republicans urge action on healthcare

Still, some Republicans say they are open to extending the subsidies — even if they don’t like them — as it becomes clear that their constituents will face rising costs.

“I’m willing to consider various reforms, but I think we have to do something,” said Republican Sen. Josh Hawley of Missouri. He said Congress should address the issue “sooner rather than later” before open enrollment begins Nov. 1.

Rep. Marjorie Taylor Greene (R-Ga.) said she is “not a fan” of Obamacare but indicated she might vote to extend it.

“I’m going to go against everyone on this issue because when the tax credits expire this year my own adult children’s insurance premiums for 2026 are going to DOUBLE, along with all the wonderful families and hard-working people in my district,” she posted on social media Monday evening.

Jalonick writes for the Associated Press. AP writers Lisa Mascaro, Matt Brown, Kevin Freking, Stephen Groves and Joey Cappalletti contributed to this report.

Oct. 7 (UPI) — Speaker of the House Mike Johnson said Tuesday that “some good things could happen with healthcare” after he spoke with President Donald Trump about the government shutdown, a vote on which is expected later in the day.

During a news conference Tuesday morning, Johnson said he spoke “at length” with the president Monday about the failure of Congress to pass a continuing resolution to temporarily fund the government.

The inability for the Senate to reach a supermajority vote in favor of the stopgap funding package shut down the government starting Oct. 1.

Johnson said Trump “wants to solve the problem.”

“The president is a dealmaker. He likes to figure these things out and work toward solutions,” the speaker said, according to ABC News.

At issue are subsidies for Affordable Care Act premiums set to expire in the new year. Senate Democratic leader Chuck Schumer said his party wouldn’t support the stopgap legislation unless Republicans provisions extending the ADA subsidies.

The Trump administration has said it’s against extending the ADA subsidies, falsely claiming undocumented immigrants are taking advantage of it. Undocumented immigrants are not eligible for health insurance under the ADA, according to the federal healthcare.gov website.

Johnson said Tuesday that negotiations over healthcare won’t happen until “the Democrats stop inflicting pain on the American people and turn the lights back on Congress and get everybody back to work.”

The Senate failed for a fifth time to pass a continuing resolution Monday evening.

Meanwhile, there appears to be some question about whether furloughed government workers will receive back pay when they return to their jobs. A memo by the White House Office of Management and Budget obtained by Axios indicates that 750,000 workers won’t receive back pay despite a 2019 law signed by Trump that guarantees it.

“Does this law cover all these furloughed employees automatically? The conventional wisdom is: Yes, it does. Our view is: No, it doesn’t,” an unnamed senior White House official told Axios.

Senate Republican leader John Thune and he believes furloughed workers would be entitled to back pay.

“I don’t know what statute they’re using,” Thune said, according to CBS News. “My understanding is, yes, that they would get paid.

“I haven’t heard this up until now, but again, it’s a very straightforward proposition … they government reopens, and this question of whether people get paid or not is a non-issue.”

Johnson, however, declined to say definitively whether that would happen.

“It is true that in previous shutdowns, many or most of them have been paid for the time that they were furloughed. But there is new legal analysis — I don’t know the details, I just saw a headline this morning, I’m not read in on it and I haven’t spoken to the White House about it — but there are some legal analysts who are saying that may not be appropriate or necessary in terms of the law requiring that backpay be provided.

“If that is true, that should turn up the urgency and the necessity of Democrats doing the right thing here,” Johnson said.

SAN DIEGO — Six Democrats running for governor next year focused on housing affordability, the cost of living and healthcare cuts as the most daunting issues facing Californians at a labor forum on Saturday in San Diego.

Largely in lockstep about these matters, the candidates highlighted their political resumes and life stories to try to create contrasts and curry favor with attendees.

Former state Assembly Majority Leader Ian Calderon, in his first gubernatorial forum since entering the race in late September, leaned into his experience as the first millennial elected to the state legislature.

“I feel like my experience and my passion uniquely positioned me in this race to ride a lane that nobody else can ride, being a millennial and being young and having a different perspective,” said Calderon, 39.

Concerns about his four children’s future as well as the state’s reliance on Washington, D.C., drove his decision to run for governor after choosing not to seek reelection to the legislature in 2020.

“I want [my children] to have opportunity. I want them to have a future. I want life to be better. I want it to be easier,” Calderon, whose family has deep roots in politics. State leaders must focus “on D.C.-proofing California. We cannot continue to depend on D.C. and expect that they’re going to give a s—t about us and what our needs are, because they don’t.”

Former U.S. Health and Human Services Secretary Xavier Becerra, who also served as the state’s attorney general after a 24-year stint in Congress, argued that it is critical to elect a governor who has experience.

“Would you let someone who’s never flown a plane tell you, ‘I can fly that plane back to land’ if they’ve never done it before?” Becerra asked. “Do you give the keys to the governor’s office to someone who hasn’t done this before?”

He contrasted himself with other candidates in the race by invoking a barking chihuahua behind a chain-link fence.

“Where’s the bite?” he said, after citing his history, such as suing President Trump 122 times, and leading the sprawling federal health bureaucracy during the pandemic. “You don’t just grow teeth overnight.”

Calderon and Becerra were among six Democratic candidates who spoke at length to about 150 California leaders of multiple chapters of the American Federation of State, County and Municipal Employees.

The union has more than 200,000 members in California and is being battered by the federal government shutdown, the state’s budget deficit and impending healthcare strikes. AFSCME is a powerful force in California politics, providing troops to knock on voters’ doors and man phone banks.

The forum came as the gubernatorial field to replace termed-out Gov. Gavin Newsom is in flux.

Former Vice President Kamala Harris announced earlier this summer that she has opted against running for the seat. Former Senate Leader Toni Atkins suspended her gubernatorial campaign in late September.

Rumors continue to swirl about whether billionaire businessman Rick Caruso or Sen. Alex Padilla will join the field.

“I am weighing it. But my focus is first and foremost on encouraging people to vote for Proposition 50,” the congressional redistricting matter on the November ballot, Padilla told the New York Times in an interview published Saturday. “The other decision? That race is not until next year. So that decision will come.”

Wealthy Democratic businessman Stephen J. Cloobeck and Republican Riverside Sheriff Chad Bianco declined an invitation to participate in the forum, citing prior commitments.

The union will consider an endorsement at a future conference, said Matthew Maldonado, executive director for District Council 36, which represents 25,000 workers in Southern California.

Former Los Angeles Mayor Antonio Villaraigosa leaned into his longtime roots in labor before he ran for office. But he also alluded to tensions with unions after being elected mayor in 2006.

Labeled a “scab” when he crossed picket lines the following year during a major city workers’ strike, Villaraigosa also clashed with unions over furloughs and layoffs during the recession. His relationship with labor hit a low in 2010 when Villaraigosa called the city’s teachers union, where he once worked, “the largest obstacle to creating quality schools.”

“I want you to know something about me. I’m not going to say yes to every darn thing that everybody comes up to me with, including sometimes the unions,” Villaraigosa said. “When I was mayor, they’ll tell you sometimes I had to say no. Why? I wasn’t going to go bankrupt, and I knew I had to protect pensions and the rest of it.”

He pledged to work with labor if elected governor.

Labor leaders asked most of the questions at the forum, with all of the candidates being asked about the same topics, such as if they supported and would campaign for a proposed state constitutional amendment to help UC workers with down-payment loans for houses.

“Hell yes,” said former Rep. Katie Porter of Irvine, who teaches at UC Irvine’s law school and benefited from a program created by state university leaders to allow faculty to buy houses priced below the market rate in costly Orange County because the high cost of housing in the region was an obstacle in recruiting professors.

“I get to benefit from UC Irvine’s investment in their professionals and professors and professional staff housing, but they are not doing it for everyone,” she said, noting workers such as clerks, janitors, and patient-care staff don’t have access to similar benefits.

State Supt. of Instruction Tony Thurmond, who entered the gathering dancing to Dr. Dre and Tupac’s “California Love,” agreed to support the housing loans as well as to walk picket lines with tens of thousands of Kaiser health employees expected to go on strike later this month.

“I will be there,” Thurmond responded, adding that he had just spoken on the phone with Kaiser’s CEO, and urged him to meet labor demands about staffing, pay, retirement and benefits, especially in the aftermath of their work during the pandemic. “Just get it done, damn it, and give them what they’re asking for.”

Former state Controller Betty Yee agreed to both requests as well, arguing that the healthcare employers are focused on profit at the expense of patient care.

“Yes, absolutely,” she said when asked about joining the Kaiser picket line. “Shame on them. You cannot be expected to take care of others if you cannot take care of yourselves.”

AFSCME local leaders listening to former U.S. Health and Human Services Secretary Xavier Becerra speak at a gubernatorial forum Saturday in San Diego.

(Seema Mehta / Los Angeles Times)

More than a thousand chanting healthcare workers, activists and local officials filled the Los Angeles Convention Center on Thursday afternoon to protest pending trillion-dollar healthcare cuts contained in Trump’s “Big Beautiful Bill.”

“Healthcare right now in America is bad,” said Romond Phillips, a mobile clinic driver, who attended the rally. “I’m out on the front lines, so I see the need for it.”

David Rolas, a community advocate from South L.A., came out to the rally to show his support. He says, growing up, he remembers how hard it was to get access to healthcare and how many people died because of it. He was diagnosed with diabetes over 20 years ago, and today, he gets healthcare through Covered California.

“It’s helped me get the medicine I need, like my insulin,” said Rolas. “As I get older, I want to make sure I’m around for my kids. But my insulin isn’t cheap, so thankfully, I have affordable healthcare right now, but I will be affected by these changes.”

Earlier this week, Democrats in the Senate refused to vote for a Republican short-term funding bill, which excluded an extension of enhanced premium tax credits. These credits, enacted in 2021, helped healthcare plans offered through the Affordable Health Care Act (known as Obamacare) to remain affordable. Without an extension, the credits will expire.

Trump’s “Big Beautiful Bill,” which was passed earlier this year, proposes nearly a trillion dollars in cuts to Medicare and Medicaid. With these changes, millions of Americans will face higher insurance premiums and possibly lose coverage. Democrats are fighting to get the subsidies extended and are demanding that Republicans reverse the Medicaid cuts.

The dispute over healthcare cuts led to the government shutdown this week.

At the rally, Holly Mitchell, a member of the Los Angeles County Board of Supervisors who represents the city’s 2nd District, says she’s fearful of going back to the days before Obamacare. Her district is made up of 2 million Angelenos, with 850,000 enrolled in MediCal.

“I don’t know about you, but I’m not going back there,” Mitchell said. “Those are horrible, inhumane, dangerous times. Black, brown and poor people die at a higher rate than they should have because they didn’t have access to healthcare.”

The rally was organized by St. John’s Community Health, a nonprofit aimed at providing healthcare to underserved communities.

Jim Mangia, president of the organization, announced that St. John’s plans to build a coalition of community-based organizations, labor unions, clinics and hospitals that would get an affordable healthcare measure on next year’s county voting ballot.

“It would go directly to voters and raise hundreds of millions of dollars to save healthcare for our most vulnerable neighbors,” said Mangia. “It would build a national example that can be replicated across the country, to undermine Trump’s billionaire tax cuts, and restore the programs and healthcare our communities need so desperately.”

The working title for the initiative is the Los Angeles County Emergency and Essential Healthcare Restoration Measure. It’s still in its early stages, with ballot language being drafted. Mangia expects that the county would need to gather around $500 million to fill the new gaps Trump’s “Big Beautiful Bill” will leave in residents’ healthcare plans.

Congresswoman Sydney Kamlager-Dove, who represents California’s 37th District, said cuts will hit her constituents hard, noting that there are 400,000 people who rely on Medicaid. About 3.5 million people in the state could lose their health insurance, she said.

“It’s about kicking people off of their healthcare benefits,” said Kamlager-Dove.

She blames the Republican party for the government shutdown, saying, “If they want to keep the government open, they would have, they would have negotiated with Democrats, but they chose not to.”

Republicans have, in turn, blamed Democrats for the closure and have said they are open to making changes to healthcare policy later.

Donald Trump has made politics into a dystopian reality show he loves to host, but Democratic leaders Chuck Schumer and Hakeem Jeffries are playing by the old rules — and the mismatch may cause Democrats to get blamed for a government shutdown.

This is not because they’re dumb (they’re not) or incompetent (as the top Democrats of the Senate and House and as representatives of New York, both have risen to positions that require a Lyndon Baines Johnson-esque dexterity most of us couldn’t sustain for a single PTA meeting).

You can see it playing out in the government shutdown. Schumer and Jeffries seem almost neurologically incapable of operating in the world Trump has created — one where politics is less about governing or even persuasion, and more about staying on offense and generating spectacle.

Schumer exudes old-fashioned backroom politics and insider deal-making, which is another way of saying that he’s scripted, sweaty and stilted. It’s not that he’s bad at speaking; it’s that the kind of speaking he has mastered — the methodical, over-enunciated style that once charmed donors and editorial boards — is the equivalent of trying to fax something in 2025.

Jeffries, by contrast, is calm and disciplined. He speaks slowly, often channeling a rhythmic pattern that is reminiscent of a preacher or litigator. In a different era — the kind of era when “normal politics” still existed — this trait might have worked brilliantly. Today, it just feels tired. He’s supposed to be the hip one, once marketed as a “bad, brilliant brother from Brooklyn.” But his recent attempts at communication feel more like a corporate onboarding seminar.

And it’s not like he’s compensating for this shortcoming by electrifying the progressive base. Jeffries’ recent praise for New York Mayor Eric Adams (calling him a man who “served courageously and authentically for decades”) was a bit like praising Nickelback for artistic innovation. It’s not just inaccurate; it’s weirdly tone deaf to the moment.

To be fair, competing with Trump’s megaphone requires a skill set that is closer to professional wrestling than to 20th century politics. Trump is chaotic and often incoherent to the point of parody. But, and this is key, he never sounds like a normal politician.

In a game where authenticity — however poorly defined and cynically constructed — is the only real currency, the Democrats’ undynamic duo come across as high-functioning androids.

Countering Trump’s superpower calls for Democrats who can compete in the attention economy: leaders who feel authentic, actually enjoy picking constant political fights and understand that “going viral” is the new “getting quoted in the New York Times.”

Indeed, the only Democrats who have shown any capacity for being able to survive in this era have been Rep. Alexandria Ocasio-Cortez of New York and California Gov. Gavin Newsom.

Schumer and Jeffries do not have these skills, despite having plenty of material to work with.

Case in point: Republicans are about to make healthcare more expensive for millions of Americans. In theory, that’s a devastating talking point. In practice, it’s difficult to imagine Schumer and Jeffries delivering it in a way that can compete with Trump’s bogus assertion that the Democrats are shutting down the government because they want free healthcare for illegal immigrants and “transgender for everybody,” whatever that means.

Faced with these mistruths and the anemic response we’re getting from Schumer and Jeffries, the best-case scenario may be that Republicans — by virtue of being the “anti-government” party — take some blame for a government shutdown. But that’s not a strategy. That’s hoping partisan inertia is still on your side.

Regardless, the shutdown is merely the latest example of Democrats struggling to compete with MAGA. The larger problem is that the Democratic Party doesn’t really have a communicator right now. It hasn’t had one since Barack Obama left the stage.

It’s probably not fair to compare a congressional leader with a presidential candidate. But even by the standards of modern congressional leaders, Schumer and Jeffries are ill-equipped for the task at hand.

Democrats need someone with Newt Gingrich’s manic energy, revolutionary zeal and theatrical flair, coupled with Nancy Pelosi’s more pragmatic toughness and ruthless discipline. This is to say, someone who understands that politics is now a form of entertainment, but who still has the moral seriousness to prevent it from devolving totally into nihilism.

Instead, they’ve got two men who might as well be AM radio hosts trying to livestream on Twitch.

Ultimately, the Democrats’ communications crisis won’t be solved until they have a presidential nominee who can actually speak the language of the moment. Until they can find one, Democrats are stuck with two guys who are no match against a man who has turned political chaos into performance art.

And if Democrats don’t find one — and soon! — they won’t just lose the narrative: They’ll lose the country that depends on it.

Matt K. Lewis is the author of “Filthy Rich Politicians” and “Too Dumb to Fail.”

WASHINGTON — With a government shutdown looming, Democrats and Republicans angrily blamed each other and refused to budge from their positions Tuesday, unable to find agreement or even negotiate as hundreds of thousands of federal workers stood to be furloughed or laid off.

The partisan standoff over healthcare and spending threatened to trigger the first U.S. government shutdown in almost seven years at 12:01 a.m. Wednesday. To avoid it, the Senate would have had to pass a House measure that would extend federal funding for seven weeks while lawmakers finish their work on annual spending bills.

A vote on the bill, along with a Democratic alternative, was scheduled for early evening. But a resolution appeared far off as tempers flared, increasing the odds of a shutdown by the hour.

Senate Democratic Leader Chuck Schumer of New York said Republicans are trying to “bully” Democrats by refusing to negotiate on an extension of healthcare benefits and other priorities.

“It’s only the president who can do this. We know he runs the show here,” Schumer said Tuesday morning, after a bipartisan White House meeting the day before yielded little progress.

“Republicans have until midnight tonight to get serious with us,” Schumer said.

President Trump and his fellow Republicans say they won’t entertain any changes to the legislation, arguing that it’s a stripped-down, “clean” bill that should be noncontroversial.

Senate Majority Leader John Thune (R-S.D.) said Republicans “are not going to be held hostage” by the Democrats’ demands. The GOP-led House was on a weeklong recess, unavailable for immediate votes even if the Senate did find bipartisan agreement. And far from entering into negotiations, Trump instead posted a fake, mocking video of Democrats on Monday evening after the White House meeting.

On Tuesday, Trump threatened retribution, saying a shutdown could include “cutting vast numbers of people out, cutting things that they like, cutting programs that they like.”

It was still unclear if either side would blink before the deadline.

Blame game escalates

Although partisan stalemates over government spending are a frequent occurrence in Washington, the current impasse comes as Democrats see a rare opportunity to use their leverage to achieve policy goals and as their base voters are spoiling for a fight with Trump. Republicans who hold a 53-47 majority in the Senate would probably need at least eight votes from Democrats to end a filibuster and pass the bill with 60 votes, since Republican Sen. Rand Paul of Kentucky is expected to vote against it.

Still, Schumer said Trump and Republicans would be to blame if the government shuts down.

A handful of Democrats said they were still deciding how to vote, holding out for a last-minute compromise. Thune said he is “hoping there are Democrats out there who are reasonable and understand what’s at stake here.”

The last shutdown was in Trump’s first term, from December 2018 to January 2019, when he demanded that Congress give him money for his U.S.-Mexico border wall. Trump retreated after 35 days — the longest shutdown ever — amid intensifying airport delays and missed paydays for federal workers.

Democrats’ healthcare asks

Millions of people could face higher insurance premiums if the healthcare subsidies expire at the end of the year. Congress first put them in place in 2021, during the COVID-19 pandemic, to expand coverage for low- and middle-income people who purchase health insurance through the Affordable Care Act.

Democrats say they want the subsidies immediately extended. They have also demanded that Republicans reverse the Medicaid cuts that were enacted as a part of Trump’s “big, beautiful bill” this summer and for the White House to promise it will not move to rescind spending passed by Congress.

“We are not going to support a partisan Republican spending bill that continues to gut the healthcare of everyday Americans,” House Democratic Leader Hakeem Jeffries said.

Thune has pressed Democrats to vote for the funding bill and take up the debate on tax credits later. Some Republicans are open to extending the tax credits, but many are strongly opposed to it.

In rare, pointed back-and-forth with Schumer on the Senate floor Tuesday morning, Thune said Republicans “are happy to fix the ACA issue” and have offered to negotiate with Democrats — if they will vote to keep the government open until Nov. 21.

No agreement at the White House

The bipartisan meeting at the White House on Monday was Trump’s first with all four leaders in Congress since retaking the White House for his second term. Schumer said the group “had candid, frank discussions” about health care and the potential for health insurance costs to skyrocket once expanded Affordable Care Act tax credits expire Dec. 31.

But Trump did not appear to be ready for serious talks. Hours later, he posted a fake video of Schumer and Jeffries taken from footage of their real news conference outside the White House after the meeting. In the altered video, a voiceover that sounds like Schumer’s voice makes fun of Democrats and Jeffries stands beside him with a cartoon sombrero and mustache. Mexican music plays in the background.

At a news conference on the Capitol steps Tuesday morning, Jeffries said it was a “racist and fake AI video.”

Schumer said that “we have less than a day to figure this out” and Trump is trolling on the internet “like a 10-year-old.”

A crucial, and unusual, vote for Democrats

Democrats are in an uncomfortable position for a party that has long denounced shutdowns as pointless and destructive, and it’s unclear how or when it would end. But party activists and voters have argued that Democrats need to do something to stand up to Trump.

Some groups called for Schumer’s resignation in March after he and nine other Democrats voted to break a filibuster and allow a Republican-led funding bill to advance to a final vote.

Schumer said then that he voted to keep the government open because a shutdown would have made things worse as Trump’s administration was slashing government jobs. He says now that he believes things have changed, including the passage this summer of the massive GOP tax cut bill that reduced Medicaid.

Shutdown preparations begin

The stakes are huge for federal workers across the country as the White House told agencies last week that they should consider “a reduction in force” for many federal programs if the government shuts down. That means that workers who are not deemed essential could be fired instead of just furloughed.

Either way, most would not be paid. The nonpartisan Congressional Budget Office estimated in a letter to Iowa Sen. Joni Ernst on Tuesday that around 750,000 federal workers could be furloughed each day once a shutdown begins.

Virginia Sen. Mark Warner, a Democrat, said some of the many federal workers in his state support a shutdown.

“What I hear from federal workers is they’ve been on a slow, shutdown firing since the beginning of this administration,” Warner said. “They want us to push back.”

Federal agencies were already preparing. On the home page of the Department of Housing and Urban Development, a large pop-up ad reads: “The Radical Left are going to shut down the government and inflict massive pain on the American people.”

Jalonick, Mascaro and Groves write for the Associated Press. AP writers Seung Min Kim, Kevin Freking, Matthew Brown, Darlene Superville and Joey Cappelletti in Washington contributed to this report.

According to some research, healthcare stocks are about as cheap as they have been in three decades. Many have experienced significant headwinds recently, but for opportunistic investors, now may be a great time to explore the industry for potential deals. Plenty of promising, yet beaten-down, healthcare stocks can be had at reasonable valuations relative to their growth potential.

Two that are worth serious consideration are Pfizer (PFE -0.50%) and Vertex Pharmaceuticals (VRTX -1.00%). Here’s more on these drugmakers.

Image source: Getty Images.

1. Pfizer

Pfizer is staring down the barrel of several patent cliffs that should happen by the end of the decade. For example, the company’s anticoagulant, Eliquis, will lose patent exclusivity by 2029 at the latest. The market is factoring that in, and in addition to the poor financial results Pfizer has produced lately, it explains its terrible performance on the market over the past few years.

However, Pfizer is rebounding. In the second quarter, Pfizer’s revenue increased by 10% year over year to $14.7 billion. The company’s adjusted earnings per share grew 30% year over year to $0.78. These are strong results for a pharmaceutical giant.

Furthermore, Pfizer’s pipeline should enable it to overcome the upcoming loss of patent exclusivity. The company has earned approval for several new products in recent years that are still in their early growth stages, especially considering that some of them are expected to receive label expansions. Abrysvo, a vaccine for the respiratory syncytial virus, is one such newer product whose second-quarter revenue increased by 155% year over year to $143 million.

Elsewhere, Pfizer has significantly improved its pipeline in recent years through licensing deals in acquisitions. The company’s oncology pipeline appears particularly promising, boasting dozens of programs, at least some of which should yield excellent clinical results in the coming years.

Lastly, Pfizer has been engaged in cost-cutting efforts. The company is on track to deliver net cost savings of $4.5 billion by the end of the year and $7.2 billion by the end of 2027. These initiatives should help boost Pfizer’s bottom line, and they are even more important considering President Trump’s aggressive tariffs.

Pfizer’s overall business still looks robust enough to recover, despite upcoming headwinds. The stock’s forward price-to-earnings (P/E) ratio of 7.7 appears dirt cheap when compared to the industry average of 16.5 for the healthcare sector. The stock is a great choice for value investors right now.

2. Vertex Pharmaceuticals

Vertex Pharmaceuticals’ forward P/E tops 20, which makes the stock look fairly expensive compared to its healthcare peers. And when we consider that the company has encountered setbacks this year, including clinical trial failures and the distribution of some illegal knockoffs of its medicines in Russia, which has impacted its sales, the picture looks even bleaker.

But at current levels, Vertex Pharmaceuticals looks attractive considering its potential. For one, the company still holds a monopoly in cystic fibrosis (CF), a rare lung disease. And in that niche, Vertex Pharmaceuticals has a reasonable amount of whitespace. Although its first CF medicine has been on the market for over a decade, Vertex has developed newer and better products.

Trikafta and Alyftrek, Vertex’s newest launches in CF, won’t lose patent exclusivity until the late 2030s. In the meantime, thousands of patients eligible for these medicines remain untreated. Translation: Expect reasonable revenue growth from this franchise for the foreseeable future.

Now add to that the company’s newer launches: Journavx in acute pain and Casgevy in beta-thalassemia and sickle cell disease. The former fills a need: It became the first approved oral, non-opioid pain inhibitor. Opioid-based therapies come with the risk of addiction and other potentially severe adverse reactions. Journavx was only approved in January. It should make a meaningful impact on Vertex’s results sooner rather than later.

Casgevy’s case is a bit different. It first earned regulatory approval in late 2023, but it has not yet contributed significantly to Vertex’s sales. That’s because it is an expensive gene editing therapy that is complex to administer. However, Vertex Pharmaceuticals is making progress in securing deals with third-party payers. Casgevy has little competition and should also, eventually, see its sales ramp up.

Beyond that, Vertex Pharmaceuticals could earn approval for zimislecel, a therapy for type 1 diabetes, within two years. The company also has late-stage candidates that could make significant progress in the meantime. Vertex still has significant upside from its current levels. The stock has faced headwinds this year, but a turnaround is, indeed, on the horizon for the biotech stock.