PHOENIX — The U.S. Supreme Court has rejected Arizona’s eleventh-hour bid to block the upcoming start of a court-ordered takeover of healthcare operations in its prisons after the state was found to have provided constitutionally inadequate care to incarcerated people and dragged its feet for over a decade in making required improvements. Justice Elena Kagan denied the state’s request Thursday, leaving an outside corrections professional set to take over healthcare management for 25,000 incarcerated people on Oct. 19.
Arizona had asked the courts to delay the takeover while it appealed that decision and the appointment of former Ohio corrections director Annette Chambers-Smith to lead the effort. The state sought the delay from the Supreme Court after lower courts rejected by the request.
Over the past 14 years, Arizona has been dogged by complaints that its prison healthcare system was run shoddily and callously and that it repeatedly failed to improve a system found to have exposed prisoners to harm and preventable deaths.
Under a 2014 settlement, the state pledged to overhaul medical and healthcare services for prisoners but was soon accused of failing to make promised improvements. That led to more than $2 million in contempt-of-court fines and the eventual revocation of the agreement by U.S. District Judge Roslyn Silver, who said corrections officials had shown little interest in making required changes.
After a 2021 trial, Silver ruled against the state, issuing an injunction that required corrections authorities to address the constitutional violations. Earlier this year, she ordered the takeover after concluding the state hadn’t gotten a semblance of compliance with court-ordered changes and the U.S. Constitution after more than a decade of litigation. Silver found that prisoners remained exposed to grave threats of harm and suffering because of systematic deficiencies in their health care.
The Arizona Department of Corrections, Rehabilitation and Re-entry did not immediately respond to a request for comment on Thursday’s decision.
In a statement, Corene Kendrick, an American Civil Liberties Union attorney who represents prisoners in the lawsuit, applauded the court’s refusal to delay the takeover, also known as a receivership. She said Arizona fought accountability at every turn while prisoners suffered. “Today’s decision clears the way for a receiver to do what the state has failed to do for more than a decade,” Kendrick said.
In seeking a delay, Arizona’s attorneys said Silver adopted a drastic takeover remedy without first trying intermediate fixes to speed compliance. They also said the judge hadn’t given the corrections department enough time to continue making progress and argued that the official appointed to run healthcare operations wouldn’t be politically accountable. They said the agency is committed to improving health care in prisons, has made significant progress since 2023 and that the prisoners won’t suffer harm if the start of the takeover were delayed by a few months.
Lawyers for prisoners said the state was minimizing its noncompliance, disputed its claim it had not been given enough time to comply after 14 years of litigation and said Silver had already tried less-intrusive remedies. They also said the state’s proposal of a months-long delay in the takeover “grievously minimizes” the harm prisoners face from the state’s inability to provide adequate care.
Complaints about health care in Arizona’s prisons have spanned both Republican and Democratic administrations.
The lawsuit was filed in 2012 during Republican Gov. Jan Brewer’s administration and continued under Republican Gov. Doug Ducey, when both contempt fines against the state were issued. Under Ryan Thornell, the corrections director in Democratic Gov. Katie Hobbs administration, the department has complained that its progress in overhauling health care operations in recent years hasn’t been acknowledged.
The lawsuit over healthcare for incarcerated people covers Arizona’s nine state-run prisons but not the nearly 10,000 Arizona inmates held in private prisons.
Billeaud writes for the Associated Press.
A proposal to tax California’s billionaires has fractured Democratic politics, repelled some of the state’s richest residents and exploded into a costly battle that’s overshadowing even the gubernatorial election.
Known as Proposition 40, the ballot measure is also dividing the very industry it’s supposed to help. The healthcare workers union behind the initiative, which would authorize a wealth tax on billionaires, says the levy would raise sorely needed funds to shore up health coverage.
By contrast, leading California hospital and doctor groups are opposing the measure ahead of the November vote. They say the one-time 5% levy on the state’s wealthiest is a risky gambit with an uncertain path to victory — as well as a distraction from other proposals to shore up healthcare.
“This is an experiment on a taxation scheme that’s not been done before, and it puts healthcare in a more vulnerable position as a result,” California Medical Assn. Chief Executive Dustin Corcoran said at a recent briefing in Sacramento. “It’s not a healthcare ballot measure.”
Less than six weeks before election day, polls show a divided electorate. But whatever the outcome, the fight is exposing a broader problem confronting California: how to preserve one of the nation’s largest expansions of publicly funded healthcare as a big chunk of the money that helped pay for it disappears.
Over the last decade, California increased access to publicly funded healthcare by broadening eligibility for Medi-Cal, the state’s Medicaid program, and other types of insurance, allowing millions more residents to gain coverage. The number of people without insurance fell to 2.4 million in 2024 from about 6.5 million in 2011.
Now, that trend is expected to reverse. According to the Congressional Budget Office, President Trump’s budget bill last year will lead to $1 trillion in healthcare-related cuts over a decade. Earlier this week, the Trump administration said it recently removed 760,000 people from Obamacare plans across the nation, alleging that some were enrolled improperly and others don’t exist.
Combined with strict work requirements, more frequent eligibility checks and a pullback in state spending pushed by Democratic Gov. Gavin Newsom, the changes are projected to push California’s uninsured population under the age of 65 to 4.6 million by 2030, according to the UC Berkeley Labor Center.
“Without trying to be melodramatic, when millions of people lose coverage, it is entirely predictable that thousands will die unnecessarily because of foregone treatment,” said Dave Regan, president of SEIU-UHW, the healthcare-workers union pushing the billionaire tax.
“There is an absolute consensus on what the problem is, and there’s a consensus that there’s no other solution on the table,” he said in an interview at Bloomberg’s San Francisco offices.
Even before the budget cuts start to bite, financial strains are mounting at institutions such as Martin Luther King Jr. Community Hospital in South Los Angeles.
MLKCH’s waiting room is now mostly used for treating patients, with 16 wooden cubicles functioning as care rooms. Sick or injured people are also cared for in the hospital’s front hallways and in what used to be the meditation chapel and the gift shop.
The hospital opened in 2015 with an emergency department built for 25,000 visits annually. In 2024, it handled 130,000. Dr. Elaine Batchlor, its CEO, said further funding reductions “would threaten the sustainability of the hospital.”
Batchlor isn’t taking a position on Proposition 40 and has been looking for other sources of revenue. SEIU-UHW’s Regan argues there’s no other way to raise the money needed to fill the massive gap.
The California Budget & Policy Center estimates the state stands to lose roughly $30 billion in federal Medi-Cal funding each year. Asking California lawmakers for that amount is a “fool’s errand,” Regan said. “And on top of that, the only people the legislature will tax are ordinary people.”
The union estimates the levy would raise $100 billion over five years, with 90% earmarked to shore up health coverage amid impending budget cuts.
Critics dispute the projection. The state’s nonpartisan Legislative Analyst’s Office says the tax would probably raise tens of billions of dollars, but potentially reduce income-tax revenue in the long run, as some ultrawealthy residents depart the state.
Recent polls show an increasingly contested path for Proposition 40. A recent UC Berkeley-Politico poll found 45% of likely voters in favor, but opposition has increased since early this year and now stands at 43%. A separate Public Policy Institute of California survey put support at 52% and opposition at 46%.
Led by Sergey Brin, wealthy opponents have poured almost $230 million into funding Building a Better California, according to a filing late Thursday. That’s helping them flood the airwaves with anti tax advertising. There are also two competing ballot measures designed to torpedo Proposition 40 if they pass.
Billionaires aren’t the only detractors. Critics have also assailed Proposition 40 for carving out an exception to California’s constitutional funding rules to steer most proceeds to healthcare. While the state generally earmarks at least 40% of General Fund revenue to public schools and community colleges, the billionaire-tax proposal excludes the new levy from that calculation.
Corcoran, the medical association chief, argues that even if Proposition 40 passes in November, legal challenges would potentially delay its implementation for years.
“There’s a lot that we can do looking ahead to 2028 when these cuts start taking greater effect that frankly would provide more immediate relief than Proposition 40 would,” he said. His group and others are pushing instead for large corporations to help cover the cost of public insurance for their workers.
Regan called that proposal “the worst public policy on planet Earth,” saying costs will be passed on to consumers and that it essentially acts as a payroll tax on low-wage workers.
He also disputed the notion the billionaire tax would lead the ultrawealthy to leave the state, pointing to Nvidia Corp. CEO Jensen Huang, who earlier this year said he would be “perfectly fine” with the levy. As for legal challenges to the billionaire tax, Regan said he believes they can be resolved in 12 months.
The uncertain funding picture has many hospitals bracing for cuts.
James Suver, CEO of Ridgecrest Regional Hospital, about 150 miles north of Los Angeles, said he’s not betting on proceeds from the billionaire tax. He’s weighing options that include pausing maternity care again, cutting physician recruitment and reducing emergency-room service.
“Our future under the most likely scenario is not looking very good,” Suver said. “We’re beyond doing minor nips and tucks to be able to offset some of the changes that I suspect may be happening in the future.”
Clanton writes for Bloomberg. Kara Wetzel of Bloomberg contributed.
Gov. Gavin Newsom has signed a package of bills that he says are intended to build on California’s record of protecting reproductive rights and expanding access to care.
One of the measures, sponsored by Assemblymember Catherine Stefani (D-San Francisco), increases access to medication abortion by making it available on community college campuses.
Another bill, sponsored by Assemblymember Jacqui Irwin (D-Thousand Oaks), focuses on military veterans, aiming to address a gap in their healthcare after the Trump administration largely banned the U.S. Department of Veterans Affairs from providing abortion services. The measure enables California veterans to access abortion and contraception services through a state program.
“Freedom means being able to make deeply personal decisions without elected officials inserting themselves in pursuit of a political agenda,” Newsom said. “California is protecting that freedom and showing the nation, particularly under increasingly severe attacks by the Trump administration, what is possible when we put patients and people first — not politics.”
The governor announced the signing of the bills on Sunday, saying they will strengthen reproductive healthcare in the state.
One of the bills, introduced by Stefani, expands the ability of certified nurse-midwives to provide care for pregnant and postpartum patients by specifying that supervision by a physician is not required when providing certain services.
The legislation also included a bill sponsored by Assemblymember Celeste Rodriguez (D-San Fernando) that aims to expand access to breast pumps and services for nursing mothers through Medi-Cal.
The slate of statewide measures on the Nov. 3 ballot provides voters two opportunities to tax the rich, which in past years has proved tantalizing to California’s left-leaning electorate.
Only one of those measures has strong voter support, however, and it’s not the proposition that’s attracted nationwide attention, ignited a nearly quarter-billion-dollar political slugfest and created a rift among top leaders in the Democratic Party.
Likely voters expressed middling support for Proposition 40, a one-time 5% tax on billionaires’ assets intended to compensate for an impending $100 billion in federal healthcare funding cuts. They were far more likely to back Proposition 3, a ballot measure that would make permanent a tax increase on the wealthy that funds schools and healthcare, according to a poll released Friday by UC Berkeley’s Institute of Governmental Studies that is co-sponsored by The Times.
Proposition 3 appears to be a much less controversial endeavor, which may explain why it has more voter support. The ballot measure would extend a tax enacted in 2012 on individuals who earn at least $360,000 a year that is set to expire in 2031. Proposition 40 proposes a brand-new tax on billionaires and is opposed by Gov. Gavin Newsom, who fears that it could hurt the state’s finances in the long run.
“When you’re going about taxing the billionaires’ assets, I mean that’s something kind of new and different, and it’s risky, and the governor’s against it, and you know a lot of people are expressing caution about it,” said Mark DiCamillo, director of the poll.
Voters are deeply concerned about income disparity but also skeptical about the unusual approach of the billionaire tax.
Proposition 40 has drawn the greatest attention and campaign spending of the 14 ballot measures voters will decide on Nov. 3.
In the poll, 45% of likely voters support the proposal, while 42% oppose it and 13% are undecided. That’s a decline in support compared with six weeks ago, when 48% of likely voters supported it while 41% opposed it, and comes after nearly $100 million of spending on television ads, social media messages and mailers, largely from opponents.
The billionaire tax was crafted by a healthcare union in response to legislation passed by congressional Republicans and signed by President Trump last year that could result in millions of Californians losing Medi-Cal coverage, rural hospitals shuttering and other healthcare services being slashed unless a new funding source is found.
The proposal would retroactively apply to billionaires who lived in California as of Jan. 1, prompting some to preemptively move out of the state. Ninety percent of the revenue would fund healthcare programs, and the remaining funds would be spent on education programs and food assistance.
There are two counterproposals on the ballot that would nullify the wealth tax if either receives more votes than Proposition 40, and they have raised $144 million. Voters are torn about Proposition 41, which would prohibit any new state taxes from being excluded from a voter-approved cap that restricts how much tax revenue the state can spend each year. The billionaire tax would have such an exclusion. Voters also are divided on Proposition 42, which would prohibit new taxes on personal property, intellectual property, retirement accounts and other assets and would limit situations in which a ballot measure or state lawmakers can impose or raise taxes retroactively — both of which are essential parts of the billionaire tax initiative.
Proposition 42 has greater support, with 43% backing it, 34% opposing it and the remainder undecided, according to the poll. Even more voters were uncertain about Proposition 41: 3 in 10 said they were undecided, while 37% said they supported it and 33% said they planned to vote against it.
The large number of undecided voters this close to the election points to voters being overwhelmed by the sheer number of statewide ballot measures, DiCamillo said.
“It’s confusion,” he said, adding that many voters may make a decision once they receive more ballot information.
That said, the fact that none of these proposals has the support of more than 50% of likely voters doesn’t bode well for their prospects, DiCamillo said.
Ballots will begin arriving in the mailboxes of the state’s 23.2 million voters in days.
Democratic voters outnumber Republicans by nearly 2 to 1 in California, but the party’s leaders are deeply divided about the billionaire tax, given the volatile state budget’s reliance on the wealthy. Newsom, who is pondering a 2028 presidential campaign, and the two men vying to replace him — Democrat Xavier Becerra and Republican Steve Hilton — oppose it. Rep. Ro Khanna (D-Fremont), a potential 2028 White House contender, supports it, as does the California Democratic Party.
Additionally, Dave Regan, president of Service Employees International Union-United Healthcare Workers West and architect of the ballot measure, has come under scrutiny. Regan has been accused of threatening and intimidating women who worked for the union’s parent organization, and of physically assaulting one, according to reporting by The Times. He was also accused of trying to extort SEIU’s state council, suggesting that it could face an investigation over “governance issues” if it did not support Proposition 40, according to an investigation commissioned by SEIU.
Regan has denied these claims, describing them as a “smear” campaign orchestrated by Proposition 40 opponents.
Much less attention has been paid to Proposition 3. Californians who earn more than $360,000 now are subject to a 10.3% tax, while those who earn more than $721,000 face a 12.3% levy. The vast majority of the billions raised through this tax go to K-12 schools, while the remainder is spent on community colleges and healthcare.
The other ballot measure that is receiving national attention is Proposition 39, which would require voters to present a government-issued identification document to cast a ballot or provide a PIN or the last four digits of their Social Security number when submitting mail-in ballots.
The measure also would require the California secretary of state and county election officials to verify that registered voters are U.S. citizens by “using government data,” which according to supporters could include information in the federal Social Security Administration database, jury summons information and other government records.
The proposal comes as Trump has continued to make claims that elections, notably in California, are being rigged by Democrats. Americans are increasingly alarmed about the security and sanctity of voting, and growing fears about intimidation efforts at polling places in the midterm elections.
Fifty-two percent of likely California voters oppose the voter ID proposal, while 39% support it and 9% are undecided, according to the poll.
“It doesn’t look like it’s in a strong position,” DiCamillo said, noting that while voters have opposed it in prior polls, the opposition has grown.
Nearly one-third of voters were undecided about two other propositions:
Voters will also face questions about environmental policy, housing, recall elections and other matters, as well as statewide, congressional and local elections. Californians are fatigued by the length of the ballot.
The Berkeley IGS/Times poll findings are based on an online survey in English and Spanish of 6,989 registered California voters, 4,512 of whom are considered likely voters, on Sept. 15-20. The results are estimated to have a margin of error of about 2 percentage points in either direction in the overall sample, and larger numbers for subgroups.
Attending to other matters that are now top priority, I momentarily strayed from the frequency with which I had been writing reflections in the year 2010; however, Hugo Chávez Frías’ proclamation last Thursday the 30th, obliges me to write these lines.
The president of Venezuela is one of the men who has done the most for the health and education of his people; since these are subjects where the Cuban Revolution has accumulated the most experience, we gladly collaborate to the maximum with this sister country in both areas.
It is by no means a matter of that country lacking doctors; quite the opposite. They had an abundance of doctors, among them there were even first-class professionals, just as in other Latin American countries. It is a social matter. The best medical doctors and the most sophisticated equipment could be placed at the service of private medicine, as it is in all capitalist countries. And often not even that, because in underdeveloped capitalism, like the type that used to exist in Venezuela, the wealthy class had sufficient means to go to the best hospitals in the United States or Europe, something that was and is customary and nobody can deny it.
Even worse, the United States and Europe have been noted for seducing the best specialists from any exploited Third World country to abandon their homeland and to emigrate to the consumer societies. Training doctors for that world in the developed countries implies fabulous sums of money that millions of poor Latin American and Caribbean families would never be able to pay. In Cuba, that used to happen until the Revolution took up the challenge, not just of training doctors capable of serving our own country, but also the other peoples of Latin America, the Caribbean or the world.
Never have we stolen the intelligences of other peoples. On the contrary; in Cuba we have trained tens of thousands of doctors and other top-level professionals, for free, in order to send them back to their own countries.
Thanks to the profound Bolivarian and Marti-inspired revolutions, Venezuela and Cuba are countries where health and education have been extraordinarily developed. Every citizen has the real right to receive general education and professional training at no cost, something that the United States has not been able to ensure for all its inhabitants. The reality is that the government of that country invests a billion dollars every year on its military machine and its war adventures. Furthermore, it is the greatest exporter of weapons and the instruments of death and the greatest market for drugs in the world. Because of this traffic, tens of thousands of Latin American lives are lost every year.
It is such a real and well-known fact that more than 50 years ago, a president having military origins bitterly denounced the decisive power accumulated by the military-industrial complex in that country.
These words would be superfluous if it were not for the intervention of the hateful and repugnant campaign unleashed by the massive Venezuelan oligarchy media, at the service of that empire, using the health problems being experienced by the Bolivarian President. We are united to the President with close and indestructible bonds of friendship that came into being from his first visit to our homeland on December 13th, 1994.
Some were surprised by the coincidence of his visit to Cuba with the necessity of seeking medical care. The Venezuelan President visited out country with the same aim that took him to Brazil and Ecuador. He had no intention of receiving medical care in our homeland.
It is well-known that for a few years now, a team of Cuban health specialists are providing their services to the Venezuelan President who, loyal to his Bolivarian principles, never considered them to be undesirable foreigners, but sons and daughters of the Great Latin American Homeland on behalf of which The Liberator fought, right up to his last living breath.
The first contingent of Cuban doctors left for Venezuela when the Vargas Stadium tragedy occurred, taking thousands of this noble country’s lives. This action of solidarity was nothing new; it made up a tradition well-established in our country from the first years of the Revolution, from the time almost half a century ago when Cuban doctors were sent to recently-independent Algeria. That tradition grew stronger while the Cuban Revolution, in the midst of a cruel blockade, was training internationalist doctors. Countries such as Peru, Somoza’s Nicaragua and other countries in our hemisphere and in the Third World were suffering from tragedies as a result of earthquakes or other causes that required Cuba’s solidarity. So, our country became the nation in the world that had the highest rate of doctors and specialized health personnel, with extremely high levels of experience and professional capabilities.
President Chávez put a great emphasis in relating with our health personnel. This way, a bond of confidence and friendship was born between him and the Cuban doctors who were always very sensitive to the treatment of the Venezuelan leader; and he was able to create thousands of health centres and outfit them with the necessary equipment in order to provide free services for all Venezuelans. There was no other government in the world that did so much, in such a short time, for the health of its people.
A large percentage of Cuban health personnel provided services in Venezuela and many of them also acted as teachers in certain subjects that were being taught to train more than 20,000 young Venezuelans who began to graduate as medical doctors. Many of them began their studies in our country. The internationalist doctors, members of Battalion 51, graduates of the Latin American School of Medicine, have earned solid prestige in carrying out complicated and difficult missions. On these bases my relations in this field with President Hugo Chávez were built.
I should add that in the course of more than twelve years, since February 2, 1999, the president and leader of the Venezuelan Revolution has not rested one single day and thus he occupies a unique place in the history of this hemisphere. All of his energy has been dedicated to the Revolution.
One could say that for every extra hour Chávez dedicates to his work, the president of the United States rests for two hours.
It was difficult, almost impossible, that his health would not suffer some sort of breakdown and this is what happened in the last few months.
He is a person used to the rigors of military life and he would stoically put up with the aches and pains that were plaguing him with ever increasing frequency. Given the friendly relations developed and the constant exchanges between Cuba and Venezuela, added to my personal health experience that I underwent since the proclamation of July 30, 2006, it is not unusual that I should have noticed the need for a strict medical check-up for the President. He is far too generous in granting me any special merit in this matter.
Of course, I admit that it was no easy task that I set for myself. It wasn’t difficult for me to notice that he had some health problems. Seven months had gone by since his last visit to Cuba. The medical team devoted to caring for his health had pleaded for me to take up the matter. From the very first moment, the President’s attitude was one of informing the people, with complete clarity, about the state of his health. That was why, at the point by then of returning, via his minister of Foreign Affairs, he informed the people about his health up to that instant and he promised to keep them informed in detail.
Each treatment was accompanied by rigorous cellular and laboratory analyses, of the kind that are done under such circumstances.
One of the tests, several days following the first surgery, showed results that determined more radical surgery and special treatment for the patient.
In his dignified message on June 30th, the noticeably recovered President speaks about the state of his health with absolute clarity.
I admit that it was no easy task for me to inform my friend about the new development. I could see the dignity with which he received the news that –while his mind was dealing with so many important tasks, among them the celebrations commemorating the Bicentennial and the formalization of the agreement on Latin American and Caribbean unity – much more than the physical suffering that radical surgery would imply, signified a test, as he put it, that he compared to the difficult moments he had to face in his lifetime as an unyielding combatant.
Along with him, the team of persons caring for him and who he described as sublime fought a magnificent battle which I have witnessed.
With no hesitation whatsoever, I state that the results are impressive and that the patient fought a decisive battle that shall lead him and Venezuela along with him, to a great victory.
One has to make sure that his declaration is communicated word for word in every language, but especially it should be translated and subtitled into English; this is a language that can be understood on this Tower of Babel into which imperialism has transformed the world.
Now the external and internal enemies of Hugo Chávez are at the mercy of his words and his initiatives. Without a doubt there shall be surprises in store for them. Let us wish him our most steadfast support and trust. The lies of the empire and the treason of the quislings shall be defeated. Today there are millions of militant and aware Venezuelans who shall never be made to submit to the oligarchy and the empire.
Fidel Castro Ruz
July 3, 2011
4:12 p.m.
Translation by AHORA