I am living with ALS, or amyotrophic lateral sclerosis, often called Lou Gehrig’s disease. The average survival time after diagnosis is two to five years. I’m in year two.

When you have a disease like ALS, you learn how slowly medical research moves, and how often it fails the people it is supposed to save. You also learn how precious time is.

For decades, the dominant pathway for developing new drugs has relied on animal testing. Most of us grew up believing this was unavoidable: that laboratories full of caged animals were simply the price of medical progress. But experts have known for a long time that data tell a very different story.

The Los Angeles Times reported in 2017: “Roughly 90% of drugs that succeed in animal tests ultimately fail in people, after hundreds of millions of dollars have already been spent.”

The Times editorial board summed it up in 2018: “Animal experiments are expensive, slow and frequently misleading — a major reason why so many drugs that appear promising in animals fail in human trials.”

Then there’s the ethical cost — confining, sickening and killing millions of animals each year for a system that fails 9 times out of 10. As Jane Goodall put it, “We have the choice to use alternatives to animal testing that are not cruel, not unethical, and often more effective.”

Despite overwhelming evidence and well-reasoned arguments against animal-based pipelines, they remain central to U.S. medical research. Funding agencies, academic medical centers, government labs, pharmaceutical companies and even professional societies have been painfully slow to move toward human- and technology-based approaches.

Yet medical journals are filled with successes involving organoids (mini-organs grown in a lab), induced pluripotent stem cells, organ-on-a-chip systems (tiny devices with human cells inside), AI-driven modeling and 3D-bioprinted human tissues. These tools are already transforming how we understand disease.

In ALS research, induced pluripotent stem cells have allowed scientists to grow motor neurons in a dish, using cells derived from actual patients. Researchers have learned how ALS-linked mutations damage those neurons, identified drug candidates that never appeared in animal models and even created personalized “test beds” for individual patients’ cells.

Human-centric pipelines can be dramatically faster. Some are reported to be up to 10 times quicker than animal-based approaches. AI-driven human biology simulations and digital “twins” can test thousands of drug candidates in silico, with a simulation. Some models achieve results hundreds, even thousands, of times faster than conventional animal testing.

For the 30 million Americans living with chronic or fatal diseases, these advances are tantalizing glimpses of a future in which we might not have to suffer and die while waiting for systems that don’t work.

So why aren’t these tools delivering drugs and therapies at scale right now?

The answer is institutional resistance, a force so powerful it can feel almost god-like. As Pulitzer Prize–winning columnist Kathleen Parker wrote in 2021, drug companies and the scientific community “likely will fight … just as they have in past years, if only because they don’t want to change how they do business.”

She reminds us that we’ve seen this before. During the AIDS crisis, activists pushed regulators to move promising drugs rapidly into human testing. Those efforts helped transform AIDS from a death sentence into a chronic condition. We also saw human-centered pipelines deliver COVID vaccines in a matter of months.

Which brings me, surprisingly, to Robert F. Kennedy Jr. In December, Kennedy told Fox News that leaders across the Department of Health and Human Services are “deeply committed to ending animal experimentation.” A department spokesperson later confirmed to CBS News that the agency is “prioritizing human-based research.”

Kennedy is right.

His directive to wind down animal testing is not anti-science. It is pro-patient, pro-ethics and pro-progress. For people like me, living on borrowed time, it is not just good policy, it is hope — and a potential lifeline.

The pressure to end animal testing and let humans step up isn’t new. But it’s getting new traction. The actor Eric Dane, profiled about his personal fight with ALS, speaks for many of us when he expresses his wish to contribute as a test subject: “Not to be overly morbid, but you know, if I’m going out, I’m gonna go out helping somebody.”

If I’m going out, I’d like to go out helping somebody, too.

Kevin J. Morrison is a San Francisco-based writer and ALS activist.

The patchwork efforts to identify and safely remove contamination left by the 2025 Eaton and Palisades fires has been akin to the Wild West.

Experts have given conflicting guidance on best practices. Shortly after the fires, the federal government suddenly refused to adhere to California’s decades-old post-fire soil-testing policy; California later considered following suit.

Meanwhile, insurance companies have resisted remediation practices widely recommended by scientists for still-standing homes.

A new bill introduced this week by state Assemblymember John Harabedian (D-Pasadena) aims to change that by creating statewide science-based standards for the testing and removal of contamination deposited by wildfires — specifically within still-standing homes, workplaces and schools, and in the soil around those structures.

“In a state where we’ve had a number of different wildfires that have happened in urban and suburban areas, I was shocked that we didn’t have a black-and-white standard and protocol that would lay out a uniform post-fire safety standard for when a home is habitable again,” Harabedian said.

The bill, AB 1642, would task the state’s Department of Toxic Substances Control with creating standards by July 1, 2027. The standards would only serve as guidance — not requirements — but even that would be helpful, advocates say.

“Guidance, advisories — those are extremely helpful for families that are trying to return home safely,” said Nicole Maccalla, who leads data science efforts with Eaton Fire Residents United, a grassroots organization addressing contamination in still-standing homes. “Right now, there’s nothing … which means that insurance companies are the decision-makers. And they don’t necessarily prioritize human health. They’re running a business.”

Maccalla supports tasking DTSC with determining what levels of contamination pose an unacceptable health risk, though she does want the state to convene independent experts including physicians, exposure scientists and remediation professionals to address the best testing procedures and cleanup techniques.

Harabedian said the details are still being worked out.

“What’s clear from my standpoint, is, let’s let the public health experts and the science and the scientists actually dictate what the proper standards and protocol is,” Harabedian said. “Not bureaucrats and definitely not insurance companies.”

For many residents with still-standing homes that were blanketed in toxic soot and ash, clear guidance on how to restore their homes to safe conditions would be a much welcome relief.

Insurance companies, environmental health academics, and professionals focused on addressing indoor environmental hazards have all disagreed on the necessary steps to restore homes, creating confusion for survivors.

Insurance companies and survivors have routinely fought over who is responsible for the costs of contamination testing. Residents have also said their insurers have pushed back on paying for the replacement of assets like mattresses that can absorb contamination, and any restoration work beyond a deep clean, such as replacing contaminated wall insulation.

Scientists and remediation professionals have clashed over which contaminants homeowners ought to test for after a fire. Just last week, researchers hotly debated the thoroughness of the contamination testing at Palisades Charter High School’s campus. The school district decided it was safe for students to return; in-person classes began Tuesday.

Harabedian hopes the new guidelines could solidify the state’s long-standing policy to conduct comprehensive, post-fire soil testing.

Not long after the federal government refused to adhere to the state’s soil testing policy, Nancy Ward, the former director of the California Governor’s Office of Emergency Services, had privately contemplated ending state funding for post-fire soil testing as well, according to an internal memo obtained by The Times.

“That debate, internally, should have never happened,” Harabedian said. “Obviously, if we have statewide standards that say, ‘This is what you do in this situation,’ then there is no debate.”

Thousands of middle-class Californians who depend on the state-run health insurance marketplace face premiums that are thousands of dollars higher than last year because enhanced federal subsidies that began during the COVID-19 pandemic have expired.

Despite fears that more people would go without coverage with the end of the extra benefits, the number enrolling in Covered California has held steady so far, according to state data.

But that may change.

Jessica Altman, executive director of Covered California, said that she believes the number of people dropping their coverage could increase as they receive bills with their new higher premiums in the mail this month. She said better data on enrollment will be available in the spring.

Altman said that even though the extra benefits ended Dec. 31, 92% of enrollees continue to receive government subsidies to help pay for their health insurance. Nearly half qualify for health insurance that costs $10 or less per month. And 17% of Californians renewing their Covered California policies will pay nothing for premiums if they keep their current plan.

The deadline to sign up for 2026 benefits is Saturday.

Here’s help in sorting out what the expiration of the enhanced subsidies for insurance provided under the Affordable Care Act, often called Obamacare, means in the Golden State.

What expired?

In 2021, Congress voted to temporarily to boost the amount of subsidies Americans could receive for an ACA plan. The law also expanded the program to families who had more money. Before the vote, only Americans with incomes below 400% of the federal poverty level — currently $62,600 a year for a single person or $128,600 for a family of four — were eligible for ACA subsidies. The 2021 vote eliminated the income cap and limited the cost of premiums for those higher-earning families to no more than 8.5% of their income.

How could costs change this year for those enrolled in Covered California?

Anyone with income above 400% of the federal poverty level no longer receives subsidies. And many below that level won’t receive as much assistance as they had been receiving since 2021. At the same time, fast-rising health costs boosted the average Covered California premium this year by more than 10.3%, deepening the burden on families.

How much would the net monthly premium for a Los Angeles couple with two children and a household income of $90,000 rise?

The family’s net premium for the benchmark Silver plan would jump to $699 a month this year from $414 a month last year, according to Covered California. That’s an increase of 69%, costing the family an additional $3,420 this year.

Who else could face substantially higher health bills?

People who retired before the Medicare-qualifying age of 65, believing that the enhanced subsidies were permanent, will be especially hit hard. Those with incomes above 400% of the federal poverty level could now be facing thousands of dollars in additional health insurance costs.

How did enrollment in Covered California change after the enhanced subsidies expired on Dec. 31?

As of Jan. 17, 1,906,033 Californians had enrolled for 2026 insurance. That’s less than 1% lower than the 1,921,840 who had enrolled by this time last year.

Who depends on Covered California?

Enrollees are mostly those who don’t have access to an employer’s health insurance plan and don’t qualify for Medi-Cal, the government-paid insurance for lower-income people and those who are disabled.

An analysis by KFF, a nonprofit that provides health policy information, found that nearly half the adults enrolled in an ACA plan are small-business owners or their employees, or are self-employed. Occupations using the health insurance exchanges where they can buy an ACA plan include realtors, farmers, chiropractors and musicians, the analysis found.

What is the underlying problem?

Healthcare spending has been increasing faster than overall inflation for years. The nation now spends more than $15,000 per person on healthcare each year. Medical spending today represents about 18% of the U.S. economy, which means that almost one out of every five dollars spent in the U.S. goes toward healthcare. In 1960, health spending was just 5% of the economy.

What has California done to help people who are paying more?

The state government allocated $190 million this year to provide subsidies for those earning up to 165% of the federal poverty level. This money will help keep monthly premiums consistent with 2025 levels for those with an annual income of up to $23,475 for an individual or $48,225 for a family of four, according to Covered California.

Where can I sign up?

People can find out whether they qualify for financial help and see their coverage options at the website CoveredCA.com.

What if I decide to go without health insurance?

People without insurance could face medical bills of tens of thousands of dollars if they become sick or get injured. And under California state law, those without coverage face an annual penalty of at least $900 for each adult and $450 for each child.