Science
A proposed law could force California health insurers to explain claim denials
When Colleen Henderson’s 3-year-old daughter complained of pain while using the bathroom, doctors brushed it off as a urinary tract infection or constipation, common maladies in the potty-training years.
Henderson, however, suspected it could be something worse, and asked for an ultrasound. The doctor and ultrasound technician told her that her insurance provider, UnitedHealthcare, would not cover it, but Henderson decided to do it anyway, charging the $6,000 procedure to her credit card. Then came the news: There was a grapefruit-sized tumor in her toddler’s bladder.
That was in 2008. The next five years, Henderson said, became a protracted battle with UnitedHealthcare over paying for the specialists who finally diagnosed and treated her daughter’s rare condition, inflammatory pseudotumor. She appealed denial of coverage for hospital stays, surgeries and medication to the insurer and state regulators, to no avail. The Sacramento-area family racked up more than $1 million in medical debt, she said, because UnitedHealthcare had decided that treatments recommended by doctors were unnecessary. The family declared bankruptcy.
“If I had not fought tooth and nail every step of the way, my daughter would be dead,” said Henderson, whose daughter eventually recovered and is now a thriving 20-year-old junior at Oregon State University. “You pay a lot of money to have health insurance, and you hope that your health insurance has your well-being at the forefront, but that’s not happening at all.”
While insurance denials are on the rise, surveys show few Americans appeal them. Various analyses have found that many of those who escalate complaints to government regulators successfully get denials overturned (unlike the Hendersons). Consumer advocates and policymakers say that’s a clear sign insurance companies routinely deny care they shouldn’t. Now a proposal in the California legislature seeks to penalize insurers who repeatedly make the wrong call.
While the measure, Senate Bill 363, would cover only about a third of insured Californians whose health plans are regulated by the state, experts say it could be one of the boldest attempts in the nation to rein in health insurer denials — before and after care is given. And California could become one of only a handful of states that require insurers to disclose denial rates and reasoning, data the industry often considers proprietary information.
The measure also seeks to force insurers to be more judicious with denials, by fining them up to $1 million per case if more than half of appeals filed with regulators are overturned in a year.
In 2023, state data show, about 72% of appeals made to the Department of Managed Health Care, which regulates the vast majority of health plans, resulted in an insurer’s initial denial being reversed.
“When you have health insurance, you should have confidence that it’s going to cover your healthcare needs,” said Sen. Scott Wiener, the San Francisco Democrat who introduced the bill. “They can just delay, deny, obstruct, and, in many cases, avoid having to cover medically necessary care, and it’s unacceptable.”
A spokesperson for the California Assn. of Health Plans declined to comment, saying the group was still reviewing the bill‘s language. Gov. Gavin Newsom’s spokesperson Elana Ross said his office generally does not comment on pending legislation.
Concerned about spiraling consumer health costs, lawmakers in states across the nation have increasingly looked for ways to verify that insurers are paying claims fairly.
In 2024, 17 states enacted legislation dealing with prior authorization of care by private insurers, according to the National Conference of State Legislatures. For example, Connecticut, which has one of the most robust denial rate disclosure laws, publishes an annual report card detailing the number and percentage of claims each insurer has denied, as well as the share that ends up getting reversed. Oregon published similar information until recently, when state disclosure requirements lapsed.
In California, there’s no way to know how often insurers deny care, which health experts say is especially troubling as mental health needs are reaching crisis levels among children and young adults. According to Keith Humphreys, a health policy professor at Stanford University, it’s easier to deny mental health care because a diagnosis of, say, depression can be more subjective than that of a broken limb or cancer.
“We think it’s unacceptable that the state has absolutely no idea how big of a problem this is,” said Lishaun Francis, senior director of behavioral health for the advocacy group Children Now, a sponsor of the bill.
Under Wiener’s proposal, private insurers regulated by the state’s Department of Managed Health Care or Department of Insurance, or both, would be required to submit detailed data about denials and appeals. They would also need to explain those denials and report the outcomes of the appeals.
For appeals that make it to the state’s independent medical review process, or IMR, insurers whose denials are overturned more than half of the time would face staggering penalties. The first case that brings a company above the 50% threshold would trigger a fine of $50,000, with a penalty ranging from $100,000 to $400,000 for a second. Each one after that would cost the company $1 million.
If passed, the measure would apply to roughly 12.8 million Californians on private insurance. It would not apply to patients on Medi-Cal, the state’s Medicaid program, or Medicare, and it would exclude self-insured plans offered by large employers, which are regulated by the U.S. Department of Labor and cover roughly 5.6 million Californians.
The phrase “deny and delay” continues to reverberate across the healthcare industry after the killing of UnitedHealthcare Chief Executive Brian Thompson in December. In a survey by the research organization NORC at the University of Chicago, conducted shortly after the attack, 7 in 10 respondents said they believed denials for health coverage and profits by health insurance companies bore a great deal or a moderate amount of responsibility for Thompson’s death.
Following Thompson’s death, UnitedHealthcare said in statements that “highly inaccurate and grossly misleading information” had been circulated about the way the company treats claims, and that insurers, which are highly regulated, “typically have low- to mid-single digit margins.”
Wiener called Thompson’s killing a “cold-blooded assassination,” and said his measure had grown out of a narrower proposal that failed last year aimed at improving mental health coverage for children and adults under age 26. But he acknowledged that the public’s reaction to the killing underscored the long-simmering anger many Americans feel about health insurers’ practices and the urgent need for reform.
Humphreys, the Stanford professor, said the U.S. health system creates strong financial incentives for insurers to deny care. And, he added, state and federal penalties are paltry enough to be written off as a cost of doing business.
“The more care they deny, the more money they make,” he said.
Increasingly, large employers are starting to include language in contracts with claim administrators that would penalize insurance providers for approving too many or too few claims, said Shawn Gremminger, president of the National Alliance of Healthcare Purchaser Coalitions.
Gremminger represents mostly large employers that fund their own insurance, are federally regulated, and would be excluded from Wiener’s bill. But even for the so-called self-funded plans, it can be nearly impossible to determine denial rates for the insurance companies hired simply to administer claims, he said.
While the bill may be too late for many families, Sandra Maturino of Rialto said she hopes lawmakers tackle insurance denials so other Californians can avoid the saga she endured to get her niece treatment.
She adopted the girl, now 13, after her sister died. Her niece had long struggled with self-harm and violent behavior, but when therapists recommended inpatient psychiatric care, her insurer, Anthem Blue Cross, would cover it for only 30 days.
For more than a year, Maturino said, her niece cycled in and out of facilities and counseling because her insurance wouldn’t cover a long-term stay. Doctors tested a laundry list of prescription drugs and doses. None of them worked.
Anthem declined to comment for this story.
Unlike so many others in similar situations, Maturino was eventually able to get outside assistance to remedy the situation. She asked her adoption agency for help, and it ended up covering the cost of her niece’s stay in a residential program in Utah, where she was diagnosed with bipolar disorder and has been undergoing treatment for a year.
Maturino said she didn’t have the energy to appeal to Anthem.
“I wasn’t going to wait around for the insurance to kill her, or for her to hurt somebody,” Maturino said.
KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF — the independent source for health policy research, polling, and journalism.
Science
Pace of N.I.H. Funding Slows Further in Trump’s Second Year
Spending on new medical research by the National Institutes of Health has fallen roughly $1 billion behind the pace of years past, delaying thousands of scientific projects and raising concerns within the agency that it may struggle to pay out the money it was allotted by Congress.
Instead of canceling grants en masse, as the N.I.H. did in the first year of this Trump presidency, it is now vetting them before approval with a “computational text analysis tool” that scans for terms including “racism,” “gender” and “vaccination refusal,” according to documents obtained by The New York Times.
That tool was meant to formalize a campaign against “woke science” that was initiated last year by the Elon Musk-led Department of Government Efficiency.
But the screening system is now exacerbating a slowdown in research spending: The N.I.H. awarded only about 1,900 new and competitive grants from October to late March, less than half the number it tended to give out by that point in the fiscal year during the Biden administration, an analysis by The Times showed.
The heaviest damage to the grantmaking apparatus was done by the protracted government shutdown in the fall, which delayed grant review meetings by months. The N.I.H. has struggled to catch up, and delays are affecting fields far beyond those ostensibly targeted by the administration’s crusade against diversity, equity and inclusion.
As of late March, for example, the National Cancer Institute had earmarked only about $72 million for new and competitive research grants, less than one-third of the nearly $250 million it had agreed to spend by that point in a typical fiscal year during the Biden administration, according to The Times’s analysis.
“It means that people get fired because there is uncertainty about whether the grant will come through,” said Dr. Joshua Gordon, a professor of psychiatry at Columbia University and a former director of the National Institute of Mental Health. “It means budgets get busted. It means research projects get stalled.”
However alarming the canceled grants and spending delays were last year, Dr. Gordon said, “I’m more worried this year.”
The Department of Health and Human Services, which oversees the N.I.H. and is led by Secretary Robert F. Kennedy Jr., has become involved this year in flagging certain grant awards and stopping their release, according to emails reviewed by The Times.
Mr. Kennedy faced sharp criticism from Democratic and Republican lawmakers alike over N.I.H. spending delays in congressional hearings this week. He is set to appear at two more hearings on Wednesday.
The N.I.H. has fallen behind in part because it lost thousands of workers last year to layoffs and early retirements. In some branches of the agency, what workers remain can barely keep up with renewing existing grants, much less awarding new ones.
One N.I.H. institute has less than half of the workers needed to vet grants for legal and financial compliance, employees were told at a recent meeting, notes from which were reviewed by The Times.
Under the most dire projections, the institute could leave $500 million of congressionally appropriated funding on the table because of difficulties processing grants, N.I.H. officials said at that meeting. They were temporarily deploying career scientists to what were effectively business roles to speed up grant awards.
The N.I.H. director, Dr. Jay Bhattacharya, has said that he is trying to root out ideologically motivated and insufficiently rigorous science. Conservatives accuse the N.I.H. of having fostered such research during the Obama and Biden presidencies by, for example, encouraging grant proposals on sexual- and gender-minority groups.
“Scientists will no longer have to mouth D.E.I. shibboleths to garner funding,” Dr. Bhattacharya and his top deputy wrote in an online article in December, the day before the N.I.H. outlined the new screening process to its employees.
Andrew Nixon, a health department spokesman, blamed the spending shortfall on “the Democrat-led shutdown,” which he said “delayed N.I.H.’s ability to issue grants” at the start of the fiscal year. Since then, he said, “timelines have returned to typical funding patterns.”
He added that the agency “uses a variety of review tools to ensure alignment with agency priorities” and that it was working to hire additional employees. “The N.I.H. intends to obligate all appropriated funds, as directed by Congress,” he said.
To understand why spending has slowed so dramatically at the N.I.H., the world’s premier funder of medical research, The Times interviewed 10 agency employees and reviewed internal documents, including spreadsheets of grants flagged by the screening tool and the list of roughly 235 terms it searches for.
The employees spoke on the condition of anonymity because they were not authorized to comment publicly.
The documents painted a picture of an agency whose leaders were seeking to exert greater control over scientific spending by, among other things, deciding whether certain grants were compatible with agency priorities. But in clamping down on the funding process, the N.I.H. created new choke points, leaving some proposals in limbo for days or weeks.
That has frustrated some senior N.I.H. officials, one of whom lamented in an email seen by The Times that it was taking too long to rework grant proposals. The official asked his staff to simply strip the proposals of disfavored terms instead.
The delays have also angered lawmakers. Congress sets the country’s medical research spending levels, even as the administration has leeway to prioritize types of studies. And despite Mr. Trump’s proposing major cuts last year, Congress preserved the N.I.H. budget at roughly $47 billion for 2026.
“It is very frustrating to understand that this administration can circumvent dollars that were designated for our scientists,” said Senator Angela Alsobrooks, Democrat of Maryland.
Congress’s budget buoyed American scientists. By late 2025, many believed that they had weathered the worst of Trump-era funding problems. The N.I.H. spent aggressively toward the end of the last fiscal year, overcoming earlier blockages and delays.
The Supreme Court also let stand a lower court’s ruling that the policy behind the cancellation of more than $780 million in N.I.H. grants was probably unlawful, a victory for groups that had argued the terminations were arbitrary and capricious.
But the Trump administration was preparing a far more systematic crackdown on what it saw as unreliable research.
In August, Dr. Bhattacharya publicly outlined the agency’s new priorities, including opposition to “research based on ideologies that promote differential treatment of people based on race or ethnicity,” a template that could be used to guide grant reviews.
Then, in December, the N.I.H. introduced its employees to the “computational text analysis tool,” allowing the agency to comb through new grant proposals and existing projects for phrases suggesting a grant “may not align with N.I.H. priorities,” a guidance document would later tell employees.
Roger Severino, a vice president of the conservative Heritage Foundation and a health official in the first Trump administration, said that weeding out such grants was necessary to rid the N.I.H. of the “politicization” of the Obama and Biden eras.
If the result was less spending on science, he said, that was only because the agency had been wasting money.
“There was a tremendous amount of bloat that grew up like barnacles on the N.I.H. research ship,” Mr. Severino said. “Those barnacles are being scraped off.”
Within some divisions of the N.I.H., the text search tool is flagging as many as half of grants, officials said, requiring staff scientists to extensively document how they will be reworked or why they already conform to agency priorities.
Flagged grants address cancer, diabetes, autoimmune diseases, H.I.V., heart disease, stroke, Alzheimer’s disease, nutrition and prenatal care, internal documents show.
In part because many of them look at the use of screenings or treatments, they sometimes include mention of “inequities” in access to care or “minority” groups who disproportionately suffer from a disease, causing the system to deem the grants not “clean.”
In one case, a biological science grant was held up for a week because the proposal had used “sex” interchangeably with “gender,” a flagged word.
American scientists already spend some 40 percent of their time on grant-related administrative tasks. Now they are being deluged by ever more paperwork, said Dr. Michael Lauer, who led external grantmaking at the N.I.H. until last year.
And because the N.I.H. is awarding grants to far fewer researchers this year, the chances of success have rarely been lower.
“This is lost time for all of us,” Dr. Lauer said. “Instead of spending their time doing science and hopefully making discoveries that will make us all healthier, they’re rewriting grant applications.”
Sheryl Gay Stolberg contributed reporting.
Methodology
The Times analyzed N.I.H. grants data from N.I.H. RePORTER for the fiscal years 2021 through 2026. The analysis excludes awards for intramural research conducted at the N.I.H. Clinical Center. The analysis focuses on new awards (Type 1 awards) and competitive renewals (Types 2, 4 and 9).
The analysis uses data through March 2026, the most recent month comparable to prior years. Previous records suggest that the data available on RePORTER for that month, however, may still be missing up to 10 percent of awards. The analysis accounts for that possibility.
Science
Lyrids Meteor Shower: How to Watch, Peak Time and Weather Forecast
Our universe might be chock-full of cosmic wonder, but you can observe only a fraction of astronomical phenomena with the naked eye. Meteor showers, natural fireworks that streak brightly across the night sky, are one of them.
The latest observable meteor shower will be the Lyrids, which has been active since April 14 and is forecast to continue through April 30. The shower reaches its peak April 21 to 22, or Tuesday night into Wednesday morning.
According to NASA, the Lyrids are one of the oldest known meteor showers, and have been enjoyed by stargazers for nearly 3,000 years. Their bright, speedy streaks are caused by the dusty debris from a comet named Thatcher. They appear to spring from the constellation Lyra, which right now can be seen in the eastern sky at night in the Northern Hemisphere.
The moon will be about 27 percent full tonight, appearing as a thick crescent in the sky, according to the American Meteor Society.
To get a hint at when to best watch for the Lyrids, you can use this tool, which relies on data from the Global Meteor Network. It shows fireball activity levels in real time.
And while you gaze at the heavens, keep an eye out for other stray meteors streaking across the night sky. Skywatchers are reporting that the amount of fireballs is double what is usually seen by this point in the year.
Where meteor showers come from
There is a chance you might see a meteor on any given night, but you are most likely to catch one during a shower. Meteor showers are caused by Earth passing through the rubble trailing a comet or asteroid as it swings around the sun. This debris, which can be as small as a grain of sand, leaves behind a glowing stream of light as it burns up in Earth’s atmosphere.
Meteor showers occur around the same time every year and can last for days or weeks. But there is only a small window when each shower is at its peak, which happens when Earth reaches the densest part of the cosmic debris. The peak is the best time to look for a shower. From our point of view on Earth, the meteors will appear to come from the same point in the sky.
The Perseid meteor shower, for example, peaks in mid-August from the constellation Perseus. The Geminids, which occur every December, radiate from the constellation Gemini.
How to watch a meteor shower
Michelle Nichols, the director of public observing at the Adler Planetarium in Chicago, recommends forgoing the use of telescopes or binoculars while watching a meteor shower.
“You just need your eyes and, ideally, a dark sky,” she said.
That’s because meteors can shoot across large swaths of the sky, so observing equipment can limit your field of view.
Some showers are strong enough to produce up to 100 streaks an hour, according to the American Meteor Society, though you probably won’t see that many.
“Almost everybody is under a light-polluted sky,” Ms. Nichols said. “You may think you’re under a dark sky, but in reality, even in a small town, you can have bright lights nearby.”
Planetariums, local astronomy clubs or even maps like this one can help you figure out where to go to escape excessive light. The best conditions for catching a meteor shower are a clear sky with no moon or cloud cover, sometime between midnight and sunrise. (Moonlight affects visibility in the same way as light pollution, washing out fainter sources of light in the sky.) Make sure to give your eyes at least 30 minutes to adjust to seeing in the dark.
Ms. Nichols also recommends wearing layers, even during the summer. “You’re going to be sitting there for quite a while, watching,” she said. “It’s going to get chilly, even in August.”
Bring a cup of cocoa or tea for even more warmth. Then lie back, scan the sky and enjoy the show.
Where weather is least likely to affect your view
Storm systems sweep across the country in early spring, and some will be obscuring skies tonight. But there will still be plenty of areas with clear skies, particularly in parts of the central United States.
“The best spot is going to be in the Upper Midwest,” said Rich Bann, a meteorologist with the Weather Prediction Center.
Minnesota, Wisconsin and Iowa will offer especially good sky-viewing weather and a beach on the Great Lakes could be a nice spot to look up at the stars.
But don’t expect to view the show from Chicago, as Illinois could see some thunderstorms. The weather will be better in the Northern and Central Plains, particularly the eastern Dakotas.
High, wispy clouds are expected over the Ohio and Tennessee Valleys and into parts of the Mid-Atlantic. But, Mr. Bann said, “you may be able to see some shooting stars through thin clouds.”
Clouds will be draped across much of the Southeast and the Northeast, though there could be some clearing in Florida, Georgia, the Carolinas and Virginia. Remember, the meteors could be visible all night long. If you look outside and see clouds, try again later.
Catching the spectacle will be challenging across much of the West, particularly from Washington into Northern California, where a storm system is bringing rain and snow. That system will move east overnight.
There are likely to be some pockets of clear skies at times across southern Nevada, northwest Arizona and southwest Utah, Mr. Bann said.
Amy Graff contributed reporting.
Science
FBI probes cases of missing or dead scientists, including four from the L.A. area
WASHINGTON — Amid growing national security concerns, the FBI said Tuesday that it has launched a broad investigation in the deaths or disappearances of at least 10 scientists and staff connected to highly sensitive research, including four from the Los Angeles area.
“The FBI is spearheading the effort to look for connections into the missing and deceased scientists. We are working with the Department of Energy, Department of War, and with our state and state and local law enforcement partners to find answers,” the agency said in a statement.
The FBI’s announcement comes after the House Oversight Committee announced that it would investigate reports of the disappearance and deaths of the scientists, sending letters seeking information from the agencies involved in the federal inquiry as well as NASA, which owns the Jet Propulsion Laboratory in La Cañada Flintridge, where three of the missing or dead scientists worked.
“If the reports are accurate, these deaths and disappearances may represent a grave threat to U.S. national security and to U.S. personnel with access to scientific secrets,” Reps. James Comer (R-Ky.), chairman of the committee, and Eric Burlison (R-Mo.) wrote in the letters.
President Trump told reporters last week that he had been briefed on the missing and dead scientists, which he described as “pretty serious stuff.” He said at the time that he expected answers on whether the deaths were connected “in the next week and a half.”
Michael David Hicks, who studied comets and asteroids at JPL, was the first of the scientists who disappeared or died. He died on July 30, 2023, at the age of 59. No cause of death was disclosed.
A year later, JPL physicist Frank Maiwald died at 61, with no cause of death disclosed.
Two other Los Angeles scientists are part of the string of deaths and disappearances.
On June 22, 2025, Monica Jacinto Reza, a materials scientist at JPL, disappeared while on a hike near Mt. Waterman in the San Gabriel Mountains.
On Feb. 16, Caltech astrophysicist Carl Grillmair was fatally shot on the porch of his Llano home. The Los Angeles County Sheriff’s department arrested Freddy Snyder, 29, in connection with the shooting. Snyder had been arrested in December on suspicion of trespassing on Grillmair’s property.
Snyder has been charged with murder.
There is no evidence at this point that the deaths and disappearances, which occurred over a span of four years, are connected.
A spokesperson for NASA, which owns JPL, said in a statement on X that the agency is “coordinating and cooperating with the relevant agencies in relation to the missing scientists.
“At this time, nothing related to NASA indicates a national security threat,” agency spokesperson Bethany Stevens wrote. “The agency is committed to transparency and will provide more information as able.”
Representatives from Caltech, which manages JPL, did not immediately respond to a request for comment.
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