Science
How California families are already bracing for looming Medicaid cuts
Ever since Elijah Maldonado was born at just 29 weeks, he has needed specialty treatments that his family could afford only with publicly funded healthcare.
Diagnosed with cerebral palsy as an infant, he spent his first three months at a public hospital in Orange County, where the familiy lives.
Now 7, Elijah receives physical and speech therapy among a host of other services paid for through Medicaid. He relies on a wheelchair funded by the government. An assistant paid for with taxpayer dollars makes sure he’s safe on the bus ride to and from school.
Each month, he receives a $957 disability check that helps to cover his and his family’s living expenses.
Josephine Rios wipes her grandson Elijah’s face.
(Juliana Yamada / Los Angeles Times)
Still learning to speak on his own, he uses a Proloquo speech app on an iPad provided by his school to tell his family when he’s hungry, needs to use the restroom or wants to play with his favorite toys.
“It’s his voice — his lifeline,” his aunt and primary caretaker Cassandra Gonzalez says of the app. Her compensation for his in-home care comes from taxpayer dollars too.
Now that lifeline — and much of the government assistance Elijah receives — is at risk of going away.
With hundreds of billions of dollars worth of cuts to Medicaid and food aid kicking in this fall thanks to the passage of the Republican-backed “One Big Beautiful Bill Act” — on top of earlier cuts imposed by Elon Musk’s Department of Government Efficiency — a host of federally funded healthcare and nutrition programs that serve low-income Americans will be scaled back, revamped with expanded work requirements and other restrictions or canceled altogether if individual states can’t find alternate funding sources.
The budget reduces federal spending on Medicaid alone by about $1 trillion over the next 10 years nationwide, with initial reductions taking effect in the coming weeks.
Gov. Gavin Newsom responded by accusing the Trump administration of “ripping care from cancer patients, meals from children and money from working families — just to give tax breaks to the ultra-rich.”
L.A. public health officials called the cuts devastating for a county where nearly 40% of the population is enrolled in Medi-Cal, the state’s Medicaid program. L.A. County’s Department of Health Services, which oversees four public hospitals and about two dozen clinics, projects a budget reduction amounting to $750 million a year, and federal funding for the Department of Public Health, which inspects food, provides substance-use treatment and tracks disease outbreaks, will drop by an estimated $200 million a year. Spending cuts have prompted hiring freezes and projections of ballooning budget deficits, county health officials said.
Spending reductions, combined with recent changes to the Affordable Care Act and Medicare, could leave an additional 1.7 million people in California uninsured by 2034, according to an analysis by the nonprofit healthcare research organization KFF.
Cuts to the Supplemental Nutrition Assistance Program (SNAP), colloquially known as “food stamps,” will exceed $280 billion over the next decade, according to projections from the Congressional Budget Office.
It’s not just that the cuts to these programs are massive by historical standards.
The new rules and restrictions are confusing and states have been given little guidance from the federal agencies that oversee health and nutrition programs on how, or even when, to implement them, experts at the Center on Budget Policy and Priorities wrote in a recent report.
What’s clear, the CBPP said, is that millions of children, older adults, people with disabilities and veterans stand to lose not just Medicaid coverage but federal aid to access the type of healthy foods that could prevent illness and chronic conditions.
More than 5 million California households receive food aid through the state’s CalFresh program and 97% percent of them will see their benefits either slashed or eliminated because of federal spending cuts, changes to eligibility requirements or financial constraints at the state level, according to an analysis by the nonpartisan California Budget Policy Center.
Elijah plays with toy cars outside his aunt’s home in Tustin.
(Juliana Yamada / Los Angeles Times)
In Orange County, where Elijah’s family lives, public health officials were already reeling from federal spending cuts in the months before the budget bill passed, said Dr. Veronica Kelley, director of the OC Health Care Agency. For example, there was the $13.2-million cut to funding for family planning services in the county, and the $4-million reduction in funding to Women, Infants and Children nutrition (WIC).
The agency has worked to prevent mass layoffs by moving public-health workers in canceled programs to other departments or leaving some positions unfilled in order to save jobs elsewhere, and it has sought out nonprofit social service organizations and philanthropies to either take over programs or help fund them, Kelley said.
Now, Kelley is preparing for possible cuts to programs to combat obesity, maintain community gardens, help seniors make better healthcare decisions and reduce the use of tobacco. The agency also has to figure out how to make up for a $4.8-million reduction in federal funds for the county’s SNAP program that takes effect on Wednesday — another casualty of the federal spending bill.
The measures that the agency has leaned on to get through the year are not sustainable, Kelley said. “We can only do that for so long,” she said. “It’s chaotic. In terms of healthcare, it’s devastating… It feels like we’re taking so many steps backward.”
The looming cuts and changes have also set off alarm bells at Kaiser Permanente, California’s largest private healthcare provider with 9.5 million members statewide, 1.1 million of whom are enrolled in Medi-Cal.
“Without the ability to pay, newly uninsured people will find themselves having to delay care, leading to more serious and complex health conditions, increasing the use of emergency services and more intensive medical services,” Kaiser Permanente Southern California Regional spokeswoman Candice Lee said in a statement to The Times.
“This will affect all of us as the cost of this uncompensated care leads hospitals and care providers to charge paying customers more to cover their costs. Some hospitals and providers, especially those in rural and underserved areas, will be unable to make up for these unreimbursed costs, and will be financially threatened by these changes.”
Standing in front of her sister Cassandra’s town home in Tustin, a quiet suburban city of 80,000 about 10 miles south of Disneyland, Elijah’s mother, Samantha Rios; grandmother Josephine Rios; and Aunt Cassandra are filled with worry.
Elijah points to a command on his Proloquo speech app, which he uses to communicate his needs.
(Juliana Yamada / Los Angeles Times)
Josephine, a nursing assistant who works at a Kaiser hospital in Orange County, said she hears the panic in patients’ voices when they describe rushing to schedule needed medical procedures in anticipation of losing their Medicaid benefits.
Earlier this year, Josephine joined delegations of unionized California healthcare workers who traveled to Washington with the aim of pressing lawmakers to oppose spending cuts.
Rep. Young Kim, the Republican who represents the Rios family’s district in Congress, was receptive to the delegation’s pleas to vote no on the budget bill, Josephine recalls. The congresswoman ultimately voted for the bill, saying on her official webpage the legislation was good for Californians because it would relieve the tax burden on families, ensure that government dollars are used effectively and “strengthen Medicaid and SNAP for our most vulnerable citizens who truly need it.”
Elijah’s Aunt Cassandra and grandmother Josephine look over his shoulder as he watches a TV show.
(Juliana Yamada / Los Angeles Times)
Now, Josephine looked on as Elijah, seated in his wheelchair, played on his iPad and watched a Disney program on his phone. He can press a tab on the touchscreen to make the tablet say “My name’s Elijah” if he’s feeling unsafe away from home, another to tell his family he needs space when upset.
Watching Elijah enjoy himself, the women said they feel awkward broadcasting their woes to strangers when all they desire is what’s best for him. They don’t need the public’s pity.
The family wants lawmakers and the public to understand how seemingly abstract healthcare decisions involving billions of dollars, and made 2,000-plus miles away in Washington, have brought new financial turmoil to a family that’s already on the edge financially.
Samantha, a single mom, works full time to provide a home for Elijah and his two sisters, ages 10 and 8. A subscription to the Proloquo speech app alone would cost $300 a year out-of-pocket — more than she can afford on her shoestring budget.
Due to changes in household income requirements, Samantha had already lost Medicaid coverage for herself and her two girls, she said, as well as her SNAP food assistance, leaving her at a loss for how to fill the gap. She now pays about $760 a month to cover her daughters and herself through her employer-based health plan.
The cut to food aid has forced her to compensate by getting free vegetables, milk, eggs and chicken from the food pantry at a local school, a reality that she said she was at first too ashamed to disclose even to relatives.
Then came the bad news Samantha recently received about Elijah’s monthly Social Security Insurance for his disability. She was stunned to hear that because of stricter income cut-offs for that type of aid, Elijah would no longer receive those checks as of Oct. 1.
“Before, he was getting $957 a month — obviously that’s grocery money for me,” Samantha said. The money also went to buy baby wipes, as well as knee pads to help him move more comfortably on the floor when not using his wheelchair.
“I don’t get food stamps. I don’t get Medi-Cal for my girls. I don’t get any of that,” Samantha said. “As of Oct. 1, now I’ve got to figure out how am I going to pay my rent? How am I going to buy groceries?”
Luckily, the sisters said, the physical, speech and behavioral-health therapies that Elijah receives are safe — for now.
And the women know they can lean on each other in tough times. The sisters and Josephine all live within minutes of each other in Tustin, close enough for Samantha’s children to eat at someone’s home when their own cupboards are bare.
Every few months, Samantha said, Elijah experiences severe seizures that can last up to 90 minutes and require hospitalization.
Cassandra and Josephine like that they can run over to help if Elijah has a medical emergency. Another sister who lives farther away is on hand when needed too.
“What’s going to happen to other families who don’t have that support system?” Samantha said.
Given the potential for further cuts to programs that pay for home-based healthcare and assistants for people with disabilities, Cassandra wonders what will happen to her own family if she can no longer work as Elijah’s caregiver.
Where would the family get the money to pay a new caregiver who is qualified enough to work with a special-needs child who can speak a few words thanks to speech therapy but who cannot eat, walk or use the restroom without supervision? What if funding is eliminated for the assistant who travels with Elijah to school?
“People think that cutting Medi-Cal, cutting food stamps or whatever isn’t going to affect that many people,” Cassandra said. “It’s affecting my nephew and nieces. It’s affecting my sister. But it’s not just affecting her household. It’s affecting my household.”
“We’re not saying we’re going to Disneyland or going out to eat every day,” Cassandra said. “This is just living. We can’t even live at this point, with things being cut.”
The women offered up principles they feel are in short supply lately in the discourse over the government’s role in public health — among them “morals” and “empathy.” Samantha adds one more word to the list.
“Humanity,” she says. “We lack it.”
Science
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April 1, 2026
Science
MAHA says red meat and beef tallow will make you healthy. The American Heart Assn. isn’t buying it
In an earlier era, the American Heart Assn. and the U.S. federal government were very closely aligned on what the American public should eat and why.
Dietary guidelines from the cardiovascular research nonprofit largely mirrored those published by the U.S. Department of Health and Human Services. American Heart Assn. representatives advised the government on the science behind its dietary advice.
But as is the case with many public health issues these days, the distance between the policies recommended by established medical groups and those endorsed by Department of Health and Human Services Secretary Robert F. Kennedy Jr. appears to be growing wider.
On Tuesday, American Heart Assn. released its updated guidelines for a heart-healthy diet. Like the new federal dietary guidelines released back in January, the document cautions against processed foods and refined sugars.
But the group pressed back on some nutrition claims that Kennedy and Make America Healthy Again influencers have touted in public statements and written into federal policy.
Unlike the new federally authorized inverted food pyramid, which gives top billing to an enormous cut of steak, a tray of ground meat, a hunk of cheese and carton of whole milk, the American Heart Assn. urges plant-based proteins over red meat, and low- or nonfat dairy products over whole-fat options.
In contrast to Kennedy’s declaration in January that the U.S. was “ending the war on saturated fat,” the heart association continues to recommend unsaturated fat sources over saturated ones for the sake of cardiovascular health.
The heart association also pushes back on Kennedy’s well-publicized passion for beef tallow as a replacement for seed oils, which he has accused (despite shaky evidence) of “poisoning” Americans.
“Animal fats (eg, beef tallow and butter) and tropical oils (eg, coconut oil, cocoa butter, and palm oil) are relatively high in saturated fat, whereas nontropical plant oils (eg, soybean, canola, and olive oils) are relatively high in unsaturated fat,” the American Heart Assn. paper reads. “In summary, as part of heart-healthy dietary patterns, nontropical plant sources of fat should be used as part of food preparation in place of animal fats and tropical oils.”
In response to questions, both the American Heart Assn. and Department of Health and Human Services emphasized their shared objectives over any differences.
“The American Heart Association’s [paper] is aligned with the Dietary Guidelines on the major issues: eat real food, avoid highly processed food, and limit refined grains and added sugar,” said Andrew Nixon, a health department spokesman. “We look forward to working collaboratively with the [American Heart Assn.] to evangelize these core principles and reverse the diet-related chronic disease epidemic.”
The heart association and the federal government have different purposes when drafting their recommendations, said Dr. Simin Liu, director of UC Irvine’s Center for Global Cardiometabolic Health & Nutrition and a professor at the UC Irvine School of Medicine.
The heart association’s guidelines are intended to reflect the best available evidence on nutrition and cardiovascular health outcomes, whereas federal nutrition standards inform the content of federally funded meals served in schools, hospitals and military dining facilities, and help determine foods included under assistance plans like the Supplemental Nutrition Assistance Program.
The two sets of guidelines aren’t totally at odds. The heart association applauded the government’s warnings against added sugars, refined grains and processed foods in January, noting that the advice aligns with the organization’s long-standing recommendations.
“Those of us in the field have been pushing for food-based dietary recommendations, like advocating people eat actual foods instead of [processed] food products,” Liu said, but “the focus on animal product consumption is a bit off the mark.”
The administration’s hearty endorsement of animal protein sources surprised many health groups, as a diet rich in red meat is strongly associated with poorer cardiovascular health.
A supplemental report published alongside the federal guidelines noted that several members of the government’s advisory panel had financial ties to meat and dairy industry groups, including the National Cattlemen’s Beef Assn., the National Pork Board and the California Dairy Research Foundation.
The heart association’s guidelines better reflect the current scientific consensus on the relationship between food and cardiovascular health, said a spokesperson for the nonprofit Center for Science in the Public Interest, and “will be a valuable resource for anyone who was confused by the mixed messages” in the government’s earlier advice.
Science
How NASA plans to keep Artemis astronauts alive if disaster strikes
EDWARDS, Calif. — If NASA’s colossal new moon rocket, slated to launch with astronauts for the first time as soon as tomorrow, explodes on the pad or breaks up as it accelerates through the atmosphere, the space agency has a plan:
Fire a powerful motor affixed to the top of the crew capsule that is literally designed to outrun debris from an exploding rocket, flip the capsule around as it soars through the air, then deploy parachutes to bring the astronauts back to safety.
Reliably pulling off this high-energy yet delicate dance isn’t easy. Engineers and scientists across the country spent years developing and testing this Launch Abort System, including many at the Armstrong Flight Research Center, which has spent decades pushing the limits of human flight in Southern California’s Mojave Desert.
For the Artemis program, aiming to bring humans back to the moon for the first time in a half-century and prepare for eventually landing people on Mars, NASA tapped the center to help execute two critical tests of the abort system in the 2010s.
In the first, NASA engineers attached the system to a dummy test capsule packed with hundreds of sensors, placed it alongside the glimmering white sand dunes of New Mexico and fired it off to simulate an abort from the launch pad.
In the second, crews headed to the Florida space coast, where they placed the abort system and test capsule on a modified missile. To mimic the conditions of a rocket ascent, they launched the missile and, after it broke the sound barrier, triggered the abort system.
It’s these kinds of extreme flight conditions that the Armstrong Flight Research Center specializes in.
Brad Flick, who retired as director of the center on March 20, recalled a poster outside his office depicting the Apollo moon landings: “The poster says, ‘Before we did it there, we practiced it here.’ And that’s what we do.”
Southern California’s pioneers in human flight
Even before NASA was called NASA, its engineers, scientists and test pilots were pushing the limits of flight in the Mojave Desert.
Out in the middle of current-day Edwards Air Force Base — one of the largest airfields in the world, at some 480 square miles — a small team began the X-plane program, a series of experimental aircraft designed to travel faster, higher and (purposefully) more awkwardly than ever before.
In 1947, with its X-1 plane, the team became the first in the history of human flight to break the sound barrier.
By the early 1960s, the full-fledged flight research center had become a hub of cutting-edge aviation research, thrown into high gear by NASA’s “brightest and boldest”:
A young pilot by the name of Neil Armstrong was guiding the rocket-powered X-15 on a number of test flights. On one where Armstrong flew above Earth’s atmosphere, he struggled to trigger a safety system designed to limit the intense forces pilots experience and overshot his runway by about 45 miles, ending up over Pasadena.
This NASA Armstrong Flight Research Center hangar houses a Gulfstream III airplane that the center will use during the Artemis II mission to track the capsule as it reenters the atmosphere.
(Genaro Molina/Los Angeles Times)
The center was also designing and testing mock-ups of a lunar lander, which Armstrong — now the center’s namesake — later used to practice landing on the moon while still here on Earth.
Meanwhile, another plane dubbed the “flying bathtub” was also taking shape at the center. The odd-looking craft essentially aimed to test whether they could fly with no wings, instead generating lift from the body of the plane. To launch it, they attached the plane to a Pontiac convertible and ripped across the nearby lake bed at 120 mph.
The data they got from the experiment informed the design of the Space Shuttle. Instead of relying solely on large wings — which would have needed to be heavy and bulky to survive the extreme conditions of reentry — the shuttle generated a fair amount of lift with its body so it could get by with stubbier, lighter wings. The necessary but perhaps inelegant design earned the Space Shuttle its own nickname: the “flying brick.”
Flick didn’t indulge in telling any of the “cowboys-in-airplanes stories” he’d heard during his nearly 40 years at the center. However, he noted that it’s a special breed that can handle the extremes of the test pilot job — and that it requires some serious risk management across the whole team.
“The safest thing to ever do with an airplane is to never fly it,” Flick said. “That’s not the business we’re in. … The people in that airplane — be they pilots, or in the cabin — they rely on us to do our jobs well, to keep them safe and alive. That’s a responsibility we take very seriously.”
Armstrong Flight Research Center Director Brad Flick stands next to a Gulfstream III airplane on March 18, 2026.
(Genaro Molina / Los Angeles Times)
Testing astronauts’ last resort
The center’s experience not only pushing far past the frontiers of flight, but also turning its experimental aircraft into “flying labs” with dozens or hundreds of sensors, has made it key to the success of NASA’s space missions over the years.
For the first of the two Artemis abort tests, called Pad Abort-1, the Armstrong Flight Research Center team painted the test capsule; installed the sensors, flight computers, wires and parachutes; and then put the whole system through a series of tests and measurements to make sure it was ready for launch.
Throughout the complex aerial gymnastics of an abort, the distribution of weight matters immensely: A top-heavy capsule performs differently than a bottom-heavy capsule. Unaccounted weight on one side can also set the capsule off-kilter. So the Armstrong team employed a series of tests involving fancy scales and gently tipping the capsule.
Aborts are also intense. The motors that pull the capsule away from the doomed rocket are designed to accelerate from 0 to 500 mph — well over half the speed of sound — in just two seconds. In the process, the capsule shakes pretty aggressively. So the team subjected the capsule to vibrations in the lab to ensure everything would still work after that kind of extreme shaking. It’s better to break stuff on the ground than in the air.
The Armstrong team ultimately selected White Sands Missile Range in New Mexico for the pad-abort test. It also oversaw the construction of the launch pad and coordinated operations for the test, which NASA successfully completed in 2010.
Years later, NASA launched its Ascent Abort-2 test atop a modified missile in preparation for the Artemis launches. For that, the Armstrong team had a more focused role designing and testing the network of hundreds of sensors that would be the agency’s eyes and ears for the test. This included strapping the sensors to a vibration table and giving them a solid shake to make sure they could handle the G-forces.
Environmental test technician Cryss Punteney places her hands on the Unholtz Dickie vibration table where components for Ascent Abort-2 were tested inside at the NASA Armstrong Flight Research Center.
(Genaro Molina / Los Angeles Times)
“If the tree falls in the forest, and no one was around to hear, did it actually make a sound?” said Laurie Grindle, Armstrong deputy center director who served as the project manager for the first abort test. “If we didn’t have any instrumentation, we could have launched something great that showed up wonderful on video, but we wouldn’t know if it performed well.”
The second test went off without a hitch in 2019. The teams got invaluable data — and some wonderful video too.
In 2022, NASA’s uncrewed Artemis I test mission with the abort system successfully reach the moon — no abort needed. When the crewed Artemis II mission launches to the moon as soon as tomorrow, the abort system will, for the first time, be responsible for keeping astronauts alive.
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