Science
The FDA knew long ago that red dye No. 3 causes cancer. Why did it take so long to ban it?
The Food and Drug Administration said Wednesday that the much-maligned red dye No. 3 will be banned in the United States because it has been shown to cause cancer in animals.
The decision, lauded by consumer advocacy groups, comes a full 25 years after scientists at the agency determined that rats fed large amounts of the artificial color additive were much more likely to develop malignant thyroid tumors than rats who weren’t given the food coloring. They also had an increased incidence of benign tumors and growths that can be precursors to cancer.
Those findings prompted the FDA to declare in 1990 that red dye No. 3 could not be used in cosmetics or drugs applied to the skin. The reason for the decision was clear: A federal law known as the Delaney clause says no color additive can be considered safe if it has been shown to cause cancer in animals or people.
Yet the dye remained a legal food coloring. It’s in the bright red cherries that dress up a bowl of Del Monte’s fruit cocktail. It makes Nesquik’s strawberry milk a pleasing shade of pink. It also colors beef jerky, fruit rolls, candy, ice cream and scores of other processed products.
Now food makers will have two years to reformulate their products without red dye No. 3. Drug companies have three years to remove it from their medicines.
The FDA does not seem to be bothered by the fact that this cancer-causing chemical will linger in the food supply. The agency’s view is that the biological process through which the dye causes cancer in rats doesn’t occur in people.
“We don’t believe there is a risk to humans,” Jim Jones, the FDA’s deputy commissioner for human foods, told members of Congress last month.
In announcing the ban, the agency added that people consume red dye No. 3 at levels far lower than those shown to cause cancer in two studies of rats. A host of other studies in both animals and humans did not show the dye to be cancerous.
Nonetheless, regulators revoked authorization of red dye No. 3 to satisfy a petition demanding that the Delaney clause be enforced.
Starburst-flavored Fruit by the Foot, which contains red dye No. 3. (Christina House / Los Angeles Times)
“Regardless of the truth behind their argument, it doesn’t matter,” said Jensen N. Jose, regulatory counsel for food chemical safety at the Center for Science in the Public Interest, which spearheaded the effort. “Once it’s established that it causes cancer, FDA must prohibit the chemical by law.”
This wasn’t the first case of the FDA banning a food additive it considers safe to comply with the Delaney clause. The situation shows why the federal law is long overdue for a refresh, food safety experts say.
“A lot of people think we need to reform this,” said Diana Winters, deputy director of the Resnick Center for Food Law and Policy at UCLA Law. “It does lead to some absurd results.”
The Delaney clause is part of a 1958 federal law that expanded the FDA’s regulatory authority over newfangled food additives developed during World War II that were making their way into consumer products, Winters said.
Back then, members of Congress were worried about the cancer risks posed by all sorts of man-made compounds. Even small amounts seemed capable of triggering cancerous growths if people encountered them over and over again.
Arthur Flemming, who served as President Eisenhower’s Cabinet secretary for health and welfare, told Congress at the time there was no way for FDA regulators to know whether any exposure level was low enough to be truly safe. Considering the many cancer risks lurking in the environment, he said, the government should “do everything possible to put persons in a position where they will not unnecessarily be adding residues of carcinogens to their diet.”
Signature Select rainbow cups, which contain red dye No. 3.
(Christina House / Los Angeles Times)
The issue was personal for Rep. James Delaney, a Democrat from New York City whose wife was undergoing cancer treatment at the time. He made sure the new law included a zero-tolerance provision for cancer-causing substances, though it said nothing about additives that might cause other kinds of health problems.
“No additive shall be deemed to be safe if it is found to induce cancer when ingested by man or animal, or if it is found, after tests which are appropriate for the evaluation of the safety of food additives, to induce cancer in man or animal,” the Delaney clause states. A 1960 amendment governing color additives extended the rule to dyes.
As the years went by, advances in toxicology allowed scientists to expand the list of known cancerous compounds, and to identify them in ever-smaller amounts. Regulators were no longer as clueless as they’d been in Flemming’s day.
In 1986, the FDA tried to take that progress into account as it evaluated the safety of two color additives — orange dye No. 17 and red dye No. 19 — for use in lipsticks, nail polishes, face powders and other cosmetics. The agency acknowledged that both dyes were capable of inducing cancer in laboratory animals. But it argued that the regulatory decision should be guided not by a literal interpretation of an aging law but by the real-world risks to people.
When those color additives were used as intended, those risks were vanishingly small: A panel of scientists from the U.S. Public Health Service determined the lifetime cancer risk posed by the red dye was 1 in 9 million at worst; for the orange dye, it was 1 in 19 billion. In both cases, the possibility of developing cancer was “so trivial as to be effectively no risk,” the panel concluded.
A federal appeals court agreed that the dyes seemed to be safe. In fact, the risks they posed were millions of times lower than the risks of smoking, the judges wrote.
Moreover, the judges noted, forbidding the use of chemicals that carry a minute risk of cancer might prompt manufacturers to use compounds that are more toxic, albeit in noncancerous ways. Substitutions like these would be “a clear loss for safety,” they wrote.
But none of that matters, the court ruled: If a dye or any other chemical is found to cause cancer in animals, the FDA’s only option under the Delaney clause was to forbid its use.
Nestle Nesquik strawberry milk, containing red dye No. 3. (Christina House / Los Angeles Times)
Regulators found themselves in a more absurd situation in 2018 when they were asked to revoke their authorization of a flavoring additive called myrcene.
When the synthetic compound was force-fed to rats at doses of 1 gram per kilogram of body weight for two years, the animals developed kidney cancer and other forms of renal disease. Female mice fed under the same conditions developed liver cancer as well, the FDA said.
But the amount of artificial myrcene consumed by a typical American is 813,000 times lower — around 1.23 micrograms per kilogram of body weight, the agency said.
Moreover, myrcene is a natural component of mangoes, citrus juices, cardamom, and herbs including basil, parsley and wild thyme. The amount of natural myrcene in the food supply is about 16,5000 times greater than its synthetic counterpart, the agency added.
Still, the FDA declared the additive unsafe “as a matter of law” while assuring the public that no one’s health was actually at risk when synthetic myrcene was on the market. It blamed the Delaney clause for the confusion.
In 2020, a group of food industry scientists said the problem goes well beyond confusion. Revoking approval for artificial myrcene “has contributed to the ongoing erosion of trust in regulatory agencies,” they argued in the journal Regulatory Toxicology and Pharmacology. Such decisions promote an irrational fear of chemicals and cause consumers to lose faith in the safety of the U.S. food supply, they wrote.
Red dye No. 3 was approved for use in U.S. food in 1907, when it was known as erythrosine. It won permanent listing as an authorized color additive for foods, supplements and ingested drugs under the name FD&C Red No. 3 in 1969.
Soon after that decision, an industry group called the Toilet Goods Assn. petitioned the FDA to upgrade the dye’s listing for cosmetics and topical drugs from provisional to permanent. The request triggered additional tests in the 1970s and ‘80s, including two long-term feeding studies in rats.
Beginning before birth and for their entire lives, the animals were put on diets that included the red dye at concentrations of 0.1%, 0.5%, 1% or 4%. Compared to male rats that didn’t consume any dye, male rats that ate the most had a significantly higher incidence of tumors — both malignant and benign — as well as abnormal cell growth in the thyroid. No other group had an increased incidence large enough to be considered statistically significant. Among female rats, the incidence of benign tumors was elevated for those on the 1% diet, though not for rats on the 4% diet, as would be expected if the dye were the cause of cancer in these animals.
After consulting with scientists from the National Toxicology Program and the U.S. Public Health Service, the FDA concluded that red dye No. 3 could cause cancer in animals. In 1990, the agency denied the industry group’s request for permanent listing.
That decision applied only to cosmetics and topical drugs, and had no immediate bearing on food products sold in the U.S. At that point, the dye had been permanently listed as an approved food additive for decades. Nothing in those rat studies indicated to the agency that its designation needed to change.
Over the years, the dye has been tested in mice, rats, gerbils, pigs, beagles and humans. An extensive review conducted by the World Health Organization and the Food and Agriculture Organization of the United Nations found “no concerns” about the dye’s ability to trigger cancer, impair fertility or cause developmental problems in people of all ages when consumed in realistic doses.
“Claims that the use of FD&C Red No. 3 in food and in ingested drugs puts people at risk are not supported by the available scientific information,” the agency said Wednesday.
Frosted sugar cookies from Favorite Day Bakery, containing red dye No. 3.
(Christina House / Los Angeles Times)
Pitting the Delaney clause’s strict legal requirements against advances in cancer research has been a longstanding challenge for the agency, officials said.
“When we ban something, it will go to court,” Dr. Robert Califf, the FDA’s commissioner, told the Senate Health, Education, Labor and Pensions committee last month. “And if we don’t have the scientific evidence that will stand up in court, we will lose in court.”
The elaborate regulatory process for removing an additive from the food supply can certainly result in litigation, said Emily Broad Leib, director of the Center for Health Law and Policy Innovation at Harvard Law School.
“The Delaney clause probably works a lot better at the outset if you’re trying to add a new substance to food,” she said. “Once things are in food, it takes a really long time to remove it.”
The way some people see it, the problem with the Delaney clause isn’t that it forces the FDA to ban food additives that don’t pose a true cancer threat. It’s that the law doesn’t address all the other ways the foods we eat can be hazardous to our health.
“There’s a lot of things in foods naturally that cause cancer, and the Delaney clause doesn’t cover that,” said Alyson Mitchell, a food scientist at UC Davis. “It also does not speak to anything regarding other illnesses, whether it’s kidney dysfunction or ADHD or mental health issues or endocrine imbalances.”
The General Accounting Office (now known as the U.S. Government Accountability Office) raised this issue back in 1981, when it advised Congress to update the Delaney clause to reflect the latest scientific and medical knowledge. It would make sense for the law to apply “ equally to cancer-causing and non-cancer-causing substances,” the GAO said.
Other items that contain red dye No. 3: Del Monte fruit cocktail, Signature Select Jordan almonds, Betty Crocker Suddenly! pasta salad, and Jack Links beef stick and cheese. (Christina House / Los Angeles Times)
California has banned all uses of red dye No. 3 in the Golden State, and prohibited the use of six other dyes in foods served or sold in schools. Scientists who examined the dyes for the California Office of Environmental Health Hazard Assessment determined that “the behavioral factors are more of a concern” than the cancer risk, said Asa Bradman, an expert on exposure assessment and epidemiology at UC Merced and co-author of the comprehensive state report.
The FDA has studied the behavioral risks of color additives and hasn’t found “a clear and causal link,” an FDA spokesperson told The Times. Studies suggest some children with behavioral challenges like ADHD appear to be sensitive to food dyes, and that genetic variants affecting the body’s ability to break down histamine are a likely cause. In the FDA’s view, that doesn’t mean the dyes themselves are “neurotoxic,” the spokesperson said.
If there was convincing evidence that an artificial dye failed to meet FDA’s safety standards, the agency would take action whether the health threats were covered by the Delaney clause or not, the spokesperson added.
Mitchell, who worked on the California report with Bradman, said that because manufacturers have been phasing out red dye No. 3 for more than a decade, it’s not a significant concern for her. She’s more worried about the hyperactivity risk posed by red dye No. 40 because it’s ubiquitous in processed foods, especially those consumed by children.
“I’m grateful for the Delaney clause because I do think it’s been very helpful in trying to protect our food,” Mitchell said. “But it doesn’t go far enough. So much of this needs to be revisited.”
A respiratory virus that doesn’t have a vaccine or a specific treatment regimen is spreading in some parts of California — but there’s no need to sound the alarm just yet, public health officials say.
A majority of Northern California communities have seen high concentrations of human metapneumovirus, or HMPV, detected in their wastewater, according to data from the WastewaterScan Dashboard, a public database that monitors sewage to track the presence of infectious diseases.
A Los Angeles Times data analysis found the communities of Merced in the San Joaquin Valley, and Novato and Sunnyvale in the San Francisco Bay Area have seen increases in HMPV levels in their wastewater between mid-December and the end of February.
HMPV has also been detected in L.A. County, though at levels considered low to moderate at this point, data show.
While HMPV may not necessarily ring a bell, it isn’t a new virus. Its typical pattern of seasonal spread was upended by the COVID-19 pandemic, and its resurgence could signal a return to a more typical pre-coronavirus respiratory disease landscape.
Here’s what you need to know.
What is HMPV?
HMPV was first detected in 2001, according to the U.S. Centers for Disease Control and Prevention. It’s transmitted by close contact with someone who is infected or by touching a contaminated surface, said Dr. Neha Nanda, chief of infectious diseases and hospital epidemiologist for Keck Medicine of USC.
Like other respiratory illnesses, such as influenza, HMPV spreads and is more durable in colder temperatures, infectious-disease experts say.
Human metapneumovirus cases commonly start showing up in January before peaking in March or April and then tailing off in June, said Dr. Jessica August, chief of infectious diseases at Kaiser Permanente Santa Rosa.
However, as was the case with many respiratory viruses, COVID disrupted that seasonal trend.
Why are we talking about HMPV now?
Before the pandemic hit in 2020, Americans were regularly exposed to seasonal viruses like HMPV and developed a degree of natural immunity, August said.
That protection waned during the pandemic, as people stayed home or kept their distance from others. So when people resumed normal activities, they were more vulnerable to the virus. Unlike other viruses, there isn’t a vaccine for human metapneumovirus.
“That’s why after the pandemic we saw record-breaking childhood viral illnesses because we lacked the usual immunity that we had, just from lack of exposure,” August said. “All of that also led to longer viral seasons, more severe illness. But all of these things have settled down in many respects.”
In 2024, the national test positivity for HMPV peaked at 11.7% at the end of March, according to the National Respiratory and Enteric Virus Surveillance System. The following year’s peak was 7.15% in late April.
So far this year, the highest test positivity rate documented was 6.1%, reported on Feb. 21 — the most recent date for which complete data are available.
While the seasonal spread of viruses like HMPV is nothing new, people became more aware of infectious diseases and how to prevent them during the pandemic, and they’ve remained part of the public consciousness in the years since, August and Nanda said.
What are the symptoms of HMPV?
Most people won’t go to the doctor if they have HMPV because it typically causes mild, cold-like symptoms that include cough, fever, nasal congestion and sore throat.
HMPV infection can progress to:
- An asthma attack and reactive airway disease (wheezing and difficulty breathing)
- Middle ear infections behind the ear drum
- Croup, also known as “barking” cough — an infection of the vocal cords, windpipe and sometimes the larger airways in the lungs
- Bronchitis
- Fever
Anyone can contract human metapneumovirus, but those who are immunocompromised or have other underlying medical conditions are at particular risk of developing severe disease — including pneumonia. Young children and older adults are also considered higher-risk groups, Nanda said.
What is the treatment for HMPV?
There is no specified treatment protocol or antiviral medication for HMPV. However, it’s common for an infection to clear up on its own and treatment is mostly geared toward soothing symptoms, according to the American Lung Assn.
A doctor will likely send you home and tell you to rest and drink plenty of fluids, Nanda said.
If symptoms worsen, experts say you should contact your healthcare provider.
How to avoid contracting HMPV
Infectious-disease experts said the best way to avoid contracting HMPV is similar to preventing other respiratory illnesses.
The American Lung Assn.’s recommendations include:
- Wash your hands often with soap and water. If that’s not available, clean your hands with an alcohol-based hand sanitizer.
- Clean frequently touched surfaces.
- Crack open a window to improve air flow in crowded spaces.
- Avoid being around sick people if you can.
- Avoid touching your eyes, nose and mouth.
Assistant data and graphics editor Vanessa Martínez contributed to this report.
Science
After rash of overdose deaths, L.A. banned sales of kratom. Some say they lost lifeline for pain and opioid withdrawal
Nearly four months ago, Los Angeles County banned the sale of kratom, as well as 7-OH, the synthetic version of the alkaloid that is its active ingredient. The idea was to put an end to what at the time seemed like a rash of overdose deaths related to the drug.
It’s too soon to tell whether kratom-related deaths have dissipated as a result — or, really, whether there was ever actually an epidemic to begin with. But many L.A. residents had become reliant on kratom as something of a panacea for debilitating pain and opioid withdrawal symptoms, and the new rules have made it harder for them to find what they say has been a lifesaving drug.
Robert Wallace started using kratom a few years ago for his knees. For decades he had been in pain, which he says stems from his days as a physical education teacher for the Glendale Unified School District between 1989 and 1998, when he and his students primarily exercised on asphalt.
In 2004, he had arthroscopic surgery on his right knee, followed by varicose vein surgery on both legs. Over the next couple of decades, he saw pain-management specialists regularly. But the primary outcome was a growing dependence on opioid-based painkillers. “I found myself seeking doctors who would prescribe it,” he said.
He leaned on opioids when he could get them and alcohol when he couldn’t, resulting in a strain on his marriage.
When Wallace was scheduled for his first knee replacement in 2021 (he had his other knee replaced a few years later), his brother recommended he take kratom for the post-surgery pain.
It seemed to work: Wallace said he takes a quarter of a teaspoon of powdered kratom twice a day, and it lets him take charge of managing his pain without prescription painkillers and eases harsh opiate-withdrawal symptoms.
He’s one of many Angelenos frustrated by recent efforts by the county health department to limit access to the drug. “Kratom has impacted my life in only positive ways,” Wallace told The Times.
For now, Wallace is still able to get his kratom powder, called Red Bali, by ordering from a company in Florida.
However, advocates say that the county crackdown on kratom could significantly affect the ability of many Angelenos to access what they say is an affordable, safer alternative to prescription painkillers.
Kratom comes from the leaves of a tree native to Southeast Asia called Mitragyna speciosa. It has been used for hundreds of years to treat chronic pain, coughing and diarrhea as well as to boost energy — in low doses, kratom appears to act as a stimulant, though in higher doses, it can have effects more like opioids.
Though advocates note that kratom has been used in the U.S. for more than 50 years for all sorts of health applications, there is limited research that suggests kratom could have therapeutic value, and there is no scientific consensus.
Then there’s 7-OH, or 7-Hydroxymitragynine, a synthetic alkaloid derived from kratom that has similar effects and has been on the U.S. market for only about three years. However, because of its ability to bind to opioid receptors in the body, it has a higher potential for abuse than kratom.
Public health officials and advocates are divided on kratom. Some say it should be heavily regulated — and 7-OH banned altogether — while others say both should be accessible, as long as there are age limitations and proper labeling, such as with alcohol or cannabis.
In the U.S., kratom and 7-OH can be found in all sorts of forms, including powder, capsules and liquids — though it depends on exactly where you are in the country. Though the Food and Drug Administration has recommended that 7-OH be included as a Schedule 1 controlled substance under the Controlled Substances Act, that hasn’t been made official. And the plant itself remains unscheduled on the federal level.
That has left states, counties and cities to decide how to regulate the substances.
California failed to approve an Assembly bill in 2024 that would have required kratom products to be registered with the state, have labeling and warnings, and be prohibited from being sold to anyone younger than 21.
It would also have banned products containing synthetic versions of kratom alkaloids. The state Legislature is now considering another bill that basically does the same without banning 7-OH — while also limiting the amount of synthetic alkaloids in kratom and 7-OH products sold in the state.
“Until kratom and its pharmacologically active key ingredients mitragynine and 7-OH are approved for use, they will remain classified as adulterants in drugs, dietary supplements and foods,” a California Department of Public Health spokesperson previously told The Times.
On Tuesday, California Gov. Gavin Newsom announced that the state’s efforts to crack down on kratom products has resulted in the removal of more than 3,300 kratom and 7-OH products from retail stores. According to a news release from the governor’s office, there has been a 95% compliance rate from businesses in removing the products.
(Los Angeles Times photo illustration; source photos by Getty Images)
Newsom has equated these actions to the state’s efforts in 2024 to quash the sale of hemp products containing cannabinoids such as THC. Under emergency state regulations two years ago, California banned these specific hemp products and agents with the state Department of Alcoholic Beverage Control seized thousands of products statewide.
Since the beginning of 2026, there have been no reported violations of the ban on sales of such products.
“We’ve shown with illegal hemp products that when the state sets clear expectations and partners with businesses, compliance follows,” Newsom said in a statement. “This effort builds on that model — education first, enforcement where necessary — to protect Californians.”
Despite the state’s actions, the Los Angeles County Board of Supervisors is still considering whether to regulate kratom, or ban it altogether.
The county Public Health Department’s decision to ban the sale of kratom didn’t come out of nowhere. As Maral Farsi, deputy director of the California Department of Public Health, noted during a Feb. 18 state Senate hearing, the agency “identified 362 kratom-related overdose deaths in California between 2019 and 2023, with a steady increase from 38 in 2019 up to 92 in 2023.”
However, some experts say those numbers aren’t as clear-cut as they seem.
For example, a Los Angeles Times investigation found that in a number of recent L.A. County deaths that were initially thought to be caused by kratom or 7-OH, there wasn’t enough evidence to say those drugs alone caused the deaths; it might be the case that the danger is in mixing them with other substances.
Meanwhile, the actual application of this new policy seems to be piecemeal at best.
The county Public Health Department told The Times it conducted 2,696 kratom-related inspections between Nov. 10 and Jan. 27, and found 352 locations selling kratom products. The health department said the majority stopped selling kratom after those inspections; there were nine locations that ignored the warnings, and in those cases, inspectors impounded their kratom products.
But the reality is that people who need kratom will buy it on the black market, drive far enough so they get to where it’s sold legally or, like Wallace, order it online from a different state.
For now, retailers who sell kratom products are simply carrying on until they’re investigated by county health inspectors.
Ari Agalopol, a decorated pianist and piano teacher, saw her performances and classes abruptly come to a halt in 2012 after a car accident resulted in severe spinal and knee injuries.
“I tried my best to do traditional acupuncture, physical therapy and hydrocortisone shots in my spine and everything,” she said. “Finally, after nothing was working, I relegated myself to being a pain-management patient.”
She was prescribed oxycodone, and while on the medication, battled depression, anhedonia and suicidal ideation. She felt as though she were in a fog when taking oxycodone, and when it ran out, ”the pain would rear its ugly head.” Agalopol struggled to get out of bed daily and could manage teaching only five students a week.
Then, looking for alternatives to opioids, she found a Reddit thread in which people were talking up the benefits of kratom.
“I was kind of hesitant at first because there’re so many horror stories about 7-OH, but then I researched and I realized that the natural plant is not the same as 7-OH,” she said.
She went to a local shop, Authentic Kratom in Woodland Hills, and spoke to a sales associate who helped her decide which of the 47 strains of kratom it sold would best suit her needs.
Agalopol currently takes a 75-milligram dose of mitragynine, the primary alkaloid in kratom, when necessary. It has enabled her to get back to where she was before her injury: teaching 40 students a week and performing every weekend.
Agalopol believes the county hasn’t done its homework on kratom. “They’re just taking these actions because of public pressure, and public pressure is happening because of ignorance,” she said.
During the course of reporting this story, Authentic Kratom has shut down its three locations; it’s unclear if the closures are temporary. The owner of the business declined to comment on the matter.
When she heard the news of the recent closures, Agalopol was seething. She told The Times she has enough capsules of kratom for now, but when she runs out, her option will have to be Tylenol and ibuprofen, “which will slowly kill my liver.”
“Prohibition is not a public health strategy,” said Jackie Subeck, executive director of 7-Hope Alliance, a nonprofit that promotes safe and responsible access to 7-OH for consumers, at the Feb. 18 Senate hearing. “[It’s] only going to make things worse, likely resulting in an entirely new health crisis for Californians.”
Because of budget cuts, the Los Angeles County Department of Public Health has ended clinical services at seven of its public health clinic sites.
As of Feb. 27, the county is no longer providing services such as vaccinations, sexually transmitted infection testing and treatment, or tuberculosis diagnosis and specialty TB care at the affected locations, according to county officials and a department fact sheet.
The sites losing clinical services are Antelope Valley in Lancaster; the Center for Community Health (Leavy) in San Pedro, Curtis R. Tucker in Inglewood, Hollywood-Wilshire, Pomona, Dr. Ruth Temple in South Los Angeles, and Torrance. Services will continue to be provided by the six remaining public health clinics, and through nearby community clinics.
The changes are the result of about $50 million in funding losses, according to official county statements.
“That pushed us to make the very difficult decision to end clinical services at seven of our sites,” said Dr. Anish Mahajan, chief deputy director of the L.A. County Department of Public Health.
Mahajan said the department selected clinics with relatively lower patient volumes. Over the last month, he said, the department has sent letters to patients about the changes, and referred them to unaffected county clinics, nearby federally qualified health centers or other community providers. According to Mahajan, for tuberculosis patients, particularly those requiring directly observed therapy, public health nurses will continue visiting patients.
Public health clinics form part of the county’s healthcare safety net, serving low-income residents and those with limited access to care. Officials said that about half of the patients the county currently sees across its clinics are uninsured.
Mahajan noted that the clinics were established decades ago, before the Affordable Care Act expanded Medi-Cal coverage and increased the number of federally qualified health centers. He said that as more residents gained access to primary care, utilization at some county-run clinics declined.
“Now that we have a more sophisticated safety net, people often have another place to go for their full range of care,” he said.
Still, the closures have unsettled providers who work closely with local vulnerable populations.
“I hate to see any services that serve our at-risk and homeless community shut down,” said Mark Hood, chief executive of Union Rescue Mission in downtown Los Angeles. “There’s so much need out there, so it always is going to create hardship for the people that actually need the help the most.”
Union Rescue Mission does not receive government funding for its healthcare services, Hood said. The mission’s clinics are open not only to shelter guests, up to 1,000 people nightly, but also to people living on the streets who walk in seeking care.
Its dental clinic alone sees nearly 9,000 patients a year, Hood said.
“We haven’t seen it yet, but I expect in the coming days and weeks we’ll see more people coming through our doors looking for help,” he said. “They’re going to have to find help somewhere.” Hood said women experiencing homelessness are especially vulnerable when preventive care, including sexual and reproductive health services, becomes harder to access.
County officials said staffing impacts so far have been managed through reassignment rather than layoffs. Roughly 200 to 300 positions across the department have been eliminated amid funding cuts, officials said, though many were vacant. About 120 employees whose positions were affected have been reassigned; according to Mahajan, no one has been laid off.
The clinic closures come amid broader fiscal uncertainty. Mahajan said that due to the Trump administration’s “Big Beautiful Bill,” Los Angeles County could lose $2.4 billion over the next several years. That funding, he said, supports clinics, hospitals and community clinic partners now absorbing patients who previously went to the clinics that closed on Feb. 27.
In response, the L.A. County Board of Supervisors has backed a proposed half-cent sales tax measure that would generate hundreds of millions of dollars annually for healthcare and public health services. Voters are expected to consider the measure in June.
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