Science
The loss of healthcare subsidies force Californians to pay more or go without
For Mikayla Tencer, being self-employed already meant juggling higher taxes, irregular income and the constant pressure of finding her own health insurance. This year, it also meant rethinking how often she could afford to see a doctor.
The 29-year-old content creator in San Francisco paid $168 a month last year for a Blue Shield health plan through Covered California. This year — without enhanced federal subsidies that expired at the end of December — that same plan would have cost $299 a month, with higher copays.
“People assume that because I’m young, I can just pick the cheapest plan and not worry about it,” Tencer said. “But I do need regular care, especially for mental health.”
Tencer is among tens of thousands of middle-class Californians facing steep increases in health insurance costs after Congress allowed enhanced federal subsidies for Affordable Care Act plans to expire Dec. 31.
Those extra subsidies were enacted in 2021 as part of temporary, pandemic-era relief, boosting financial help for people buying coverage on state-run insurance marketplaces such as Covered California. The law also expanded eligibility to people earning more than 400% of the federal poverty level, about $62,600 for a single person and $128,600 for a family of four.
Mikayla Tencer records a TikTok video featuring eyeliners. Her blog showcases Bay Area attractions and local businesses.
(Paul Kuroda/For The Times)
With the expiration of the enhanced subsidies, people above that income threshold no longer receive federal assistance, and many who still qualify are seeing sharply higher premiums and out-of-pocket costs. On top of the loss of the extra federal benefits, the average Covered California premium this year rose by 10.3% because of fast-rising medical costs.
Jessica Altman, executive director of Covered California, said that about 160,000 Californians lost their subsidies when the enhanced federal assistance expired because their incomes were higher than 400% of the federal poverty level.
To lower her monthly bill, Tencer switched to the cheapest Covered California option, bringing her premium down to about $161 a month. But the savings came with new costs. Primary care and mental health visits now carry $60 copays, up from $35.
When she showed up for a psychiatric appointment to manage her ADHD and generalized anxiety disorder, she said, she learned her doctor was out of network.
“That visit would have been $35 before,” she said. “Now it’s $180 out of pocket.”
Because of the higher costs, Tencer said she has cut therapy from weekly to biweekly sessions.
“The subsidies made it possible for me to be self-employed in the first place,” Tencer said. “Without them, I’m seriously thinking about applying for full-time jobs, even though the market is terrible.”
For another self-employed Californian, the increase was even more dramatic.
Krista, a 42-year-old photographer and videographer in Santa Cruz County, relies on costly monthly intravenous treatments for a rare blood disorder. She asked that her full name not be used but shared her insurance and medical documents with The Times.
Last year, she paid about $285 a month for a Covered California plan. In late December, she received a notice showing her premium would rise to more than $1,200 a month. The rise was due to her loss of federal subsidies, as well as a 23% increase in the premium charged by Blue Shield.
“It terrified me. I thought, how am I ever going to retire?” she asked. “What’s the point?”
Krista ultimately enrolled in a plan costing about $522 a month, still nearly double what she had been paying, with a $5,000 deductible. She said she cannot downgrade to a cheaper plan because her clinic bills her treatment to insurance at roughly $30,000 a month, according to medical statements.
To cut costs and preserve the ability to save for retirement and eventually afford a place of her own, Krista decided to move into an RV on private land. The decision came the same week she received notices showing a rent increase and a steep jump in her health insurance premiums.
Mikayla Tencer, a marketing influencer, with her elder dog, “Lucky” at Alamo Square Park.
(Paul Kuroda/For The Times)
Krista said she had been planning for more than a year to find a long-term living situation that would enable her to live independently, rather than continue paying more for an apartment.
“Nobody asks to be sick,” Krista said. “No one should have their life ruined because they get diagnosed with a disease or break a leg.”
Although overall enrollment in Covered California this year has held steady, Altman said, she worries that more people will drop coverage as bills with the higher premiums arrive in the mail.
Those fears are already playing out.
Jayme Wernicke, a 34-year-old receptionist and single mother in Chico who earns about $49,000 a year, said she was transferred from Medi-Cal to a Covered California Anthem Blue Cross plan at the end of 2023. Her premium rose from about $30 a month to $60, then jumped to roughly $230 after the subsidies expired.
“For them to raise my health insurance almost 400% is just insane to me,” Wernicke said.
Her employer, a small family-owned business, does not offer health insurance. Her plan does not include dental or vision care and, she said, barely covers medical costs.
“At a certain point, it just feels completely counterintuitive,” she said. “Either way, I’m losing.”
Wernicke dropped her own coverage and plans to pay for care with cash, calculating that the state tax penalty is less than the cost of premiums. Her daughter remains insured.
Two other Californian residents told The Times that they also decided to go without coverage because they could no longer afford it. They declined to provide their full names, citing concerns about financial and professional consequences.
Under California law, residents without coverage face an annual penalty of at least $900 per adult and $450 per child.
One, a 29-year-old self-employed publicist in Los Angeles requires medication for epilepsy. Last year, she paid about $535 a month for a silver plan through Covered California. This year, the same plan would have cost $823.
After earning about $55,000 last year, she calculated that paying for care out of pocket would cost far less. Her epilepsy medication costs about $175 every three months without insurance, and her annual doctor visits total roughly $250.
“All of that combined is still far less than paying hundreds of dollars every month,” she said.
Another, April, a 58-year-old small-business owner in San Francisco, canceled her insurance in December after her quoted premium rose to $1,151 a month for a bronze plan and $1,723 for a silver plan, just for herself. Last year, April said she paid $566 for both her and her daughter. This year, her daughter’s premium alone jumped from $155 to $424.
The bronze plan also carried a $3,500 deductible for lab work and specialist visits, meaning she would have had to pay thousands of dollars out of pocket before coverage kicked in, on top of the higher monthly premium.
“The subsidies were absolutely what allowed me to sustain my business,” April said. “They were helping me sustain my financial world and have affordable care.”
She rushed to complete medical tests before dropping coverage and hopes to go a year uninsured.
“The scariest part is not having catastrophic coverage,” she said. “If something happens, it can be millions of dollars.”
Tencer, the content creator in San Francisco, believes that in order to make the nation healthier, affordable healthcare should be universal.
“Our government should be providing it.” she said. “People can’t go to the doctor for routine checkups, they can’t get things checked out early, and they can’t access the resources they need.”
Science
Owners of fire-destroyed Palisades mobile home park seek to displace residents for development deal
For months, former residents of the Pacific Palisades Bowl Mobile Estates have feared the uncommunicative owners of the property would seek to displace them in favor of a more lucrative development deal after the Palisades fire destroyed the rent-controlled, roughly 170-unit mobile home park.
A confidential memorandum listing the Bowl for sale indicates the owners intend to do exactly that.
The memorandum, quietly posted on a website associated with the global commercial real estate company CBRE, says that the Palisades fire created a “blank canvas for redevelopment” at a site “ideally positioned for a transformative residential or mixed-use project.”
“I just thought, oh my god, this is so much propaganda and false advertising,” said Lisa Ross, a 33-year resident of the Bowl and a Realtor. “How can they even get away with printing this?”
Neither the current owners of the Bowl nor the real estate companies listed on the memorandum responded to requests for comment.
The memorandum describes the current single-family residential zoning as “favorable” for developers; however, the city and mobile housing law experts have painted a different picture.
Fire debris at Pacific Palisades Bowl in January 2026.
(Myung J. Chun / Los Angeles Times)
“Multifamily and mixed-use development on this site is not allowed by existing zoning and land use regulations,” Mayor Karen Bass’s office said in a statement Wednesday, adding only low density single-family housing or reconstructing the mobile home park are currently allowed. “Mayor Bass will continue taking action and [work] with residents to restore the Palisades community.”
City Councilmember Traci Park also reiterated her focus on getting the mobile home park rebuilt and allowing residents to return, with a spokesperson noting she is not entertaining the potential for any rezoning efforts from a developer.
Zoning changes typically require a city council vote and are subject to the mayor’s approval or veto.
Beyond the zoning laws, the site is also currently governed by a state law requiring cities to preserve affordable housing along the coast and a city ordinance protecting mobile home residents against sudden displacement.
Spencer Pratt, a resident of the Palisades and an outspoken supporter of the neighborhood’s mobile home community, criticized the mayor and the owners in a statement to The Times. “It’s unfortunate that Karen Bass has not advocated for mobile home residents impacted by the fire,” he said, “and that the current owner of the Bowl is ignoring good faith offers from residents to buy the property.”
The mayor’s office disputed this, noting Bass recently led a delegation of Palisadians, including mobile home owners, to Sacramento to advocate for recovery. “Mayor Bass’ priority is getting every Palisadian home — single-family homeowners, town home owners, renters, mobile home owners.”
Los Angeles Mayor Karen Bass speaks during a private ceremony outside City Hall with faith leaders, LAPD officers and city officials to commemorate the one-year anniversary of the Eaton and Palisades fires on Jan. 7, 2026.
(Allen J. Schaben / Los Angeles Times)
Bass also advocated for the federal government to include the Bowl in its debris cleanup efforts; however, the Federal Emergency Management Agency ultimately refused to include it, unlike other mobile home parks impacted by the Palisades fire. Its reasoning: It could not trust the owners to rebuild the park as affordable housing.
Court rulings over the years found the owners routinely failed to maintain the infrastructure and worked to replace the park with an “upscale resort community.” Residents also accused the owners of attempting to circumvent rent control regulations.
After the fire, it ultimately took more than 13 months to begin cleaning up the debris.
Ross said she approached the owners with independent mobile home park developers who were interested in buying the fire-destroyed lot and letting residents rebuild within months. She also approached the owners with a proposition that the former residents band together to buy the park. She heard nothing back.
“They don’t communicate,” Ross said. “It’s a feuding family. That’s also why we had so many problems with maintenance and with upgrades in the park.”
Pratt, who is running for mayor against Bass, also called on private developers like Rick Caruso to step in and save the Bowl. (Caruso’s team noted his rebuilding nonprofit is looking into how to help residents of the Bowl.)
Ross is a fan of Pratt’s proposition. “We need those kinds of people — we need Rick Caruso. That would be great,” Ross said. To sweeten the deal: “I’ll cook for him. I would make him all his favorite dishes.”
Science
A virus without a vaccine or treatment is hitting California. What you need to know
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.”
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