California
Food, fluoride and funding: How a new Trump term might affect health in California
Donald Trump’s return to the White House stands to significantly shape the health of Californians — the foods they eat, the medicines they take, the costs they face and more.
Trump has said he’ll grant a prominent health role to supporter Robert F. Kennedy Jr., who has made discredited claims about vaccines and bucked the advice of pediatricians and dentists by advocating an end to water fluoridation. Policy analysts expect cuts to Medicaid.
And though Trump has publicly distanced himself from the conservative Project 2025 playbook, many of its proposals overlap with Trump’s agenda and the Republican Party platform. As such, analysts say its detailed proposals on opioid addiction, contraception, mental health treatment and more bear watching.
“I think everything is on the table,” said Gerald Kominski, a senior fellow at the UCLA Center for Health Policy Research.
Already, California Atty. Gen. Rob Bonta has vowed to take the incoming president to court if his administration tries to stymie the state’s progressive agenda.
“Every action they take will likely provoke a lawsuit,” said Larry Levitt, executive vice president for health policy at the Kaiser Family Foundation. “California was a leader in the legal opposition to the first Trump administration, and I would expect that to be the case again this time.”
But some of those moves may not have legal remedies, Levitt cautioned. For example, if Kennedy makes changes to the Food and Drug Administration that weakens its ability to ensure foods and medicines are safe, “there’s not a whole lot California will be able to do to stop that.”
Elections matter. Here are six ways this could affect the Golden State.
Reproductive rights
While Trump has publicly claimed credit for being able to “kill” Roe vs. Wade through his Supreme Court appointments, he’s been harder to pin down on his plans for abortion in a second term. He has said on social media that he wants to leave the matter up to the states, and favors exceptions for rape, incest or life-threatening pregnancies.
With a state constitution that names abortion as a fundamental right, California has some of the strongest reproductive healthcare protections in the U.S.
Yet the administration could attempt to restrict abortion in the state by limiting access to mifepristone, one of the most common drugs used in medication-induced abortions. Conservative groups have been trying to get courts to withdraw the FDA’s approval for the drug.
More than 60% of abortions in the U.S. are induced with medication, according to the Guttmacher Institute, a research group that supports abortion rights.
Project 2025 suggests limiting access to mifepristone by reviving a 19th century law called the Comstock Act that prohibits sending abortion-causing agents by mail. Though both Trump and Vice President-elect JD Vance said during the campaign that they would not enforce it, Vance was among 40 Republican lawmakers who signed a letter last year asking the Department of Justice to do just that. That could matter if Vance has another change of heart and tries to sway his boss.
“Obviously, it would be challenged in court, but we could see a huge disruption to the provision of medication abortion if they decided to try to enforce that,” said Amy Friedrich-Karnik, director of federal policy at the Guttmacher Institute.
Vaccines
Public health experts have been alarmed by Trump’s embrace of Kennedy, who dismisses overwhelming evidence that vaccines are safe. A recent study estimated that a federal program to help pay for childhood immunizations against diseases such as measles, polio and rotavirus has prevented more than 1 million deaths and 32 million hospitalizations since its inception in 1994.
This week, Kennedy said he wouldn’t take vaccines away from anyone who wanted them. “People can make individual assessments about whether that product is going to be good for them,” he told NBC News.
Trump himself said he would cut federal funding to schools with vaccine mandates. His campaign said he was talking about COVID-19 vaccines in particular, but as a candidate, he repeatedly made the pledge without clarifying that. California requires elementary and secondary school students to be immunized against a range of diseases unless they have a medical exemption; the COVID-19 shot is recommended but not mandatory.
In other areas of public health, Trump has said he “probably would” disband the White House Office of Pandemic Preparedness and Response Policy, even as the country is facing a mounting threat from bird flu.
And Kennedy triggered concerns by calling fluoride “an industrial waste” and saying he would push to have the mineral removed from drinking water. The CDC says fluoridation to prevent tooth decay is one of the 20th century’s greatest public health achievements, and more than half of Californians live in communities with fortified water.
Gender-affirming care
California law requires health plans and insurers licensed by the state to provide transgender enrollees with medically necessary gender-affirming care. It also aims to protect doctors from laws that criminalize such care in other states.
But access to gender-affirming care could still be undermined by federal action. Trump said he would press Congress to block the use of federal funds for gender-affirming care, a position also reflected in the Republican Party platform.
A prohibition could be modeled on the decades-old Hyde Amendment, which prevents federal funds from being used to pay for abortions, or tied to appropriations bills, said Julianna S. Gonen, director of federal policy for the National Center for Lesbian Rights.
If implemented, people who rely on public programs such as Medicaid or Medicare could end up with “really limited access to gender-affirming care,” said Lindsey Dawson, director for LGBTQ Health Policy for KFF.
California officials might decide to have the state pick up the tab. Gonen said it would be “very hard” for the Trump administration to block states from doing so, although the last Trump administration threatened to withhold some Medicaid funding from California over its abortion policies.
Trump has taken particular aim at gender-affirming care for transgender youth, and he has a stated goal of prohibiting it “in all 50 states.” He said hospitals that provide such treatment would be cut off from Medicaid and Medicare funding. Gonen said losing that money would be “an existential threat” for health facilities.
Medicaid
In his first term, Trump proposed changes that would reduce federal spending on Medicaid. Trump has promised to spare Medicare and Social Security, but that could make Medicaid a target if spending cuts are needed, some public health experts believe.
“Medicaid would definitely be on the chopping block,” said Edwin Park, a research professor at Georgetown University’s McCourt School of Public Policy.
Cuts in Washington could force California to either pony up more money or shrink existing programs. California has relied on its own dollars to expand its Medicaid program, known as Medi-Cal, to cover people regardless of their immigration status, said John Baackes, chief executive of L.A. Care, the largest publicly operated health plan in the country. But amid budget deficits, “there’s a limitation of what California can do.”
Park added that Trump’s Republican allies have also floated plans that would restrict or prohibit state taxes on healthcare providers, further squeezing funding for Medicaid programs.
Nutrition and food safety
After Kennedy dropped out of the race and endorsed Trump, the former president seemed eager to delegate responsibility for food policy to his new ally, telling supporters last month that “I’m gonna let him go wild on the food.”
Kennedy told NBC that he would work to remove chemical additives from foods that are banned in Europe but still allowed in the U.S. Some of those substances, including red dye No. 3, will become illegal in California in 2027 under a law signed by Gov. Gavin Newsom last year.
Kennedy said he would eliminate the FDA departments tasked with assessing the safety of food ingredients because they are not “doing their job.” It’s not clear if Trump would go along with that.
Project 2025 calls for a repeal of the nation’s dietary guidelines on the grounds that they’ve gone astray by considering the environmental impact of food production. Project 2025 also embraces genetic engineering and other crop biotechnology. It’s not clear if Trump supports those proposals, though in his first term he eased restrictions on genetically engineered foods.
The Affordable Care Act
Trump tried unsuccessfully to roll back the Affordable Care Act during his first term. This time around, Trump has said he would only replace the landmark law if a better plan were devised.
Vance raised the idea of dividing up “risk pools,” which are used to share medical costs and calculate insurance premiums. Critics cautioned that doing so could drive up rates for elderly people with chronic conditions.
Mark A. Peterson, a professor at the UCLA Luskin School of Public Affairs, said that despite continued jabs at the law, “it’s very unlikely that Republicans will want to take on the Affordable Care Act. It did not go well for them last time … and now the Affordable Care Act is more popular than ever.”
A more immediate target may be a set of enhanced subsidies for people buying health insurance through Affordable Care Act marketplaces, which are due to expire at the end of 2025. One analysis found that if that happens, more than 1.5 million Californians would see their annual costs rise by an average of $967.
The Trump campaign has criticized the subsidies, arguing they helped insurance companies more than patients.
California
Strong winds fuel rapid spread of wildfires in Southern California
CAMARILLO, Calif. — A Southern California wildfire has destroyed 132 structures, mostly homes, in less than two days, fire officials said Thursday as raging winds were forecast to ease.
The fire started Wednesday morning in Ventura County and has grown to about 32 square miles at 5% containment. Its cause has not been determined.
Ten people have been injured in the course of the fire, Ventura County Sheriff James Fryhoff said. Most of them suffered from smoke inhalation or other non-life-threatening injuries.
Fire officials said 88 other structures were damaged but did not specify whether they had been burned or affected by water or smoke damage.
Some 10,000 people remained under evacuation orders Thursday as the Mountain Fire continued to threaten some 3,500 structures in suburban neighborhoods, ranches and agricultural areas around Camarillo in Ventura County.
County fire officials said crews working in steep terrain with support from water-dropping helicopters were focusing on protecting homes on hillsides along the fire’s northeast edge near the city of Santa Paula, home to more than 30,000 people.
Kelly Barton watched as firefighters sifted through the charred rubble of her parents’ ranch home of 20 years in the hills of Camarillo with a view of the Pacific Ocean. The crews uncovered two safes and her parents’ collection of vintage door knockers undamaged among the devastation.
“This was their forever retirement home,” Barton said Thursday. “Now in their 70s, they have to start over.”
Her father returned to the house an hour after evacuating Wednesday to find it already destroyed. He was able to move four of their vintage cars to safety but two — including a Chevy Nova he’d had since he was 18 — burned to “toast,” Barton said.
Officials in several Southern California counties urged residents to be on watch for fast-spreading blazes, power outages and downed trees during the latest round of notorious Santa Ana winds.
Santa Anas are dry, warm and gusty northeast winds that blow from the interior of Southern California toward the coast and offshore, moving in the opposite direction of the normal onshore flow that carries moist air from the Pacific. They typically occur during the fall months and continue through winter and into early spring.
Ariel Cohen, the National Weather Service’s meteorologist in charge in Oxnard, said Santa Ana winds were subsiding in the lower elevations but remained gusty across the higher elevations Thursday evening.
The red flag warnings, indicating conditions for high fire danger, expired in the area except for in the Santa Susana Mountains, Cohen said. The warnings will expire by 11 a.m. Friday in the mountains.
The Santa Ana winds are expected to return early-to-midweek next week, Cohen added.
The Mountain Fire was burning in a region that has seen some of California’s most destructive fires over the years. The fire swiftly grew from less than half a square mile to more than 16 square miles in little more than five hours on Wednesday. By Thursday evening it was mapped at about 32 square miles and Gov. Gavin Newsom had proclaimed a state of emergency in the county.
Marcus Eriksen, who has a farm in Santa Paula, said firefighters kept embers from spreading to his home, his vehicles and other structures even as piles of compost and wood chips were engulfed.
The flames were up to 30 feet tall and moving quickly, Eriksen said Thursday. Their speed and ferocity overwhelmed him, but the firefighters kept battling to save as much as they could on his property. Thanks to their work, “we dodged a bullet, big time,” he said.
Sharon Boggie said the fire came within 200 feet of her house in Santa Paula.
“We thought we were going to lose it at 7:00 this morning,” Boggie said Thursday as white smoke billowed through the neighborhood. She initially fled with her two dogs while her sister and nephew stayed behind. Hours later the situation seemed better, she said.
The Ventura County Office of Education announced that more than a dozen school districts and campuses in the county were closed Thursday, and a few were expected to be closed Friday.
Utilities in California began powering down equipment during high winds and extreme fire danger after a series of massive and deadly wildfires in recent years were sparked by electrical lines and other infrastructure.
Power was shut off to nearly 70,000 customers in five counties over the heightened risk, Southern California Edison said Thursday. Gabriela Ornelas, a spokesperson for Edison, could not immediately answer whether power had been shut off in the area where the Mountain Fire was sparked.
The wildfires burned in the same areas of other recent destructive infernos, including the 2018 Woolsey Fire, which killed three people and destroyed 1,600 homes near Los Angeles, and the 2017 Thomas Fire, which burned more than a thousand homes and other structures in Ventura and Santa Barbara counties. Southern California Edison has paid tens of millions of dollars to settle claims after its equipment was blamed for both blazes.
California
California agency boosts reporting requirements for autonomous vehicle incidents
(Reuters) – A California state agency said Thursday it is mandating enhanced data reporting requirements for autonomous vehicles including reports for incidents where self-driving cars get stuck.
The California Public Utilities Commission (CPUC) is requiring companies to file detailed trip-level incident reports that cover both collision and non-collision incidents, including citations and stoppage events. In June, GM self-driving unit Cruise agreed to pay the maximum $112,500 penalty to the CPUC for failing to promptly provide complete information to the commission about a serious crash involving one of its robotaxis last year.
(Reporting by David Shepardson)
California
With progressive ballot measures on track to fail, California's political identity is questioned
There was no surprise on election night when a solid majority of California voters selected Democratic presidential nominee Kamala Harris over former President Trump. But the outcomes of a list of ballot measures told a more complicated story of a state known for its liberal bent.
Voters overwhelmingly supported a measure to undo a decade of progressive criminal justice reform, and preliminary poll results showed they were poised to reject measures that would increase the minimum wage and ban forced prison labor.
Proposition 6 — which would ban “involuntary servitude” as punishment for a crime — lacked majority support in deep-blue California on Wednesday even as supporters promoted it as a way to end what they call modern-day slavery. A similar measure was on track to pass in Nevada.
California voters also rejected a measure that would have made it easier for cities to impose rent control and pass local bond measures for affordable housing.
Some progressive voters in the state, where Democrats control the governor’s office and Legislature, were dumbfounded by the early results, while Republicans seized on the moment as proof that California is becoming more conservative.
“It’s a new day in California,” Assembly Republican leader James Gallagher of Yuba City said in a social media post about the election results. “The shift is beginning.”
But longtime California election watchers were more tempered about what the outcome of the ballot measures say about the state’s political leanings.
Mark Baldassare, survey director for the Public Policy Institute of California, a nonpartisan think tank that conducts polling, said confusing initiative descriptions can deter voters from supporting initiatives even if they actually agree with their intent — especially in a state that is accustomed to seeing a slew of wonky questions on their ballot each year on issues from kidney dialysis to condoms.
“Propositions are a part of the ballot where you don’t have Ds and Rs, you have yeses and nos,” Baldassare said. “The electorate looks at this on an issue-by-issue basis. I don’t feel like it’s necessarily an indicator that it’s a shift to the right. I think that the default for the voter is always ‘no.’ ”
Californians have defied the state’s liberal reputation when voting on ballot measures before. They have twice rejected ballot measures to abolish the death penalty in the past; and in 2008 they passed Proposition 8, which banned same-sex marriage. (On Tuesday, Californians passed a measure that stripped the last vestiges of Proposition 8 from the California Constitution, reaffirming gay marriage, which remains a federal right.)
Campaign messaging goes a long way for ballot measures, Baldassare said, and voters often weigh their decisions partly based on who is listed as supporters and opponents alongside the question on the ballot. Sometimes, it gets complicated.
In the case of Proposition 33, which was endorsed by the California Democratic Party and would have repealed a law that bars local governments from regulating rent on some buildings, even rent control proponents fed up with the cost of living voiced concerns about unintended impacts of the measure.
Millions were spent for and against Proposition 33, with opponents warning it could make California’s housing shortage worse. A proposition coined as a “revenge measure” was added to the ballot, targeting how a healthcare foundation that is a prime proponent of rent control measures could spend their revenue.
Proposition 6 proponents chalked up its likely failure not to voters’ support for “slavery” but to growing concerns about public safety and how those worries could impact any policy measure related to prison reform. In addition to approving Proposition 36, which cracks down on criminal sentencing for theft and fentanyl crimes, voters also ousted progressive-leaning prosecutors in L.A. County and the Bay Area.
Antonio Villaraigosa, the former Los Angeles mayor who is running for governor in 2026 and is expected to position himself as a moderate among a crowded field of Democrats, was reluctant to speculate about what ballot measure results mean before all of them are called. But he said he believes voters want a “course correction” on issues like crime and the economy.
As the Democratic Party nationally grapples with a potential Republican trifecta — winning control of the White House, the Senate and the House of Representatives — and what it means for its movement and the future of the nation, California politicians also need to take a pulse check, he said.
“Are we really listening to people or are we spending all of our time telling them what they ought to do?” Villaraigosa said.
But many California Democrats were undeterred by the ballot measure results, again gearing up to lead the resistance against Trump. They pointed to the approval of progressive-backed causes such as a historic climate change bond and a measure to extend a tax to fund Medi-Cal as proof California remains a liberal bastion in a sea of red.
Assemblymember Alex Lee (D-San José), chair of the California Progressive Legislative Caucus, said that he’s disappointed by some of the ballot measure results but that “all the corporate and conservative special-interest money” spent on the complex initiatives should be considered before making judgments about the state’s electorate.
“On the whole, California is still more progressive than a country where just over half of the voters voted for a fascist,” Lee said just hours after Trump was elected to return to the White House.
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