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News

California steps up to improve LGBTQ youth suicide hotline in wake of Trump administration cuts

Just weeks after the Trump administration announced that IT would eliminate specialized suicide prevention support for LGBTQ youth callers through the 988 Suicide & Crisis Lifeline, California is taking action to improve behavioral health services and provide even more affirming and inclusive care. 

Through a new partnership with The Trevor Project, Gov. Gavin Newsom and the California Health and Human Services Agency, or CalHHS, will provide the state’s 988 crisis counselors enhanced competency training from experts, ensuring better attunement to the needs of LGBTQ youth, on top of the specific training they already receive.

This partnership builds on existing collaborations, like those under California’s Master Plan for Kids’ Mental Health, and reflects a shared commitment to evidence-based, LGBTQ+ affirming crisis care. 

Callers to 988 will continue to be met with the highest level of understanding, respect and affirmation when they reach out for help.

“While the Trump administration continues its attacks on LGBTQ kids, California has a message to the gay community: we see you and we’re here for you. We’re proud to work with the Trevor Project to ensure that every person in our state can get the support they need to live a happy, healthy life,” said Gov. Newsom.

“To every young person who identifies as LGBTQ+: You matter. You are not alone. California will continue to show up for you with care, with compassion, and with action,” said Kim Johnson, secretary of CalHHS. “Through this partnership, California will continue to lead, providing enhanced support for these young people.”

“There could not be a more stark reminder of the moral bankruptcy of this administration than cutting off suicide prevention resources for LGQBT youth. These are young people reaching out in their time of deepest crisis — and I’m proud of California’s work to partner with the Trevor Project to creatively address this need. No matter what this administration throws at us, I know this state will always meet cruelty with kindness and stand up for what’s right," said First Partner Jennifer Siebel Newsom.
 
California’s crisis call centers

Across California, 12 988 call centers remain staffed around the clock by trained crisis counselors, ready to support anyone in behavioral health crises, including LGBTQ youth.

If you, a friend, or a loved one are in crisis or thinking about suicide, you can call, chat, or text 988 and be immediately connected to skilled counselors at all times. Specialized services for LGBTQ youth are also available via The Trevor Project hotline at 1‑866‑488‑7386, which continues as a state-endorsed access point.
 
State supports

California’s Children and Youth Behavioral Health Initiative, or CYBHI, a key component of Governor’ Newsom’s Master Plan for Kids’ Mental Health, offers behavioral health services and supports for children, youth, and families.  

In addition to focused messaging for LGBTQ youth within three ongoing statewide youth mental health campaigns, CYBHI has funded more than a dozen community organizations to provide targeted services for LGBTQ youth by establishing or expanding LGBTQ community spaces, increasing workforce supports, reducing behavioral health stigma, and raising awareness about suicide prevention. 

Additional free continuum-of-care services are available to help address concerns before they become crises, including peer support through CalHOPE and virtual behavioral health services platforms BrightLife Kids and Soluna. These resources are available for all California youth, young adults, and families, regardless of insurance or immigration status.

Why this matters

LGBTQ youth are four times more likely to attempt suicide than their peers, and without affirming services, their risk increases dramatically. Since its launch in 2022, the 988 LGBTQ+ “Press 3” line connected more than 1.5 million in crisis.
 
How to get help 

Call, text or chat 988 at any time to be connected with trained crisis counselors.

Text PRIDE, or dial 1‑866‑488‑7386, to reach Trevor Project specialists.

Visit CalHOPE for non-crisis peer and family support.

‘Big Beautiful Bill’ will have Americans paying higher prices for dirtier energy

Congress passed Donald Trump’s tax and spending bill on July 3, 2025. Kevin Carter/Getty Images

When congressional Republicans decided to cut some Biden-era energy subsidies to help fund their One Big Beautiful Bill Act, they could have pruned wasteful subsidies while sparing the rest. Instead, they did the reverse. Americans will pay the price with higher costs for dirtier energy.

The nearly 900-page bill that President Donald Trump signed on July 4, 2025, slashes incentives for wind and solar energy, batteries, electric cars and home efficiency while expanding subsidies for fossil fuels and biofuels. That will leave Americans burning more fossil fuels despite strong public and scientific support for shifting to renewable energy.

As an environmental engineering professor who studies ways to confront climate change, I think it is important to distinguish which energy technologies could rapidly cut emissions or need a financial boost to become viable from those that are already profitable but harm the environment. Unfortunately, the Republican bill favors the latter while stifling the former.

A large piece of mechanical equipment picks up coal from the ground.
The Spring Creek Mine in Decker, Mont., is just one mine in the Powder River Basin, the most productive coal-producing region in the U.S. AP Photo/Matthew Brown

Cuts to renewable electricity

Wind and solar power, often paired with batteries, provide over 90% of the new electricity added nationally and around the world in recent years. Natural gas turbines are in short supply, and there are long lead times to build nuclear power plants. Wind and solar energy projects – with batteries to store excess power until it’s needed – offer the fastest way to satisfy growing demand for power. Recent technological breakthroughs put geothermal power on the verge of rapid growth.

However, the One Big Beautiful Bill Act rescinds billions of dollars that the Inflation Reduction Act, enacted in 2022, devoted to boosting domestic manufacturing and deployments of renewable energy and batteries.

It accelerates the phaseout of tax credits for factories that manufacture equipment needed for renewable energy and electric vehicles. That would disrupt the boom in domestic manufacturing projects that had been stimulated by the Inflation Reduction Act.

Efforts to build new wind and solar farms will be hit even harder. To receive any tax credits, those projects will need to commence construction by mid-2026 or come online by the end of 2027. The act preserves a slower timeline for phasing out subsidies for nuclear, geothermal and hydrogen projects, which take far longer to build than wind and solar farms.

However, even projects that could be built soon enough will struggle to comply with the bill’s restrictions on using Chinese-made components. Tax law experts have called those provisions “unworkable,” since some Chinese materials may be necessary even for projects built with as much domestic content as possible. For example, even American-made solar panels may rely on components sourced from China or Chinese-owned companies.

Princeton University professor Jesse Jenkins estimates that the bill will mean wind and solar power generate 820 fewer terawatt-hours in 2035 than under previous policies. That’s more power than all U.S. coal-fired power plants generated in 2023.

That’s why BloombergNEF, an energy research firm, called the bill a “nightmare scenario” for clean energy proponents.

However, one person’s nightmare may be another man’s dream. “We’re constraining the hell out of wind and solar, which is good,” said U.S. Rep. Chip Roy, a Texas Republican who is backed by the oil and gas industry.

Workers install solar panels on a roof.
Federal tax credits for homeowners who install solar panels will now expire at the end of 2025. AP Photo/Michael Conroy

Electric cars and efficiency

Cuts fall even harder on Americans who are trying to reduce their carbon footprints and energy costs. The quickest phaseout comes for tax credits for electric vehicles, which will end on Sept. 30, 2025. And since the bill eliminates fines on car companies that fail to meet fuel economy standards, other new cars are likely to guzzle more gas.

Tax credits for home efficiency improvements such as heat pumps, efficient windows and energy audits will end at the end of 2025. Homeowners will also lose tax credits for installing solar panels at the end of the year, seven years earlier than under the previous law.

The bill also rescinds funding that would have helped cut diesel emissions and finance clean energy projects in underserved communities.

A car connects to a large metal box with a thick cable.
Federal tax credits for buying electric vehicles will end on Sept. 30, 2025. AP Photo/Jae C. Hong

Support for biofuels and fossil fuels

Biofuels and fossil fuels fared far better under the bill. Tens of billions of dollars will be spent to extend tax credits for biofuels such as ethanol and biodiesel.

Food-based biofuels do little good for the climate because growing, harvesting and processing crops requires fertilizers, pesticides and fuel. The bill would allow forests to be cut to make room for crops because it directs agencies to ignore the effects of biofuels on land use.

Meanwhile, the bill opens more federal lands and waters to leasing for oil and gas drilling and coal mining. It also slashes the royalties that companies pay to the federal government for fuels extracted from publicly owned land. And a new tax credit will subsidize metallurgical coal, which is mainly exported to steelmakers overseas.

The bill also increases subsidies for using captured carbon dioxide to extract more oil and gas from the ground. That makes it less likely that captured emissions will only be sequestered to combat climate change.

Summing it up

With fewer efficiency improvements, fewer electric vehicles and less clean power on the grid, Princeton’s Jenkins projects that the law will increase household energy costs by over $280 per year by 2035 above what they would have been without the bill. The extra fossil fuel-burning will negate 470 million tons of anticipated emissions reductions that year, a 7% bump.

The bill will also leave America’s clean energy transition further behind China, which is deploying more solar and wind power and electric vehicles than the rest of the world combined.

No one expected President Joe Biden’s Inflation Reduction Act to escape unscathed with Republicans in the White House and dominating both houses of Congress, even though many of its projects were in Republican-voting districts. Still, pairing cuts to clean energy with support for fossil fuels makes Trump’s bill uniquely harmful to the world’s climate and to Americans’ wallets.

This article includes some material previously published on June 10, 2025.The Conversation

Daniel Cohan, Professor of Civil and Environmental Engineering, Rice University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Clearlake City Council to discuss new power study, management salary increase

CLEARLAKE, Calif. — The Clearlake City Council this week will review a new feasibility study by Sonoma Clean Power on alternative power options, and discuss salary adjustment for management employees. 

The council will meet at 6 p.m. Thursday, July 17, in the council chambers at Clearlake City Hall, 14050 Olympic Drive.

The agenda can be found here.

The meeting will be broadcast live on the city's YouTube channel or the Lake County PEGTV YouTube Channel. 

Community members also can participate via Zoom. The webinar ID is 819 8866 1218, the  pass code is 899422. One tap mobile is available at +16694449171,,82771053751#, or join by phone at 669-444-9171 or 646-931-3860.

Under business, the council will consider a presentation of a feasibility report from Sonoma Clean Power to provide service within the city. 

Sonoma Clean Power is “a non-profit that purchases electricity generation for customers in Sonoma and Mendocino counties, while PG&E continues to maintain and operate all the poles, wires and substations of the grid,” the staff report explained. 

The company conducted a study in 2019 which found that “it would be unable to offer competitive service to Lake County residents at the time,” according to the staff report.

However, market and regulatory conditions have improved and the new feasibility study conducted this year suggests a total bill saving of 4.2% to 12.9%.

The study also outlined a service start date to be the second quarter of 2027.

In other business, the council is being asked to consider a 2.4% cost-of-living adjustment, or COLA, for the city’s management employees under the Management Classification and Benefits Plan. 

The proposed adjustment is based on the March-to-March Consumer Price Index, or the CPI, which rose 2.4% over the past year. Previous increases were 1.9% in 2019, 1.5% in 2020, 2.6% in 2021, 8.5% in 2022, 5% in 2023, and 3.5% in March 2024.

The staff report also noted that, over the five years prior to Fiscal Year 2022-23, COLA adjustments for management lagged behind those given to all other employment groups, resulting in a narrowing pay gap between management and other employees — a situation referred to in the report as salary compaction. 

In 2022-23, the council voted to approve a 6% COLA to management to bring their cumulative increases in line with the other city bargaining units.

As of July 1, all other bargaining groups received a 3% COLA, the report said. Staff recommends a 2.4% COLA for management employees. 

The council will also hold a public hearing on converting a portion of Acacia Street, from Arrowhead Road to Sonoma Avenue, to a one-way street. The proposal aims to improve traffic flow and safety, according to the staff report. Parking will also be redesigned. 

“The area has high traffic and safety concerns around Pomo School,” the staff report said. “There have been numerous near misses with both vehicles and pedestrians.”

On the meeting’s consent agenda — items that are considered routine in nature and usually adopted on a single vote — are warrants and council minutes; continuation of emergency declarations for winter storms and the Boyles Fire; approval of Resolution 2025-29 supporting an application for Land and Water Conservation Fund grants for the Austin Skatepark Rehabilitation Project; approval of an agreement with Government Finance Services to provide finance and administrative services for fiscal year 2025–26; notification of expiring committee appointments; and approval of a five-year extension to the PEG TV Agreement.
The council also will hold a closed session to discuss anticipated litigation; conduct a performance evaluation of the city attorney; and discuss ongoing litigation in Case No. CV-424401, Koi Nation of Northern California v. City of Clearlake, in Lake County Superior Court.

Email Lingzi Chen at This email address is being protected from spambots. You need JavaScript enabled to view it.. 

Cal Fire launches online viewer to monitor vegetation burn severity from California wildfires

The new California Vegetation Burn Severity Online Viewer. Courtesy image.

Cal Fire’s Fire and Resource Assessment Program, or FRAP, has launched the new California Vegetation Burn Severity Online Viewer, an interactive public mapping tool that shows how wildfires have impacted vegetation across the state. 

This resource supports California’s commitment to transparency and wildfire resilience under Senate Bill 1101.

The Burn Severity Viewer displays burn severity data for all wildfires over 1,000 acres in California from 2015 to 2023.

With this information easily accessible, landowners, planners, scientists, and the public are empowered to better understand postfire conditions, support ecological recovery and plan for future fire resilience.

“This tool helps Californians see and understand how fire affects our landscapes,” said Chris Keithley, assistant deputy director for FRAP. “It gives communities data to support efforts to plan prescribed burns, guide restoration work, and reduce future wildfire risk.”

The Burn Severity Viewer has several benefits to post fire recovery planning: 1) helps identify areas in need of reforestation or active restoration; 2) improves fire preparedness by assisting prescribed fire practitioners in planning treatments based on past burn severity and fuel changes; 3) enhances safety by offering insights for fire suppression planning and understanding how previous burns might influence future fire behavior; 4) informs habitat management by identifying changes to wildlife habitat and supporting conservation work.

This new tool features interactive maps showing burn severity across all land ownerships. Users can search fires by name, year, cause, or size; view multiple data layers, including fire perimeters and severity classifications; add custom data layers; and generate downloadable, georeferenced maps for field use. 

The viewer will be updated annually to include new qualifying fires.

Burn severity is measured using advanced remote sensing techniques and translated into both the Composite Burn Index, or CBI, for forested areas and a continuous severity scale for all vegetation types. 

Data are derived from satellite imagery processed one year after each fire to account for vegetation recovery and delayed tree mortality.

The tool’s development is guided by a Technical Advisory Committee with experts from the California Wildfire & Forest Resilience Task Force – Science Advisory Panel, California Air Resources Board, NASA , U.S. Geological Survey, and U.S.D.A. Forest Service.

This marks Phase 1 of the project, focused on the online viewer with planned annual updates. Phase 2 will deliver downloadable datasets as Cal Fire continues to refine methods, especially for non-forested landscapes.

The viewer is now live and available to the public here.

For more information about Cal Fire’s Fire and Resource Assessment Program visit the webpage.

Senators sound alarm on potential purging of eligible voters through DHS database

Several U.S. senators are raising concerns about eligible individuals being removed from the voter rolls.

On Tuesday, U.S. Senators Alex Padilla (D-Calif.), Ranking Member of the Senate Rules and Administration Committee, Gary Peters (D-Mich.), Ranking Member of the Senate Homeland Security and Government Affairs Committee (HSGAC), and Jeff Merkley (D-Ore.) expressed serious concerns that recent changes to and the expanded use of the insufficiently tested Department of Homeland Security’s (DHS) Systematic Alien Verification for Entitlements (SAVE) program could purge eligible citizens from state voter rolls.

In addition to President Trump’s attempts to create obstacles to the ballot box through his anti-voter “election integrity” executive order earlier this year, DHS overhauled the program to verify the citizenship of voters on state voter rolls over false concerns of noncitizen voting. 

However, the senators said the administration’s political agenda and data quality issues could lead to the erroneous disenfranchisement of eligible voters. 

The senators warned that U.S. Citizenship and Immigration Services, or USCIS, has not conducted sufficient testing to root out errors and false positives that could make the SAVE program ready for widespread use by states to determine voter eligibility, independent of other databases.

They also criticized DHS’ lack of transparency surrounding the program’s operations and safeguards. 

More than nine million records have already been run through the new SAVE program with little to no transparency.

“States and nonpartisan voter advocacy organizations have expressed concerns with using the SAVE program as a standalone tool to determine voter eligibility without adequate safeguards,” wrote the senators. “In particular, there are concerns that data quality issues may cause state and local officials who rely on the program to receive false positives or incomplete results. This means state and local officials must take on additional burdens to verify SAVE’s results and to ensure that eligible Americans are not denied their right to cast a ballot.”

“Public transparency and assurances that the Department is appropriately protecting citizens’ rights, including privacy, is extremely important,” continued the Senators. “Unfortunately, DHS has not issued any of the routine and required documentation about the program’s operations and safeguards or issued any public notice or notice to Congress. … It has been reported that the Department is apparently preparing to urge all state election officials to use this program but has not provided these officials with any briefings about its capabilities or safeguards.”

The Senators expressed particular concern with the fact that DHS briefed the Election Integrity Network — an organization founded by Cleta Mitchell, a lawyer who worked to overturn the results of the 2020 election — on the changes to the SAVE program before providing information to lawmakers or the public. 

They requested that the Senate Rules and Administration Committee and HSGAC receive any materials shared with external organizations as well as a briefing on these changes to the SAVE program.

Additionally, the Senators reiterated a series of questions for the record that Padilla previously asked USCIS Director nominee Joseph Edlow about the SAVE program. After receiving no substantive response from Edlow, the senators asked Secretary Noem to respond to the same questions by July 29. 

Senator Padilla led 11 Senators in introducing the Defending America’s Future Elections Act to repeal Trump’s illegal anti-voter executive order and prevent the Department of Government Efficiency, or DOGE, from accessing sensitive voter registration data and state records. 

Padilla previously led 14 Democratic senators in calling on Trump to revoke his illegal anti-voter executive order and issued a statement slamming the order when it was announced.

Full text of the letter is below:

We are seeking information regarding the recent overhaul of the Systematic Alien Verification for Entitlements (SAVE) program, which the Department has apparently undertaken with the goal of expanding the program to verify citizenship of voters on state voter rolls. 

States and nonpartisan voter advocacy organizations have expressed concerns with using the SAVE program as a standalone tool to determine voter eligibility without adequate safeguards. In particular, there are concerns that data quality issues may cause state and local officials who rely on the program to receive false positives or incomplete results. This means state and local officials must take on additional burdens to verify SAVE’s results and to ensure that eligible Americans are not denied their right to cast a ballot. 

Public transparency and assurances that the Department is appropriately protecting citizens’ rights, including privacy, is extremely important. Unfortunately, DHS has not issued any of the routine and required documentation about the program’s operations and safeguards or issued any public notice or notice to Congress. Recent reports indicate that the Department of Homeland Security has run more than 9 million voter records through the new SAVE system. It has been reported that the Department is apparently preparing to urge all state election officials to use this program but has not provided these officials with any briefings about its capabilities or safeguards.

We are also gravely concerned that the Department has not shared information with lawmakers and the public, but did reportedly provide a private advance briefing about the changes to the database to the Election Integrity Network, an organization founded by Cleta Mitchell, a lawyer who worked to overturn the results of the 2020 election. 

We request that USCIS brief the staff of the Senate Committees on Rules and Administration and Homeland Security and Governmental Affairs and provide any other materials that have been shared with external organizations like EIN about the updates to the SAVE program.

Further, Ranking Member Padilla previously posed a series of nomination hearing questions for the record to Joseph Edlow, the nominee to be Director of USCIS about the SAVE program but received no substantive responses in his reply. Given Mr. Edlow’s lack of response and the impact the use of this program will have on the American people, we are once again seeking complete and substantive answers to similar questions from you. As the program continues to be in use, we respectfully seek responses no later than July 29, 2025.

1) What level of access to the SAVE program and the underlying data that feeds into it was provided to staff of the Department of Government Efficiency?

a) What precautions, if any, were taken to ensure the integrity of the SAVE program and the data it accesses were not compromised?

b) In initiating your changes, what if any notice did you provide to the public on data privacy?

c) Will you commit that going forward USCIS will review and monitor all the user access, usage, and other relevant data related by all personnel to the SAVE program to ensure that individuals’ data is not compromised and compliance with the Privacy Act? 

2) USCIS has announced that users can search the program using an individual’s Social Security Number, name, and date of birth. What categories of information are being shared by USCIS with the Social Security Administration, and vice versa?

a) Does USCIS plan to segregate that data from searches that are conducted using a Department-issued identification number?

b) Can you describe the testing USCIS has done to confirm accuracy of this expanded program? What is your accuracy rate? Is it possible to determine what percentage of US citizens could be falsely identified as non-citizens in the SAVE program?

c) How will USCIS work to educate state and local election officials on the potential for falsely identifying individuals as noncitizens or providing inconclusive findings that can occur when using the system in the context of verifying voter eligibility?

3) How does the Department plan to fund the SAVE program now that it is free to government agencies at the federal, state, and local level?

a) What steps will be taken to ensure the program has the infrastructure to support this level of use, including hiring additional staff that may be needed for manual verifications to reconcile contradictory information? 

4) Does the Department have memoranda of agreement (MOA) with each state or local agency that uses the SAVE program?

a) If not, which agencies are using SAVE without an MOA? 

b) Existing MOAs between USCIS and states on voting require remediation steps before a state may remove a voter from their rolls following a SAVE program’s non-confirmation of citizenship. How is USCIS actively seeking to ensure that states are in compliance with this provision of the MOA? 

c) Will you make the MOAs public?

5) Is the expansion of this program covered by the SAVE System of Records Notice published in 2020?

a) If so, please provide a copy of the SAVE MOA or Computer Matching Agreement.

b) If not, please provide any relevant interagency data-sharing or data-matching agreements between the Department and the Social Security Administration.

6) Have you completed an updated Privacy Impact Assessment (PIA) for the SAVE program. If so, please provide a copy. If not, please address:

a) Data quality requirements and procedures

b) Data retention and information sharing policies

7) Does SAVE retain data from voter rolls? If so:

a) What data elements are saved?

b) Who within the Department has access to any saved data?

c) How long is this data retained?

As Secretary, you have a responsibility to assure the public that the Department is acting appropriately to protect citizens’ rights and personally identifiable data. We look forward to your prompt attention to these important questions.

How 17M Americans enrolled in Medicaid and ACA plans could lose their health insurance by 2034

The millions of people losing insurance include many who get coverage through the ACA marketplace. sesame/DigitalVision Vectors via Getty Images

The big tax and spending package President Donald Trump signed into law on July 4, 2025, will cut government spending on health care by more than US$1 trillion over the next decade.

Because the final version of the legislation moved swiftly through the Senate and the House, estimates regarding the number of people likely to lose their health insurance coverage were incomplete when Congress approved it by razor-thin margins. Nearly 12 million Americans could lose their health insurance coverage by 2034 due to this legislation, according to the nonpartisan Congressional Budget Office.

However, the number of people losing their insurance by 2034 could be even higher, totaling more than 17 million. That’s largely because it’s likely that at least 5 million Americans who currently have Affordable Care Act marketplace health insurance will lose their coverage once subsidies that help fund those policies expire at the end of 2025. And very few Republicans have said they support renewing the subsidies.

In addition, regulations the Trump administration introduced earlier in the year will further increase the number of people losing their ACA marketplace coverage.

As a public health professor, I see these changes, which will be phased in over several years, as the first step in a reversal of the expansion of access to health care that began with the ACA’s passage in 2010. About 25.3 million Americans lacked insurance in 2023, down sharply from 46.5 million when President Barack Obama signed the ACA into law. All told, the changes in the works could eliminate three-quarters of the progress the U.S. has made in reducing the number of uninsured Americans following the Affordable Care Act.

Millions will lose their Medicaid coverage

The biggest number of people becoming uninsured will be Americans enrolled in Medicaid, which currently covers more than 78 million people.

An estimated 5 million will eventually lose Medicaid coverage due to new work requirements that will go into effect nationally by 2027.

Work requirements target people eligible for Medicaid through the Affordable Care Act’s expansion. They tend to have slightly higher incomes than other people enrolled in the program.

Medicaid applicants who are between 19 and 64 years old will need to certify they are working at least 80 hours a month or spending that much time engaged in comparable activities, such as community service.

When these rules have been introduced to other safety net programs, most people lost their benefits due to administrative hassles, not because they weren’t logging enough hours on the job. Experts like me expect to see that occur with Medicaid too.

Other increases in the paperwork required to enroll in and remain enrolled in Medicaid will render more than 2 million more people uninsured, the CBO estimates.

And an additional 1.4 million would lose coverage because they may not meet new citizenship or immigration requirements.

In total, these changes to Medicaid would lead to more than 8 million people becoming uninsured by 2034.

Many of those who aren’t kicked out of Medicaid would also face new copayments of up to US$35 for appointments and procedures – making them less likely to seek care, even if they still have health insurance.

The new policies also make it harder for states to pay for Medicaid, which is run by the federal government and the states. They do so by limiting the taxes states charge medical providers, which are used to fund the states’ share of Medicaid funding. With less funding, some states may try to reduce enrollment or cut benefits, such as home-based health care, in the future.

Losing Medicaid coverage may leave millions of low-income Americans without insurance coverage, with no affordable alternatives for health care. Historically, the people who are most likely to lose their benefits are low-income people of color or immigrants who do not speak English well.

Protester holds sign that says 'My friend had cancer. ACA saved his life.'
A supporter of the Affordable Care Act stands in front of the Supreme Court building on Nov. 10, 2020. Samuel Corum/Getty Images

ACA marketplace policies may cost far more

The new law will also make it harder for the more than 24 million Americans who currently get health insurance through Affordable Care Act marketplace plans to remain insured.

For one, it will be much harder for Americans to purchase insurance coverage and qualify for subsidies for 2026.

These changes come on the heels of regulations from the Trump administration that the Congressional Budget Office estimates will lead to almost 1 million people losing their coverage through the ACA marketplace. This includes reducing spending on outreach and enrollment.

What’s more, increased subsidies in place since 2021 are set to expire at the end of the year. Given Republican opposition, it seems unlikely that those subsidies will be extended.

Not extending the subsidies alone could mean premiums will increase by more than 75% in 2026. Once premiums get that unaffordable, an additional 4.2 million Americans could lose coverage, the Congressional Budget Office estimates.

With more political uncertainty and reduced enrollment, more private insurers may also withdraw from the ACA market. Large insurance companies such as Aetna, Cigna and UnitedHealth have already raised concerns about the ACA market’s viability.

Should they exit, there would be fewer choices and higher premiums for people getting their insurance this way. It could also mean that some counties could have no ACA plans offered at all.

Ramifications for the uninsured and rural hospitals

When people lose their health insurance, they inevitably end up in worse health and their medical debts can mount. Because medical treatments usually work better when diagnoses are made early, people who end up uninsured may die sooner than if they’d still had coverage.

Having to struggle to pay the kinds of high medical bills people without insurance face takes a physical, mental and financial toll, not just on people who become uninsured but also their families and friends. It also harms medical providers that don’t get reimbursed for their care.

Public health scholars like me have no doubt that many hospitals and other health care providers will have to make tough choices. Some will close. Others will offer fewer services and fire health care workers. Emergency room wait times will increase for everyone, not just people who lose their health insurance due to changes in Trump’s tax and spending package.

Rural hospitals play a crucial role in health care access.

Rural hospitals, which were already facing a funding crisis, will experience some of the most acute financial pressure. By one estimate, more than 300 hospitals are at risk of closing.

Children’s hospitals and hospitals located in low-income urban areas also disproportionately rely on Medicaid and will struggle to keep their doors open.

Republicans tried to protect rural hospitals by designating $50 billion in the legislative package for them over 10 years. But this funding comes nowhere near the $155 billion in losses KFF expects those health care providers to incur due to Medicaid cuts. Also, the funding comes with a number of restrictions that could further limit its effectiveness.

What’s next

Some Republicans, including Sens. Mike Crapo and Ron Johnson, have already indicated that more health care policy changes could be coming in another large legislative package.

They could include some of the harsher provisions that were left out of the final version of the legislation Congress approved. Republicans may, for example, try to roll back the ACA’s Medicaid expansion.

Moving forward, spending on Medicare, the insurance program that primarily covers Americans 65 and older, could decline too. Without any further action, the CBO says that the law could trigger an estimated $500 billion in mandatory Medicare cuts from 2026 to 2034 because of the trillions of dollars in new federal debt the law creates.

Trump has repeatedly promised not to cut Medicare or Medicaid. And yet, it’s possible that the Trump administration will issue executive orders that further reduce what the federal government spends on health care – and roll back the coverage gains the Affordable Care Act brought about.

Portions of this article first appeared in a related piece published on June 13, 2025.The Conversation

Simon F. Haeder, Associate Professor of Public Health, Texas A&M University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

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Community

  • Lake County Wine Alliance offers sponsor update; beneficiary applications open 

  • Mendocino National Forest announces seasonal hiring for upcoming field season

Public Safety

  • Lakeport Police logs: Thursday, Jan. 15

  • Lakeport Police logs: Wednesday, Jan. 14

Education

  • Woodland Community College receives maximum eight-year reaffirmation of accreditation from ACCJC

  • SNHU announces Fall 2025 President's List

Health

  • California ranks 24th in America’s Health Rankings Annual Report from United Health Foundation

  • Healthy blood donors especially vital during active flu season

Business

  • Two Lake County Mediacom employees earn company’s top service awards

  • Redwood Credit Union launches holiday gift and porch-to-pantry food drives

Obituaries

  • Rufino ‘Ray’ Pato

  • Patty Lee Smith

Opinion & Letters

  • The benefits of music for students

  • How to ease the burden of high electric bills

Veterans

  • CalVet and CSU Long Beach team up to improve data collection related to veteran suicides

  • A ‘Big Step Forward’ for Gulf War Veterans

Recreation

  • Wet weather trail closure in effect on Upper Lake Ranger District

  • Mendocino National Forest seeking public input on OHV grant applications

  • State Parks announces 2026 Anderson Marsh nature walk schedule 

  • BLM lifts seasonal fire restrictions in central California

Religion

  • Kelseyville Presbyterian to host Ash Wednesday service and Lenten dinner Feb. 18

  • Kelseyville Presbyterian Church to hold ‘Longest Night’ service Dec. 21

Arts & Life

  • Auditions announced for original musical ‘Even In Shadow’ set for March 21 and 28

  • ‘The Rip’ action heist; ‘Steal’ grounded in a crime thriller

Government & Politics

  • Lake County Democrats issue endorsements in local races for the June California Primary

  • County negotiates money-saving power purchase agreement

Legals

  • March 3 hearing on ordinance amending code for commercial cannabis uses

  • Feb. 12 public hearing on resolution to establish standards for agricultural roads

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