The Brief

Becoming a doctor will likely become even more difficult under the new tax bill Congress approved after lawmakers slashed the amount of money medical school students can borrow in federal loans.

The extra burden may mean fewer students choose careers in medicine, particularly low-income students. Patients, in turn, may see fewer doctors practicing family medicine.

The new rules, part of the sweeping Republican-backed “big, beautiful bill” that President Donald Trump signed into law July 4, cap federal debt for professional degree students at $50,000 annually and $257,000 for the life of a student’s college journey, including undergraduate debt.

Previously graduate students could borrow up to the cost of their programs to afford their degrees with so-called Grad PLUS loans. Starting next year, those loans will disappear. While all graduate programs are affected by the new law, medical school lasts four years and regularly requires more than $300,000 for tuition, housing, food and other expenses for a degree.

Without public loans, many students will have to borrow from private lenders, which provide far fewer protections for loan repayment and, unlike federal plans, don’t offer loan forgiveness.

Public service loan forgiveness, which can occur after 10 years of employment in nonprofit settings, is a particular draw for medical school graduates who choose to work in government or nonprofit hospitals and care facilities that pay less but have a mission of treating the poor.

Private lenders may also deny some students loans or charge higher interest rates based on their financial history. Private loans typically require cosigners, which not all borrowers are able to arrange.

Martha Santana-Chin, chief executive of the insurer L.A. Care Health Plan, said the cost of college, medical school and loan repayment already presents “financial barrier after financial barrier” that prevents many from pursuing medicine. Reliance on private loans will make it even harder for low-income students in particular to become doctors, she said.

“If you don't have access to loans, if you don't have access to preferred loan terms, it's going to be that much more difficult for you,” Santana-Chin said.

The rules kick in for new students July 1, 2026. A student who has Grad PLUS before that date can continue to use it for their remaining program term, up to a maximum of three years.

The lower borrowing limits are a key way Congress tried to record savings in the tax bill. By capping how much graduate students can borrow, limiting how much loan debt is forgiven and increasing in many cases how much borrowers of all degrees pay monthly, taxpayers cover less of the tab. But the Republican bill includes huge tax and revenue cuts that, even with other budget savings, add more than $3 trillion to the national debt in the next decade. The higher-ed savings were about $300 billion.

”Straightforward economic logic would suggest (the new rules) are going to make it less likely for some of those students to be able to pursue graduate degrees than they are now,” said Jordan Matsudaira, a professor at American University. He was also chief economist at the U.S. Department of Education during the Biden administration.

“I don't think we've ever been in a position where we've sent students to the private loan market looking for loans on this scale to be able to finance their education,” he added.

California medical school debt levels

U.S. Department of Education data from the Biden administration that Matsudaira shared with CalMatters show California’s largest producer of doctors, the University of California, regularly graduates students with debt in excess of $200,000, the most the new law says a graduate student in a professional program may borrow from the government.

• At UC Irvine’s school of medicine, the median debt from federal loans for med students was $195,000 for the years 2019-20 to 2022-23. That means that half of the students borrowed more and likely almost all of the new students in those situations would need private loans. Twenty-five percent of students there borrowed at least $254,000 and 10% borrowed at least $284,000. 
• Every UC medical school had at least 10% of graduates with debt above $200,000. For UC Riverside, it was $270,000. At UCLA and UC San Diego, 10% of graduates borrowed more than $255,000. 
• Many new graduates in similar situations would need $55,000 to $70,000 or more in private debt to finance their education. 
• Four of the six UC medical schools had at least 10% of students borrowing more than $73,000 in a single year; new students in similar situations would need to find at least $23,000 in financing from private loans or some other support.
• At the private University of Southern California, 50% of graduates borrowed more than $260,000, and 25% borrowed in excess of $328,000, so a large chunk of new students would need to borrow at least $128,000 in private loans or find other ways of paying. A spokesperson for the school said no one was available to answer CalMatters’ questions. 

There were 1,334 students graduating with medical degrees and 361 with similar doctor of osteopathic medicine degrees in 2023, a UC San Francisco report found. The UCs accounted for nearly 800 medical degree graduates.

The University of California perspective

Calvin Yang, a rising senior at UC Berkeley, said attending medical school has been his dream since he was a child. The new caps on federal borrowing won’t deter him from becoming a doctor, but they’ll slow him down and may force him to attend cheaper schools.

He plans to take at least one gap year after he graduates next spring and work to save as much as he can to avoid private loans.

“It's frustrating to see restrictions on our ability to simply want to pursue an education in order to help the world, right?” he asked. “Long COVID persists. Mental health remains a major issue, diabetes, obesity — those all require medical professionals.”

He thinks some students will “reconsider the medical school pathway.” The loan caps are a concern among his friends with medical school ambitions.

“We do think that the private market will meet a lot of the needs of those students,” said Shawn Brick, associate vice provost of student financial support for the UC Office of the President. “Approval rates are fairly high for medical students.”

Still, “we do share the concern … about the student who may not have credit that would give them access to loans in the private market.”

Brick said the UC has time to work with private lenders on financial products that “would be more accessible to students who maybe don't have the best credit.”

The median loan size UC med students have had to borrow has declined by about $50,000 over the past four years, adjusted for inflation, UC data show. At the same time, UC grant aid for med students has grown by about 50%.

Nearly 3,000 UC med students receive an average of $32,000 in UC grants to support their education. The UC also issues its own loans, but in small numbers.

Doctors and advocates weigh in

Even before these changes, Dr. Julián Restrepo said medical school leaves doctors with so much debt that he knows people who are paying off loans decades after graduating, surgeons who work multiple jobs and resident physicians who pick up extra shifts to make ends meet.

“It is a huge burden for us, and it very well determines where we live, where we work, how we work and how we manage our practices,” Restrepo said.

Restrepo graduated from Texas A&M University’s medical school in 2012 and did his residency at Los Angeles County Medical Center. He now works as a primary care physician at a federally qualified health center in Los Angeles and said public service loan forgiveness is an effective way to recruit high quality physicians and specialists to underserved areas.

With interest, Restrepo’s loan of about $230,000 grew to more than $300,000. He made payments on the loan as part of the public service loan forgiveness program for about seven years until a Biden-era loan forbearance program temporarily kicked in.

An L.A. Care program aimed at recruiting physicians to underserved areas will pay off the remainder of his loans, and Restrepo said he’s extremely fortunate. At many points in his career he was forced to defer his loan payments because he couldn’t afford it.

The Association of American Medical Colleges also thinks the impending reliance on private loans may lead to fewer future doctors. “We are concerned that this added barrier could deter qualified candidates from pursuing a medical degree altogether, which could ultimately worsen the existing and expected physician workforce shortage,” said Kristen Earle, director of student financial services at the association, which oversees the medical school entrance exam. The association projects a national shortage of 86,000 physicians by 2036. California, like much of the country, has a shortage of primary care physicians, with the Central Coast, Central Valley and Southern Border regions projected to have the most severe shortages.

More pressure on medical residents

And while medical degrees eventually lead to relatively high salaries that are typically $220,000 a year to more than $400,000 depending on the specialization, early career doctors earn much less in residency, a training period of three to sometimes seven or more years. As residents, doctors work 60 to 80 hours a week for salaries of about $70,000 to $100,000, depending on the region and whether residents are unionized.

Private lenders offer a wide range of interest rates for medical school, from about 3% to more than 14%. Federal rates fall in the middle of that range, are less variable and pegged to inflation. Some private lenders indicate online that they don’t require borrowers to pay while they’re in residency for a few years, while others require only a small payment. In either case, the unpaid interest grows the overall debt a borrower will have to pay off.

Earle said she hopes that private lenders keep interest rates fairly low for medical school students because they're a good bet to pay off their debt given the higher earnings potential.

Mahima Iyengar is in her final year of residency at the massive Los Angeles General Medical Center to become a primary care physician.

She said she borrowed $250,000 in federal loans to attend medical school — $50,000 above next year’s maximum — and has no idea how someone like her would have avoided private loans. She wanted to study at the public University of Maryland, a less expensive option in her home state, but wasn’t admitted. Instead she attended the University of Rochester, another highly competitive but pricier private medical school hundreds of miles from home.

“I could have tried to live cheaper in med school, but I don't think it would have been much more possible than how I was living with three, four roommates,” said the 31-year-old, who’s also a leader in her union.

Like a majority of medical school students, Iyengar knew she’d use public service loan forgiveness.

Now that option will be gone for professional school debt above $200,000.

“We want a diverse group of people taking care of patients, because we know that patients have better outcomes from providers that understand where they've come from,” she said. But that diversity might ebb if lower-income students, who are more likely to be students of color, feel priced out of med school.

UC agrees. “We don't know for sure, but we are concerned about this slowing the efforts to build the physician workforce across the country, and especially in California, where we've got significant needs in primary care in rural areas,” said Heather Harper, spokesperson for UC’s medical operations.

L.A. Care has invested $255 million since 2018 in scholarships for medical students and loan repayment for physicians to try and recruit doctors, but Santana-Chin said it’s not enough money to meet the need. She hopes that medical schools see the federal changes as a “call to action” to make education more affordable, she said.

This story first appeared on The LA Local.

Rabbi Amy Bernstein says the wind-whipped fire in January 2025 that scorched much of the Pacific Palisades, destroying her home and damaging her synagogue, “blew everything open” for the community’s faith leaders.

“If our hearts must break, let them break open,” said the rabbi, who leads Kehillat Israel where 300 families out of 900 lost their homes. “This tragedy has really pushed us closer to one another. We’re working to change the things we need changed.”

Faith leaders both in the Pacific Palisades and in Altadena and Pasadena — devastated by the pair of fires that tore across Southern California — have relied on interfaith and community partnerships to rally congregants who are picking up the pieces 16 months later.

They’ve had to learn on the fly about insurance coverage and local land use regulations while still trying to keep their scattered flock together and raising money for basic needs. Pastors in Altadena have had to fight to protect the rights of Black people who decades ago found pathways to home ownership in that community despite redlining — but now risk losing their land to outside developers who sense an investment opportunity.

And throughout this span, faith leaders have had to cater to the emotional and spiritual needs of their communities and think about how they want to rebuild their sanctuaries that were lost or damaged in the fire. More than a dozen houses of worship burned to the ground or were damaged.

Interfaith relationships have become stronger after the fires

This would have been difficult for faith leaders to handle but for the interfaith relationships that became closer and stronger after the fires, said the Rev. Grace Park, associate pastor at Pacific Palisades Presbyterian Church, which burned down.

Methodists, Presbyterians, Catholics, Jews and yogis have not just found common ground in human suffering and loss, but have learned how to lean on one another in a time of dire need, she said.

“It’s a sense of mutual affection and respect, learning from each other and leaning on one another,” Park said. “We’re sharing the joys and the deep valleys of what it means to lead through a time of tragedy.”

Brother Satyananda, a senior monk at the Self Realization Fellowship, lost his living quarters and belongings in the fire. Much of the campus, started by Paramahamsa Yogananda who brought ancient spiritual practices from India to the West, fortunately survived the fire.

Satyananda recalls one day when Bernstein picked up on his sadness and offered him “motherly compassion.”

“We share the same profession where we’re tuned to people in need,” he said. “Now, our relationship has changed because we’re tuning into each other. There’s a greater level of trust.”

Pastor BJ King, who leads LoveLand LifeCenter, worked with the late Rev. Cecil B. Murray to heal communities and build interfaith coalitions after the 1992 Los Angeles riots.

“Back then, there was a choice whether or not to get involved,” he said. “But with these fires, there is no choice. It has affected everybody.”

Pastors have had to acquire new skills

King’s congregation has switched to online services after their leased church building in Altadena suffered smoke damage. Twelve families lost their homes. In addition to helping meet people’s basic needs, King has created a program organizing gatherings to connect therapists with those in need of mental health.

“Many people didn’t even know they needed that,” he said.

One of the most powerful roles faith leaders have played after the fire is to “continue to talk with power, people in charge,” said Pastor Jonathan DeCuir, who leads Victory Bible Church in Pasadena. He and others in the region have continued to meet with local officials and even conferred with Gov. Gavin Newsom to keep things moving for their communities.

DeCuir chairs the board of a nonprofit called Legacy Land Project, which provides financial aid, legal support and guidance on building contractors, as well as medical care to those affected by the fires.

The disaster has brought a level of camaraderie that DeCuir says he has never seen among the region’s clergy.

“Denominational lines have been crossed,” he said. “Even if we have different theological stances or approaches to ministry, we are all now looking at how to care for our people and community. If we don’t come together, Altadena will never ever be the same. The people won’t be there anymore. That, to me, is terrifying.”

While a church is more than a building, physical churches do appear as “beacons of hope” in traumatized communities, said Pastor Mayra Macedo-Nolan, executive director of Clergy Community Coalition in Pasadena. Her group has lobbied for houses of worship to be prioritized on the same footing as businesses in the rebuilding plan.

“When people start seeing churches rebuilding in Altadena, they’re going to feel like it’s going to be OK because the churches are coming back,” she said.

Reimagining a purposeful future

Pastor Jonathan Lewis, fourth from right, holds a groundbreaking service at the site of the burned Fountain of Life Nazarene Church to mark the beginning of its rebuilding in Altadena, Calif., April 26, 2026.

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Members of the congregation join in prayer during the groundbreaking ceremony at the site of the burned Fountain of Life Nazarene Church, marking the beginning of its rebuilding, April 26, 2026, in Altadena, Calif.

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Pastor Jonathan Lewis poses for a photo with his congregation during a groundbreaking service at the site of the burned Fountain of Life Nazarene Church, marking the beginning of its rebuilding, April 26, 2026, in Altadena, Calif.

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On April 26, the Altadena Fountain of Life Church broke ground to build a new sanctuary after their house of worship, which had stood for over three decades, was destroyed in the fire. Pastor Jonathan Lewis, who ministers to about 75, hopes the church will be ready in time for Easter next year.

“It’ll be a Resurrection Sunday for our church, too,” he said.

Alexis Duncan, who grew up in Altadena attending that church, came to the groundbreaking with her 6-year-old daughter. She lost both her home and her church building.

“It means everything to me that they’re rebuilding because I want the church to be there for my daughter as she grows up,” she said. “This new beginning gives me and my family hope and the encouragement to come back.”

Some churches like Altadena Community Church, a United Church of Christ congregation, are pausing to rethink their future purpose. The Rev. Michael Lewis, who took over in February after the previous pastor retired, said the congregation is looking into several possibilities for the one-acre lot, including affordable housing.

“We know that a church is not intended to be a landlord and the pastor is no property manager,” he said. “But, we’re also thinking about who is able to return to Altadena? How will this rich, economically diverse community that was scattered by the fire come back?”

The church has been around since the 1940s. A haven for actors, poets and musicians, the former sanctuary also served as a vibrant performance space. Lewis said they hope to incorporate a performance stage into the new facility.

“It’ll look different from what we had before,” he said. “Once we figure out how to build community, we can decide what physical structures will help us support that community.”

As for Kehillat Israel, on May 15, members will carry their Torah scrolls back to their sanctuary, marking one of the first returns by a house of worship to the Palisades since the disaster.

Judaism has had “a long history of starting over,” Bernstein said.

“It’s encoded in our cultural approach to the world, that there are things that can always be taken away from you,” she said. “But what you become can never get taken away.”

Gov. Gavin Newsom announced Friday that he has requested a yearlong extension of FEMA funding for L.A. fire survivors. Without the extension, the money will run out July 9.

Now the decision on FEMA support lies with the federal government.

The funds have allowed many survivors to afford temporary housing and other daily needs. Most have yet to return home — 2 in 3 survivors who were living in Altadena or Pacific Palisades at the time of the fires are still displaced, according to the latest survey of more than 2,100 survivors by the nonprofit Department of Angels. Nearly 40% of respondents reported they will either soon run out of temporary housing insurance coverage or have already.

The situation is particularly dire for low-income households: Nearly 80% of respondents making $50,000 or less said they didn’t think they could afford housing for three months once coverage ended.

“The data is clear: This recovery is not over,” said Angela Giacchetti of the Department of Angels at a news conference organized by the Eaton Fire Collaborative in Altadena on Thursday. “If you are a survivor, you know this in your bones. For many families, it has barely begun. People have just begun to stabilize. We need federal support that reflects the scale of this disaster and systems that survivors can actually navigate and access over time.”

FEMA assistance isn’t reaching most survivors

The FEMA Individuals and Households Program can provide funding for survivors of disasters to pay for temporary housing, repair their homes, and respond to other challenges that insurance may not cover. It can also help cover costs if a survivor has no insurance.

Gil Barel has been relying on FEMA funds to pay rent on a small back house for herself and her son for the last year. She said they still haven’t been able to return to their rent-controlled Pasadena apartment because of smoke damage, though she still has to pay the rent for it.

Gil Barel is paying rent on a smoke-damaged apartment in Pasadena while FEMA funds have helped her cut the cost of temporary housing.

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Barel doesn’t know what they’ll do if the FEMA funding runs out.

“ I'm really stressed out,” she said. “I think I'm just kind of trying to put that thought aside and hope for the best.”

But in the 15 months since the fires, most survivors have not accessed FEMA funding. About 60% have received no FEMA assistance beyond the initial $770 payments dispersed in the immediate aftermath of the fires, according to the Department of Angels survey.

Many have faced denials, according to disaster case manager workers with Catholic Charities of L.A. and lawyers with Legal Aid Foundation of L.A.

That’s the situation for Gayle Nicholls-Ali and her husband, Rasheed, who lost their Altadena home of 15 years in the Eaton Fire. They’ve relied on their insurance to pay for a rental in Montrose, but that’s rapidly running out. And because they have that insurance, FEMA has denied further support.

Gayle Nicholls-Ali and her husband, Rasheed, lost their home in the Eaton Fire. They plan to rebuild, but the cost is a major hurdle.

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“A lot of our ALE [Additional Living Expenses insurance] is going to run out before we even are able to get into a house,” Nicholls-Ali said.

Without FEMA or insurance support, they’ll have to find a way to pay rent on top of a mortgage. They also face a big gap in the cost of their rebuild versus how much their insurance covers. Nicholls-Ali said without the help of FEMA and other sources of funding, recovering feels further out of reach.

Funds for long-term recovery still in limbo

FEMA funding extensions have been routine in past disasters, including the 2023 wildfires in Hawaii and after devastating flooding in North Carolina in 2024.

But the agency has faced significant cuts during the second Trump administration, and there are indications that disaster aid is becoming increasingly political. For example, President Donald Trump has approved aid for just 23% of requests from states with a Democratic governor and two Democratic senators, compared to 89% for states that with Republican governors and senators, according to an analysis by Politico.

The state has also not received more than $33 billion for long-term recovery, which can help pay for infrastructure upgrades and repairs, as well as help rebuild schools, parks and homes. That money was requested by state and local leaders shortly after the January 2025 fires and hasn’t been appropriated by Congress.

An international team of disease detectives is now racing to connect with the more than two dozen passengers who disembarked the MV Honius cruise ship on the Atlantic island of St. Helena before the hantavirus outbreak was identified.

These individuals have flown across the world, including to the United States.

The risk of further spread of this virus is low since it requires close and prolonged contact with an infected individual — and those infected seem to transmit the virus for only a brief period of time. But public health officials want to make sure the outbreak is contained.

Here's how authorities are using the practice of contact tracing to contain the outbreak and keep the hantavirus from spreading.

Contact tracing 101

The concept of modern contact tracing dates to the 1930s and was part of an effort to stop the spread of syphilis. It involves locating the close contacts of anyone who may have been infected. "By identifying people who are at risk of infection," says Preeti Malani, an infectious disease physician at the University of Michigan, "you try to get ahead when people don't have symptoms yet with the goal of preventing the infection from continuing to propagate."

This is a well-tested approach for containing an infectious disease. "It's the oldest tool in the epidemiologic toolbox," explains Malani. "We thought about this a lot early in the pandemic with COVID. But we also do contact tracing for sexually transmitted infections, for things like meningitis and even measles."

Malani likens contact tracing to monitoring ripples in a pond, "trying to prevent those outer rings from propagating by isolating individuals and by identifying individuals who might be at risk of infection."

The idea that "there's a time period where people don't have symptoms but could be harboring the virus, that's what contact tracing helps identify," says Malani.

It starts by pinpointing someone with an infection or suspected infection of the disease in question — in this case, hantavirus. Epidemiologists then look to see with whom they've recently had close contact since these individuals are more likely to have been infected.

This hunt for those with the greatest probability of infection is important. "Otherwise, it becomes an impossible web to contain because everyone is connected to everyone," says Boghuma Titanji, an infectious diseases doctor at Emory University. "So you have to stratify by high, intermediate and low-risk contacts."

The next step involves public health agencies ordering precautions for those who are infected or who may be infected but aren't showing symptoms yet. Such measures may include quarantine, so that an individual doesn't come into contact with even more people — who may then become infected.

One challenge that hantavirus presents is that its incubation period can last up to several weeks. In other words, "people take a long time to become symptomatic after they've been exposed," says Titanji. "Some of these primary contacts would have to be monitoring themselves for symptoms for up to 45 days to be at the tail end of that very long incubation period."

Aboard and ashore

The work isn't high-tech but it is painstaking, requiring officials to reconstruct the many interactions someone may have had over days or weeks.

Onboard the cruise ship, "you might have an individual who is a source of an infection," says Titanji, laying out a hypothetical example. "And then they were sitting at a dinner table with one individual who then goes back to their cabin and shares a bed with their partner who has a conversation with someone else on the deck."

Once someone disembarks the ship, the number of potential interactions can grow quite quickly. This is why officials were concerned when a KLM flight attendant fell ill after being aboard a flight with one of the infected cruise ship passengers. Fortunately, the flight attendant ultimately tested negative for hantavirus.

Titanji is heartened by what she's seen playing out so far. "It seems like the international collaborative effort has been really robust and the mechanisms for containment are in place and underway," she says.

Public health officials argue that contact tracing is a powerful approach that will reduce further spread. "We can break this chain of transmission," said Abdi Mahmoud, the director of the World Health Organization's health emergency alert and response efforts, at a press conference on Thursday.

He has good reason to be confident. Contact tracing was vital during the fight against COVID-19 and helped end the Ebola crisis in Liberia, containing the epidemic there more than a decade ago. Some of the contact tracing even involved hours-long hikes through the jungle to a remote village.

Authorities are hoping for similar success with this hantavirus outbreak.
Copyright 2026 NPR

The sky above Los Angeles State Historic Park in Chinatown will be dotted with color Saturday with the annual Kite Festival.

The festival had its beginnings as a joyful protest in 2021, back when a proposal for a Dodger Stadium gondola included cutting through the airspace above the park. Organizers say last year’s Kite Festival drew a crowd of about 7,000.

“The Kite Festival, [for] some people, it’s their favorite day in Los Angeles,” said Sue Bell Yank, executive director of Clockshop, the nonprofit arts org that runs the festival. “It’s the time when they really feel connected to their city. More so than any other time.”

This year’s programming includes a kite-making station where you can build your own flying art for a donation of $5, along with art workshops and the unveiling of a large floating, inflatable sculpture by Guatemalan kite artist Francisco Ramos.