The Brief

Each year nearly 400,000 children with Medi-Cal health insurance lose coverage for a period of time and then must re-enroll. Often they still qualify for publicly subsidized healthcare but get kicked off because of administrative errors or lost paperwork. Sometimes their families miss the income cutoff by a couple of hundred dollars for a few months.

That’s a problem, advocates say, because early childhood comes with a host of vital health checks, vaccinations and developmental screenings. Without them, kids are at risk of falling behind on language development and social behaviors or missing early disease detection.

California tried to close that coverage gap in last year’s budget, but a November ballot initiative erased that investment even as it improved payments to doctors, clinics and hospitals that serve low-income households.

Now, children’s advocates are asking Gov. Gavin Newsom to try again and provide money for all low-income children to stay on Medi-Cal without renewal requirements until age 5 — but they concede it may already be too late.

The federal government must approve California spending Medi-Cal dollars this way, but the Trump administration’s executive order on federal spending and attempted funding freeze signaled an intent to make deep cuts to a variety of social safety net programs.

Still advocates say they are moving forward with their request for Newsom.

“This is a clear opportunity to address systemic barriers that hinder Medi-Cal access,” said Mayra Alvarez, president of the Children’s Partnership, the organization leading the funding request.

Statewide, about 56% of all children rely on Medi-Cal insurance.

Last year, in the midst of a multibillion-dollar deficit, Newsom and state legislators agreed to spend $33 million to fund the program starting in 2026. The money would draw from one of the only growing revenue streams available to the state during a tight year, a special tax on health insurance plans that helps fund Medi-Cal.

But the bill Newsom signed had a catch. It stipulated that if voters passed a ballot measure to invest a majority of the health insurance tax money on pay increases for Medi-Cal doctors, then continuous coverage and other investments made by lawmakers in the state budget would not be funded.

The ballot measure passed with an overwhelming 68% of votes.

Supporters argued, and voters agreed, that the nearly $7 billion raised by the health insurance tax annually should be used to shore up the state’s expansive and often strained public health insurance program. Pay increases would encourage more doctors and clinics to accept Medi-Cal patients, supporters argued.

This time around, advocates are less certain that the state would be able to spend money on continuous coverage for kids even if lawmakers agree to fund it.

Early congressional budget discussions indicate the GOP-controlled government wants to significantly reduce Medicaid spending. Medi-Cal is California’s version of the federal Medicaid program.

California can’t go alone on Medi-Cal change

California would need a waiver from the Trump administration to use the money from the health insurance tax in the way that advocates want.

“Our plan as a coalition is to continue moving forward and asking for the funding to be allocated and the waiver to be submitted,” said Courtney Armstrong, director of government affairs for the First 5 Association of California. “I don’t know what the likelihood is of the waiver being approved or not. Obviously it’s in the context of bigger threats to Medicaid. Potentially [the Trump Administration] is amenable to the argument that kids need access to health coverage.”

Advocates had pressured the state last year to submit a waiver request to invest in the program before President Joe Biden left office, but the Department of Health Care Services stopped pursuing the issue after the ballot measure passed in November.

According to a statement from the Department of Health Care Services, without funding it could no longer pursue the waiver request.

“The passage of Proposition 35 makes inoperative continuous coverage for children up to age 4” as lawmakers authorized last year, the statement from health care services said.

Medi-Cal kids are vulnerable

Providers who serve Medi-Cal patients say preventing kids from losing health insurance is critically important in their early years. Kids need regular pediatric checks and follow-up care. When they lose insurance, even temporarily, doctors and insurers also lose the ability to track and make sure they’re getting services on-time and not missing critical check points.

“This is singularly the most vulnerable population that we serve,” said Michael Hunn, chief executive officer of CalOptima Health, the largest Medi-Cal plan in Orange County. “We value and strongly recommend this continuous coverage because of what it means to set the health trajectory of an individual from little on.”

CalOptima serves nearly 74,000 children ages 0 to 5 and covers about 6,000 births each year, Hunn said.

“What I’m most concerned about with this change in continuous eligibility is that parents will have to make a choice between the medical care of their child and rent or food, and that is a very difficult place to put a family,” Hunn said.

For a few years during the federal COVID-19 emergency, eligibility checks were paused nationwide. During that time, the percentage of kids who “churn” in and out of Medi-Cal within one year dropped from 7.5% to 1%, according to Children’s Partnership, the group leading the budget ask. When the federal emergency ended, rates went back up.

“The writing was on the wall that this type of policy could avoid any child between 0 and 5 losing their care,” Alvarez with Children’s Partnership said.

One of the most frequent reasons why people lose Medi-Cal coverage is that their income exceeds the cutoff by $200, sometimes even less than $100, said Georgina Maldonado, executive director of the Community Health Initiative of Orange County, a nonprofit that helps people apply for Medi-Cal and other social services.

“The federal poverty level chart is not realistic for those that reside in California,” Maldonado said.

Supported by the California Health Care Foundation (CHCF), which works to ensure that people have access to the care they need, when they need it, at a price they can afford. Visit www.chcf.org to learn more.

The 2028 Summer Olympics and Paralympics in Los Angeles are officially two years away, and applications are now open to volunteer at the Games.

Organizers are seeking 60,000 people for roles like providing translation or guiding guests and athletes. They want volunteers for job categories including communications, driving, ceremonies and technology.

The bulk of volunteer positions will be in Los Angeles, with some opportunities in Oklahoma City, which will host a handful of competitions, and the Olympic soccer tournament sites, too.

Volunteering presents a potential way for some locals who balked at high ticket prices to participate in the summer Games, but they're a substantial commitment. Volunteers need to be available for 10 eight-hour shifts during either the Olympics or Paralympics if they want to participate.

A large volunteer program is a regular facet of the Olympics. In 1984, the last time L.A. hosted, nearly 29,000 people volunteered during the event.

To volunteer this time around, applicants need to be at least 18 years old and be proficient in English. Volunteers don't need to be local to Los Angeles or live in the U.S.

The first step is applying through LA28. Selected applicants will then have a chance to be interviewed in person in Los Angeles or online.

This summer's World Cup has been a bonanza for corporate sponsors.

Hydration breaks are "powered by Powerade." Each game crowns a Michelob Ultra "superior player of the match." Even the signs announcing player substitutions have a label slapped on: Rexona deodorant, which is owned by Unilever. They're the "official personal care sponsor" of this World Cup.

This relentless branding is nothing new for major sporting events, but it has provoked outrage in Los Angeles, where protests during the tournament took aim at FIFA's corporate partners, saying they betrayed the city's values.

At a demonstration in downtown L.A. last week, advocates rallied against a number of high-profile sponsors of the tournament, including Home Depot, the official "home improvement retailer" for the 2026 World Cup.

Its signature orange branding has been splashed across tournament activations this summer, but in the L.A. area its parking lots have been the sites of high profile immigration raids. Last summer in Monrovia, a man was killed fleeing ICE activity in a Home Depot parking lot after he ran onto a freeway and was hit by a car. In another incident, federal agents jumped out of a Penske moving van at the Westlake Home Depot and detained 16 people.

" Their parking lots have been turned into hunting grounds," said Miriam Arghandiwal, an organizer with the Boycott Home Depot Coalition.

" FIFA has been intentional in allowing the people's game to become the billionaire's game, and there's no better example of this than its choice in sponsors," she said at the protest.

The group also railed against FIFA partners Hyundai and Kia, citing a 2022 report that suppliers of Hyundai and Kia had used child labor in its Alabama factories. LAist has reached out to Home Depot and the Hyundai Motor Group, which also owns Kia, for comment.

Demonstrators said they wanted FIFA to make corporate accountability a metric of accepting a sponsor.

" We know mega-events like the World Cup can only happen with the support of host communities, local infrastructure and resources, with the workers throughout various supply chains that make these events possible," said Valerie Lizárraga with the nonprofit Jobs to Move America.

The group was also gathered to demand action from the Los Angeles Sports and Entertainment Commission, which runs the L.A. World Cup Host Committee. Demonstrators said they were dissatisfied with the committee's guidance on human rights for the World Cup.

A spokesperson for that commission deferred to FIFA for comment on corporate sponsorships. FIFA did not respond to LAist's request.

Last week, a small group of climate activists also demonstrated outside SoFi Stadium against Saudi energy company Aramco, another major FIFA partner. They were calling on FIFA to drop the fossil fuel giant as a sponsor.

The World Cup is wrapped up in Los Angeles after Friday's quarterfinal match between Spain and Belgium. But advocates rallying in L.A. say they are looking toward the future.

" Things like the World Cup [and] the Olympics are events that are fueled by people," said Father Thomas Carey, a member of Clergy and Laity United for Economic Justice. "The question is, do we hold them to account to take care of and protect the people who work for them and the people who attend their games?"

Next year, Los Angeles will host the 2027 Super Bowl. And the year after that will be the Olympics.

The Trump administration is abandoning its most aggressive attempt to end gender-affirming care for youth nationally, according to an official document obtained by NPR.

The document shows that the Department of Health and Human Services will not be finalizing a proposed rule that would have blocked all Medicaid and Medicare funding for hospitals that provide pediatric gender-affirming care.

The Centers for Medicare and Medicaid Services told NPR in a statement: "CMS does not comment on future rulemaking or speculate on potential actions. The Trump Administration rejects ideologically driven surgical interventions on vulnerable children."

(Surgery is very rare among transgender people under age 18, and the rule applied to all gender-affirming care, which is mainly therapy and medications for children.)

A "victory" for trans rights, but not a "retreat" by HHS

The fact that the Trump administration is backing off from this action is "a victory for people who are defending the rights and interests of trans people," says Sam Bagenstos, a professor at Michigan Law who served as general counsel at HHS under the Biden administration. "But I don't think it indicates a more general retreat from the aggressive posture of the Trump administration."

Bagenstos notes that this type of leverage — a "conditions of participation" rule for the Medicare and Medicaid program — has historically been used by HHS to compel states and hospitals to meet basic health and safety standards. Things like "making sure that you have stockpiles of certain kinds of equipment, making sure that you have certain kinds of emergency protocols, making sure that you have certain staffing ratios," he explains.

The proposed rule was unprecedented, Bagenstos says, because it instead would have prohibited certain kinds of treatments for a certain population. He says it seemed unlawful in a variety of ways. For one, "it violates the Medicare Act, which says that Medicare and Medicaid can't be used to control the practice of medicine within the state — states get to regulate the practice of medicine," Bagenstos says.

Medical groups opposed the change

Normally, HHS would propose a rule, accept public comment for 60 days, and then finalize the rule so that it could take effect. In this case, after proposing the rule in December and receiving more than 30,000 comments, the administration is abandoning the rule. At least in the next year, it will not be finalized and will not take effect.

The American Medical Association and the Children's Hospital Association both submitted comments urging the agency to rescind or withdraw the proposed rule. Major U.S. medical groups say that puberty blockers and sex hormones are safe and can be effective for transgender young people.

Even so, gender-affirming care for youth is banned in 27 states after a flurry of laws passed over the last several years. In the remaining 23 states, many hospital clinics that offer gender-affirming care have continued to operate, while others have shuttered in the past year citing pressure from the Trump administration.

That pressure has come in the form of this proposed rule, another rule that would bar federal Medicaid reimbursement for transgender pediatric patients, and a declaration from Health Secretary Robert F. Kennedy Jr. that aimed to redefine the standard of care. (Interestingly, the press release issued when those actions were unveiled in December is now missing from the HHS website, as is the Kennedy declaration document.)

The Medicaid rule is currently in the final stage of review and appears to be on track to take effect in the coming weeks. A coalition of Democratic-led states sued over the so-called Kennedy declaration and succeeded in blocking it in federal court in Oregon. The Trump administration has not appealed that decision so far.

Protesters who are against gender-affirming care for young people gathered outside Boston Children's Hospital in September 2022.

(

Carlin Stiehl for The Boston Globe

/

Getty Images

)

At the same time, the Department of Justice has issued administrative and criminal subpoenas to hospitals seeking full personal medical files for transgender youth and employment files for their medical providers, although many of those attempts have been blocked in court so far. The Trump administration has also reached settlements with hospitals in Texas and Ohio that involved establishing "detransition" clinics.

And last month, when the Supreme Court allowed states to bar young transgender girls from sports, the White House issued a press release saying that the decision "Bolsters President Trump's Push to Eliminate Transgender Insanity." The release listed actions targeting transgender people across the federal government, from passport markers to military service to research funding.

Will hospitals that ended care for trans youth restart it?

While the Trump administration does not appear to be backing down from anti-transgender actions broadly, its decision not to finalize its most aggressive healthcare rule is significant, says Katie Keith, director of the Health Policy and the Law Initiative at Georgetown University who also worked in the Biden administration. Those other efforts are not nearly as durable as a finalized rule that takes effect, she notes.

The decision of the Trump administration not to finalize this rule "should give hospitals more confidence to either resume or continue offering the care," she says. Because the rule was never in effect, "I would argue that they should have been doing this all along anyway."

Kellan Baker agrees. He's a senior adviser for health policy at the Movement Advancement Project think tank, which focuses on LGBTQ issues. "This administration may have checked itself in one of the most extreme expressions of its agenda and I think people should take solace in that," he says. "But at the same time, this administration is continuing to show that its ultimate goal is eliminating healthcare for trans people and that it is apparently prepared to use almost any means necessary to do so."

The Medicare and Medicaid rule could theoretically be revived at some point, since it has not been formally withdrawn. An entry in the Trump administration's recent unified agenda sets a final action date for the proposed rule as December 2028, just before President Trump leaves office.

Copyright 2026 NPR