The Brief

Despite the loss of federal subsidies that lowered costs for millions, California’s private health insurance marketplace held nearly steady this enrollment season. In all, 1.9 million Californians renewed their plan or selected one for the first time — a 2.7% drop compared to last year.

A closer look, however, shows Californians are making concessions to afford staying insured.

More enrollees are opting for “bronze-level” plans. These plans have lower monthly premium costs but higher deductibles and copays; they cover 60% of medical expenses — leaving enrollees to pay the rest. One-in-three new enrollees chose bronze plans for 2026, compared to one-in-four last year, according to Covered California. And 130,000 Californians renewing their coverage switched from a silver or higher-metal tier plan to bronze.

“Many Californians see the value in remaining covered, but they had to make sacrifices and shift to lower-tier plans. We see it as a commitment to health and the value that Covered California provides,” Jessica Altman, Covered California’s executive director said in a statement.

While bronze-level plans may offer people some peace of mind, the high deductibles and copays tend to discourage people from seeking care, said Miranda Dietz, director of the Health Care Program at the UC Berkeley Labor Center.

“Those out-of-pocket costs do impact people’s decisions to get care, so that’s worrisome as well,” Dietz said.

People earning above 400% of the federal poverty level — $62,600 for an individual and $128,600 for a family of four — no longer qualify for premium assistance after Congress chose not to extend the enhanced subsidies at the end of last year, pushing many to opt for plans with cheaper premiums or drop their marketplace plans entirely.

Of the 224,000 middle-income enrollees set to renew, 22% cancelled their plans, according to Covered California. New sign ups for people in this income bracket decreased by 59% compared to last year.

Whether those who renewed coverage or newly signed up continue to pay their premiums is another question. A clearer picture of who stays enrolled will emerge around April, Covered California said.

“Once you actually face the prospect of paying that premium and the stress that puts on your budget, it’s entirely possible that some of those folks may fall off, and the [enrollment] numbers might go down,” Dietz said.

Affording care: A growing stress point 

It’s unknown whether people who cancelled their marketplace health plans are enrolling in other types of insurance. Covered California data from the last five years show that when people terminate their marketplace plan, 10% to 14% of them report becoming uninsured.

The Affordable Care Act’s enhanced premium subsidies, first enacted in 2021 as part of federal COVID-19 response, helped lower the insurance costs for millions of Americans. They especially helped middle-income earners by allowing them to qualify for financial assistance for the first time, capping premiums at 8.5% of income. That help is now gone, and premiums are up an average of 10%.

Lower-income enrollees remain eligible for standard federal premium aid available since ACA marketplaces launched. They also benefit from state help. California allocated $190 million in 2026 to provide state-funded tax credits for people who earn up to 165% of the federal poverty level — $25,823 for an individual or $53,048 for a family of four — averaging about $45 a month per enrollee.The end of the enhanced federal subsidies also come at a time when poll after poll shows health care costs are a growing stress point for people. Seven in 10 Californians say health care expenses place a financial strain on their household, according to a recent survey by the California Health Care Foundation. Four in 10 have medical debt and six in 10 report skipping care. Meanwhile, eight in 10 Californians say making health care affordable is an “extremely” or “very” important priority for state officials and lawmakers in 2026.

Just past the doorway at ALTO, off busy Ventura Boulevard in Studio City, the bar opens up under exposed post-and-beam ceilings, tanned cowhides hanging along the walls like abstract art.

Grab a seat at one of the small tables and settle in for the open-fire South American restaurant's new, more casual bar concept, where street food takes center stage from executive Chef Esteban Klenzi and co-founder Juana Castellanos.

In its first year, ALTO has already landed a spot in the Michelin Guide California.

One culture, two chefs

Both chefs came up through fine dining — including time in Spain's Basque Country — and watched their peers wear rigid, high-pressure kitchen culture as a badge of honor.

But Castellanos and Klenzi wanted something different.

For Klenzi, cooking is as much about feeling as it is about food — an idea his new bar menu extends directly.

"It's like cooking at home for my friends or my family," he said.

ALTO Co-Founder Chef Juana Castellanos and Executive Chef Esteban Klenzi.

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Their connection runs deeper than the kitchen, though. Both chefs grew up around the Río de la Plata, the shared basin uniting Argentina and Uruguay into a single Rioplatense identity — once part of the same Spanish colonial territory before an 1828 treaty, brokered under British pressure, split them apart. Not unlike the Basque Country straddling Spain and France: one culture, divided by a border neither side chose.

What to order

The bar leans into what Klenzi calls the rotisserías tradition — the everyday, prepared-food spots common across Argentina. That shows up in the Tongue & Trout Roe Toast ($17): sous-vide beef tongue over brioche, finished with a celery-carrot vinaigrette and a crown of trout roe. It's a savory, briny bite, perfect for sharing to start the meal.

Close-up of two pieces of toast on a dark plate, each topped with ruffled, thin-sliced beef tongue tinted pale pink, scattered with chopped herbs and diced vegetables, and crowned with a generous mound of glistening orange roe.

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The Real Deal ($18) — ALTO's take on the classic choripán sandwich — pulls from the dinner menu, too: short rib and smoked pork, the same cuts used in the Asado Banderita and Pork Txuleta.

When the pair first sat down to design the menu, Klenzi found himself facing a deceptively simple question: "Should we make a burger? Or shall we make a choripán?"

They chose the choripán, prizing the way beef and pork together deliver, in his words, "the best flavor you can get from both of them." Lard from the pork chop trim adds richness; the short rib's fat keeps the sausage moist, with smokiness carried over from that same applewood-smoked chop.

For something heartier, there's the Banderita & Frites ($39): a thinner cut of short rib than its dinner-menu counterpart, seared on both sides.

Alongside it, try the smashed potatoes from Weiser Family Farms, cooked in the charcoal oven with beef tallow. Klenzi refuses to serve french fries — this is his answer instead, crisp outside, rich with tallow underneath.

What to drink

A pour from ALTO's Vermucito Experience, served over ice with soda water.

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Ever since I wrote about Spanish vermouth last month, I've been a magnet for the stuff — not complaining, especially during these warmer months. ALTO had me covered, though the serving style looked nothing like what I'm used to.

Unlike the Spanish and Italian style of an orange slice and olive, Argentine vermouth is served over ice with soda water — lighter, easier to drink.

A cozy corner of ALTO's dining room, where velvet chairs surround a wood-burning fireplace.

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On the table: a trio from the Vermucito Experience — Las Flores blanco from Uruguay, and La Fuerza's rojo and sideral from Argentina, Malbec-based pours ranging from $12 to $22.

"When you pour it in the glass, it's almost red. It looks almost like a wine," Klenzi said of La Fuerza's rojo, made with Malbec. "You can really feel the pure essence of the Malbec wine."

The regular dinner menu is a great choice for a special night out. But the bar is for every other night — the "almost every day" Klenzi imagined when he decided a choripán, not a burger, was the answer.

"If we see your face every day, we're gonna take care of you every day," Klenzi said.

The Trump administration on Thursday proposed significant changes to Head Start, the nation's early education program for children from low-income families. The move would diminish the program's federal standards and give states and parents more control.

"We have 1,600 Head Start providers across the country," Alex Adams, the U.S. Department of Health & Human Services' assistant secretary for family support, said in a call with reporters. "And one-size-fits-all mandates from Washington cannot fully account for the realities facing these 1,600 grantees."

Head Start not only provides preschool and childcare, but also meals and support services for qualifying families. It now serves more than 700,000 kids each year from birth to age 5.

Since its launch in 1965, the $12 billion HHS program has, for the most part, enjoyed bipartisan support. Lawmakers often cite it as a success — including Health Secretary Robert F. Kennedy Jr. during the call with reporters announcing these changes. But in recent years, some conservatives have criticized Head Start, saying it wastes money and fails to have a lasting impact on students.

Aiming to cut costs

The new proposal would limit the amount of money Head Start centers can spend on administrative overhead, from a 15% cap to 5%. This change should save the government $2.2 billion, Adams said, which it plans to reinvest in the program. The goal is to create 200,000 more spots for children, he said.

To get those costs down, the administration said it proposes cutting regulations and "compliance-driven activities," according to a press release. Similarly, they are shifting decisions about several standards — such as student-teacher ratios, education requirements, background checks and transportation practices — back to states.

Childcare providers are not sold on the proposal.

"If we look at the previous actions of the administration, what they have done is not in favor of expanding the program," said Yvette Sanchez Fuentes, senior vice president with Start Early, an Illinois-based Head Start partner.

"Is it enough to just bring kids in the door if we're not actually giving kids and families what they need?"

Sanchez Fuentes said administrative costs are not only things like payroll and day-to-day operations, but also help fill gaps in care. "If you, for example, have children with disabilities you [can use] some of those funds to pay for additional special services or staff with specialties who could come in and support kids."

The administration's proposal also says parents are children's primary teachers and seeks to bring in more parent opinions on "structure and curriculum" into the classrooms and emphasizes nutrition and exercise.

Loosening the standards

Head Start's current standards are laid out in a detailed 133-page guide. The manual is used not only by the program's centers, but also by many unaffiliated private childcare centers across the country.

These standards include safety guidelines, spell out who is eligible for Head Start and provide detailed rules — such as the requirement that kids in the program brush their teeth once daily with fluoride toothpaste.

Erica Phillips, the executive director for the National Association for Family Child Care, said about 10% of her members are Early Head Start childcare partners, while the rest are home-based providers around the country.

"The Head Start performance standards were a consistent … evidence-based set of standards," she said. "It can be helpful to have a nationally recognized benchmark."

Phillips said her organization will be on the lookout for variations across states. She said she worries "quality is now dependent on your ZIP code or on your geography."

The Trump administration sees it differently.

"Flexibility is permission. It's not a mandate," Adams said. "The opportunity for these programs to make a different decision does not necessarily mean they must make a different decision."

The changes did not come as a complete surprise: The conservative Heritage Foundation has long criticized the program, saying it "doesn't work." In Project 2025, the foundation's policy blueprint that the Trump administration has taken many cues from, the message is clear — eliminate Head Start.

Advocates see what they characterize as the erosion of quality and decrease in standards as the first step in dismantling the program.

A long runway

Thursday's announcement came in the form of a notice of proposed rulemaking, or NPRM. It kicks off a lengthy, formalized process of public comment and talks with stakeholders. It could be six months to a year before any new standards take effect.

"I just really want folks to know Head Start is open," said Tommy Sheridan, deputy director at the National Head Start Association (NHSA), a nonprofit that advocates for the program. "The quality of Head Start children and families truly comes from the people that are running Head Start programs. Those folks are going to be the same. They're going to be able to do that."

The administration says the NPRM will be published in the Federal Register on Friday and be open to public comment for 60 days.

Edited by: Natalie Escobar
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