The Brief

Faced with potential federal spending cuts that threaten health coverage and falling childhood vaccination rates, Monica Soni, the chief medical officer of Covered California, has a lot on her plate — and on her mind.

California’s Affordable Care Act health insurance exchange covers nearly 2 million residents and 89% of them receive federal subsidies that reduce their premiums. Many middle-income households got subsidies for the first time after Congress expanded them in 2021, which helped generate a boom in enrollment in ACA exchanges nationwide.

From the original and enhanced subsidies, Covered California enrollees currently get $563 a month on average, lowering the average monthly out-of-pocket premium from $698 to $135, according to data from Covered California.

The 2021 subsidies are set to expire at the end of this year unless Congress renews them. If they lapse, enrollees would be on the hook to pay an average of $101 a month more for health insurance — not counting any premium hikes in 2026 and beyond. And those middle-income earners who did not qualify for subsidies before would lose all financial assistance — $384 a month, on average — which Soni fears could prompt them to drop out.

At the same time, vaccination rates for children 2 and under declined among 7 of the 10 Covered California health plans subject to its new quality-of-care requirements. Soni, a Los Angeles native who came to Covered California in May 2023, oversees that program, in which health plans must meet performance targets on blood pressure control, diabetes management, colorectal cancer screening, and childhood vaccinations — or pay a financial penalty.

Lack of access to such key aspects of care disproportionately affects underserved communities, making Covered California’s effort one of health equity as well. Soni, a Harvard-trained primary care doctor who sees patients one day a week at an urgent care clinic in Los Angeles County’s public safety net health system, is familiar with the challenges those communities face.

Covered California reported last November that its health plans improved on three of the four measures in the first year of the program. But childhood immunizations for those under 2 declined by 4%. The decline is in line with a national trend, which Soni attributed to postpandemic mistrust of vaccines and “more skepticism of the entire medical industry.”

Most parents have heard at least one untrue statement about measles or the vaccine for it, and many don’t know what to believe, according to an April KFF poll.

Health plans improved on the other three measures, but not enough to avoid penalties, which yielded $15 million. The exchange is using that money to fund another effort Soni manages, which helps 6,900 Covered California households buy groceries and contributes to over 250 savings accounts for children who get routine checkups and vaccines. Some of the penalty money will also be used to support primary care practices around California.

In addition to her bifurcated professional duties, Soni is the mother of two young children, ages 4 and 7. KFF Health News senior correspondent Bernard J. Wolfson spoke with Soni about the impact of possible federal cuts and the exchange’s initiative to improve care for its enrollees. This interview has been edited for length and clarity.

Soni worries about a decline in childhood vaccination rates and potential federal budget cuts that could lead to large-scale disenrollments.

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Q: Covered California has record enrollment of nearly 2 million, boosted by the expanded federal subsidies passed under the Biden administration, which end after this year. What if Congress does not renew them?

A: Our estimates are that it will approach 400,000 Californians who would drop coverage immediately. We hear every day from our folks that they’re really living on the margins. Until they got some of those subsidies, they could not afford coverage.

As a primary care doctor, I am the one to treat folks who show up with preventable cancers because they were too afraid to think about what their out-of-pocket costs would be. I don’t want to go back to those days.

Q: Congress is considering billions in cuts to Medicaid. How would that affect Covered California and the state’s population more broadly, given that more than 1 in 3 Californians are on Medi-Cal, the state’s version of Medicaid?

A: Those are our neighbors, our friends. Those are the people working in the restaurants we eat at. Earlier cancer screenings, better chronic disease control, lower maternal mortality, more substance use disorder treatment: We know that Medicaid saves lives. We know it helps people live longer and better. As a physician, I would be hard-pressed to argue for rolling back anything that saves lives. It would be very distressing to watch that come to California.

Q: Why did Covered California undertake the Quality Transformation Initiative?

A: We were incredibly successful at covering nearly 2 million, but frankly we didn’t see improvements in quality, and we continue to see gaps for certain populations in terms of outcomes. So, I think the question became much more imperative: Are we getting our money’s worth out of this coverage? Are we making sure people are living longer and better, and if not, how do we up the ante to make sure they are?

Q: There’s a penalty for not meeting the targets, but no bonuses for meeting them: You meet the goals or else, right?

A: We don’t say it like that, but that is true. And we didn’t make it complicated. It’s only four measures. It’s things that as a primary care doctor I know are important, that I take care of when I see people in my practice. We said get to the 66th percentile on these four measures, and there’s no dollars that you have to pay. If you don’t, then we collect those funds.

Q: And you use the penalty money to fund the grocery assistance and child savings accounts.

A: That’s exactly right. We had this opportunity to think about what would we use these dollars for and how we actually make a difference in people’s lives. So, we cold-called hundreds of people, we sent surveys out to thousands of folks, and what we heard overwhelmingly was how expensive it is to live in California; that folks are making trade-offs between food and transportation, between child care and food — just impossible decisions.

Q: You will put up to $1,000 a child into those savings accounts, right?

A: That’s right. It’s tied to doing those healthy behaviors, going to child well visits and getting recommended vaccines. We looked at the literature, and once you get to even just $500 in an account, the likelihood of a kid going to a two- or four-year school increases significantly. It’s actually because they’re hopeful about their future, and it changes their path of upward mobility, which we know changes their health outcome.

Q: Given the rise in vaccine skepticism, are you worried that the recent measles outbreak could grow?

A: I am very concerned about it. I was actually reading some posts from a physician colleague who trained decades earlier and was talking about all the diseases that my generation of physicians have never seen. We don’t actually know how to diagnose and take care of a number of infectious diseases because they mostly have been eradicated or outbreaks have been really contained. So, I feel worried. I’ve been brushing off my old textbooks.

This article was produced by KFF Health News, which publishes California Healthline, an editorially independent service of the California Health Care Foundation.

KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.Subscribe to KFF Health News' free Morning Briefing.

This article first appeared on KFF Health News and is republished here under a Creative Commons license.

Bob Mackie, a prolific costume and fashion designer whose dazzling, over-the-top creations helped define some of the most memorable moments in 20th century entertainment, died at 87 years old Monday of pneumonia in Palm Springs, Calif.

Mackie's official Instagram channel shared news about the designer's death.

"It is with a heavy heart that we share the news that Mr. Bob Mackie passed away today," the statement on Instagram said. "He lived his 87 years to the fullest, fulfilling his dream of being a Fashion and Costume Designer, which is all he ever wanted to do. His genius and extraordinary designs will live on forever, continuing to bring beauty into this world."

Over a career spanning more than six decades, Mackie dressed generations of stars from Bette Midler to Taylor Swift. Some of his designs became as famous as the performers who wore them, such as Marilyn Monroe's risqué, rhinestone-encrusted sheath dress worn while singing to President John F. Kennedy in 1962 (which he sketched for his employer, French designer Jean Louis), and Cher's jet-black, bondage-inspired ensemble topped with a feathered Mohawk headdress at the 1986 Oscars.

"The way you dress is your way of telegraphing to the person that's looking at you, who you are and where you're coming from," Mackie told NPR in 1990.

Cher and Bob Mackie attend the premiere of "Bob Mackie: Naked Illusion" in 2024 in Los Angeles. The pair enjoyed a long performer-designer partnership.

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While Mackie was celebrated as a haute couture designer, he was far more passionate about crafting one-of-a-kind looks for entertainers. "I think there are people who design runway fashion who say they're like telling a story. No, they're not. They're just making a cute frock and hope somebody buys it," he told the NPR-distributed podcast Bullseye with Jesse Thorn in 2025.

Growing up in Southern California, Mackie's fascination with glamour came from Hollywood, not high fashion. "I never looked in a fashion magazine when I was a kid. But I looked in all the movie magazines and theater magazines," he said on Bullseye. "That was more interesting to me."

Mackie dropped out of his studies at the Chouinard Art Institute — now part of California Institute of the Arts — when he was spotted by the legendary designer Edith Head and landed a job sketching for Paramount Studios in 1961. His career quickly took off, and he forged lasting relationships with such entertainment royalty as Whitney Houston, Bette Midler, Tina Turner, Diana Ross and Carol Burnett.

For The Carol Burnett Show, which started in the late 1960s and ran for more than a decade, Mackie designed an estimated 17,000 costumes — about 50 per week. One of his most famous creations was the outrageous dress for Burnett's 1976 Gone With The Wind parody where she appeared as "Starlett O'Hara" wearing a green velvet dress made from curtains — with the curtain rod still attached. That dress now resides in the Smithsonian Institution's National Museum of American History.

"Not all of our sketches were gems. Some were bombs," Burnett recalled in a 2003 Fresh Air interview. "Sometimes he would put me in stuff that would literally save the sketch."

Perhaps nothing captured Mackie's theatrical sensibility more than the ludicrous Donald Duck costume — complete with webbed booties and oversized rear end — that Elton John wore while performing at a 1980 concert in New York's Central Park.

"It was very difficult for me to play the piano, plus the fact I'd never walked in flippers before," John reminisced in Who Is Mackie?, a short film about the designer. "I was dancing across the stage, falling over myself, and I just couldn't sing for laughing – because it looked ridiculous, but it looked fabulous."

Miley Cyrus in Bob Mackie as she performs onstage in 2024 at the 66th GRAMMY Awards in Los Angeles.

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Mackie continued dressing major 21st-century stars such as Miley Cyrus, Zendaya and Pink. He also collaborated with Mattel on a line of Barbie dolls. His awards included nine Emmys, a Tony Award, three Oscar nominations, and lifetime achievement awards from the Council of Fashion Designers of America and RuPaul's Drag Race. He had served as the show's first guest host and jokingly referred to himself in some media interviews as "the patron saint of drag queens."

"I know exactly which outfits he did because there is a rhythm and a movement and a choice of proportions of color that no one else does like that," RuPaul said in the 2024 documentary Bob Mackie: Naked Illusion. "That's how you know that someone is channeling the divine."
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A month into the school year, teachers in the Los Angeles Unified School District are still adapting to the district’s new policy that bans screen time for its youngest kids and will soon place significant restrictions on older students.

One first grade teacher has switched to jigsaw puzzles instead of having her students complete activities on a learning app. A middle school science teacher is considering how to teach Newton’s Third Law of physics with toy cars instead of a video simulation. Some teachers say they are struggling to adjust after years of technology woven into their curriculum.

“Our goals haven’t changed whether we’re on screens or not,” said Armaghan Khan, an eighth grade teacher at Johnnie Cochran Jr. Middle School. “The idea is still to provide quality standards of mind instruction. And so, what does that look like when you’re not on a screen? And for a lot of the newer teachers, myself included, we’ve never really taught that way.”

Passed in June, LAUSD’s policy generally prohibits use of district-issued devices for students in early education through first grade. It places caps on every other grade level — the higher the grade, the more screen time is allowed. And by the time students reach high school, they are allowed up to 90 minutes per week in each subject area.

The new policy followed months of organizing by parents who argued that students — and teachers — had become too dependent on digital devices in classrooms. They argued that schools should prioritize teacher-led instruction, hands-on activities and interaction with peers. Some also said their children’s struggles to regulate their emotions were a direct result of using screens in the classroom.

But the new restrictions on screen time have also meant that teachers have to rethink lessons built around laptops, tablets and digital instructional programs. Many are concerned about students with disabilities and English language learners who may disproportionately rely on technology, even though accommodations are possible.

Corinne Hyde, a professor of education at USC, said she worries that the policy could unnecessarily restrict teachers’ ability to use technology when they believe it would benefit students.

“We should trust teachers to make good instructional decisions, and that as long as we equip them with appropriate professional development and support, that they are fully capable of making the appropriate decisions about how to use technology in their classrooms, or if they should use technology in their classrooms,” said Hyde.

No screen time for LAUSD’s youngest learners

Last year, the youngest daughter of Julie Edwards, a parent and member of the group Schools Beyond Screens, would come home obsessed with JiJi, a penguin cartoon that appears on a gamified learning platform. Now, Edwards’ first grader comes home eager to talk about her friends and her school’s ticket-based rewards system, she says.

“There’s still more work to do,” said Edwards. “But I think everything is like moving in such a great direction, and I’m just really hoping that because this is happening on an institutional level, it really starts to filter down into families’ personal lives.”

Edwards’ daughter’s teacher has made a number of changes to go screenless. So has Martha Medina, a first grade teacher at Logan Academy of Global Ecology, who also lost other classroom support. This year, she no longer has instructional coaches, who help with targeted learning interventions, or teachers’ aides.

Medina had planned to have students rotate among three 15-minute stations so she could provide individualized attention. One station would be with her, another in the library and a third would use a learning app on an iPad.

Under the new policy, Medina can no longer use the app as planned. Instead, students at the third station work on jigsaw puzzles or art-related activities designed to reinforce uppercase and lowercase letters.

She said the changes have made it much more difficult to run the three groups, limit constant disruptions and keep children on task.

“Parents are worried that the kids are going to be on the iPad all day,” she said. “That’s just not the case in primary. There’s no way we can have the kids on iPads all day. There’s too much to teach.”

Teachers prepare for changes ahead

Khan is among the upper-grade teachers who are adjusting their lesson plans to comply with limits that will go into effect in January.

Under the policy, middle school students will be limited to one hour of screen time each week in each subject area.

“I feel a lot of times the district leadership comes up with these ideas, and however well intentioned they are, they leave it to the rest of us to kind of figure out how to implement them, or just what the best case looks like,” Khan said.

He added that he has spent the past eight years building his curriculum around electronic devices. Like many schools nationwide, his school had been a “one-to-one,” meaning each student has access to a device. Those devices had largely replaced textbooks, and, to some extent, paper and pencil.

“We were using a lot of digital resources, and some of them have been really amazing,” he said.

One of Khan’s favorite tools is Gizmos, a program that allows him to show students simulations to explore science concepts that can be difficult to demonstrate in a classroom. For example, students visualize the heart pumping blood through veins and arteries throughout the body. Or, they can explore Newton’s Third Law — the concept that for every action, there is an equal and opposite reaction — through a simulated car crash.

“I can always get two toy cars and have them crash together so they can see the law and effect,” Khan said. “But with the simulation, it lets me just get much more granular and just deeper into just how it applies to their everyday lives.”

He also said technology has been particularly important for students with disabilities and English language learners, who may rely on digital tools for accommodations and language support.

The district told EdSource that it has made professional learning opportunities available to school administrators and teachers, both in-person and virtually, to help with the transition.

“Our goal is to ensure that all school sites are well-prepared with the tools, understanding, and support needed to effectively implement these guidelines in a way that supports student learning and well-being,” LAUSD said in a statement.

Khan said he has not had access to that support yet. Still, despite what he described as “growing pains,” he remains optimistic about the changes.

“I do think there is merit in the idea. I don’t just want to be doom and gloom about having to switch,” Khan said. “I’m looking forward to the challenge.”

This story first appeared on Long Beach Post.

Automated speed cameras have arrived in Long Beach, and they’re scheduled to begin issuing tickets soon.

The cameras are part of a state-authorized pilot program to see if writing automated speeding tickets can make roads safer.

A speed limit sign is posted as crews install new speed cameras on Artesia Boulevard in North Long Beach on Friday, Sept. 11, 2026.

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Long Beach has seen a surge of deadly crashes in recent years and was picked as a pilot city after the mayor and city officials lobbied for the chance to install cameras.

When they start

Crews began installing the speed cameras this week. Nearby signs will warn drivers, said Joshua Hickman, director of Public Works. The cameras will start issuing warnings for 60 days before citations start.

The warning period is expected to start in October; then citations would start going out in December, Hickman said.

How they work

The cameras capture only the rear license plates of drivers speeding 11 mph or more over the posted speed limit. Based on that license plate information, a citation will be issued to the address where the car is registered.

License plate data is kept within the Public Works Department and not shared with any law enforcement agencies, including Long Beach police, Hickman said.

Where they are

Half of the cameras are on streets where deadly or severe crashes have occurred most often. The other half are going in school zones or in areas where street racing is a problem.

You can find an interactive map of the speed camera locations here.

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How much is a citation

Citations range from $50 to 500 based on speed.

If a driver does not receive any warnings during the 60-day warning period, then the first speeding offense will result in a warning. After that, they will get a citation with a fine.

Payment is due within 30 days, but payment plans and diversion programs are available.

You can find more info on those here.

How will the money be spent?

The city anticipates half of the speeding ticket revenue, roughly $2.5 million, will cover the costs of running the camera program.

The other half will be spent on traffic-calming measures in neighborhoods where traffic engineers determine they’re needed most. The state law authorizing the pilot program says the money can’t be spent on anything else.

Safety measures could include crosswalks, no-turn-on-red signs and speed humps. The city has received an influx of requests from residents asking for some sort of safety measure in their neighborhood since the start of the year.

Traffic deaths

Residents have said they’re fed up with dangerous streets, and the city is trying to respond.

Last year, Long Beach recorded its deadliest year on the roadways in more than a decade – 53 fatal traffic collisions.

Scott Musquiz mounts new speed cameras onto a light pole on Artesia Boulevard in North Long Beach on Friday, Sept. 11, 2026.

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Earlier this year, Long Beach City Council directed the Public Works Department to hire third-party contractors to speed up their ability to install quick-build safety measures.

But traffic deaths this year have kept up the pace. At this time last year, the city had tallied 35 traffic deaths. As of Friday, this year’s total is at 33.

State pilot

Long Beach is able to install speed cameras thanks to a 2023 state bill that approved a five-year pilot for Long Beach as well as six other cities.

The city was allowed to install speed cameras immediately after the bill passed and had until Jan. 1, 2027, to begin the pilot.

Street safety advocates have criticized Long Beach for its delayed rollout compared to other cities.

Success in other cities

San Francisco installed 33 speed cameras last October and reported a 72% reduction in speeding after six months of citations.

Brian Woodward, left, gets assistance as he prepares a speed camera to be mounted as crews install new cameras on Artesia Boulevard in North Long Beach on Friday, Sept. 11, 2026.

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In Oakland, 18 speed camera locations saw a 70% drop in speeding drivers, on average.

Los Angeles and Glendale have yet to deploy their speed cameras.

Potential expansion to PCH

A state bill currently on Gov. Gavin Newsom’s desk would allow Long Beach to install two more speed cameras on Pacific Coast Highway.

If signed, the cameras could be installed as soon as Jan. 1 and would follow the same rules as the other cameras.

The aftermath of a fatal high-speed crash at Anaheim Street and Pacific Coast Highway on March 23, 2020.

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PCH is a state route, meaning it was not included in the state pilot program because it’s not controlled by the city of Long Beach.

State Sen. Lena Gonzalez, who authored the bill, said PCH accounts for about one-fifth of the city’s traffic deaths despite covering less than 1% of the city’s roadways.

The 78th Emmy Awards air Monday night, hosted by Law & Order: SVU star Mariska Hargitay.

The Television Academy already kicked things off earlier this month: what was once the Creative Arts Emmys was expanded and rebranded into a two-night ceremony highlighting casting, guest actors, game shows, documentaries, behind-the-scenes craftspeople and more. Rob Reiner was posthumously awarded his third Emmy for a guest appearance on The Bear. Hargitay, Monday night's host, won two awards for her documentary My Mom Jayne. 

Monday's ceremony will include 19 awards, including those for top comedy series, top drama series and best actor and actress in each.

Here's what to know to watch the ceremony.

When are the Emmy Awards this year?

The show will be live Monday night on NBC and Peacock starting at 8 p.m. ET, 5 p.m. PT. A pre-show and live coverage will air on E! starting at 5 p.m. ET, 2 p.m. PT.

Who is nominated this year?

Familiar titles like Hacks, Abbott Elementary and The Bear are all nominated for top comedy series alongside newcomers Widow's Bay and Margo's Got Money Troubles. On the drama side, last year's winner The Pitt is facing off against Pluribus, Slow Horses, The Diplomat and more.

A whole swath of actors on The Pitt got their first nominations this year, as did Dale Dickey and Kate O'Flynn for Widow's Bay. You can find the nominees here, along with hopes from NPR critics here.

What else can I expect? 

The Television Academy has announced that Noah Kahan will perform "Bridge Over Troubled Water" as part of the In Memoriam segment. Presenters will include Alan Cumming, Sally Field, Jon Hamm, Marcello Hernández, Niecy Nash-Betts, Keke Palmer, Amy Poehler, Florence Pugh, Rachel Sennott and Zendaya.
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