The Brief

Gov. Gavin Newsom announced today that he will seek to regulate prescription drug middlemen that he blames for driving up costs for patients, less than a year after he vetoed similar oversight for the companies called pharmacy benefit managers.

The plan — part of a revised state budget proposal that Newsom will unveil in full on Wednesday — calls for licensing pharmacy benefit managers through California’s Department of Managed Health Care and requiring them to report their operational and financial details.

“Prescription drug prices are out of control and we’re shining a light on hidden costs,” Newsom said in a statement.

California has long sought to more closely monitor pharmacy benefit managers, which serve as intermediaries between insurance companies and pharmaceutical drug manufacturers, controlling the list of drugs covered by health insurance plans, negotiating their prices and processing claims. Critics say these companies needlessly raise costs by tacking on fees and withholding manufacturer discounts as profit. They can also restrict access for patients to some higher priced name-brand drugs.

But legislative efforts to rein them in have repeatedly withered in the face of the powerful industry lobby, which contends that more stringent regulations would drive up health insurance premiums by billions of dollars annually.

Bill Head, assistant vice president for the Pharmaceutical Care Management Association, the industry group that represents pharmacy benefit managers, said the organization supports Newsom’s goal to lower prescription drug prices, but blamed pharmaceutical manufacturers for rising costs.

“Drug companies alone set and raise drug prices, and the price is the problem. We look forward to working with the administration to ensure transparency across the drug supply chain and to ensure consumers benefit,” Head’s statement said.

According to the association, its members are projected to save Californians $108 billion over the next 10 years in drug costs.

Last year, a measure made it all the way to Newsom’s desk that would have required pharmacy benefit managers to get licensed through the state insurance department, disclose the prices they pay and the discounts they negotiate with drug manufacturers, and then pass on 100% of those discounts to insurance plans.

Newsom vetoed it in September, writing in a message that he was not convinced that the bill’s “expansive licensing scheme” would achieve the desired result of bringing down prescription drug prices.

“We need more granular information to fully understand the cost drivers in the prescription drug market and the role that [pharmacy benefit managers] play in pricing,” the governor said at the time.

The governor’s office would not explain why Newsom’s perspective on regulations had shifted in the eight months since, only saying that they "will continue to collaborate with legislative leaders."

His proposal, according to a summary provided by his office, would allow the state to review pharmacy benefit managers’ contracts, perform financial audits and issue penalties, and require the companies to report detailed drug pricing data to California’s Department of Health Care Access and Information.

California Gov. Gavin Newsom announces a partnership with Civica Rx to provide insulin to Californians for $30 for 10 milliliters, which he said was as little as one-tenth of the current cost.

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Ringo Chiu

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Sipa USA via Reuters

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Newsom’s proposal also would require benefit managers to act in the best interest of health plans and clients, something known as fiduciary duty.

Geoffrey Joyce, director of health policy at the USC Schaeffer Center and an expert on drug pricing, said health economists have argued for years that establishing a fiduciary duty for pharmacy benefit managers would solve many of the perceived problems caused by the business model.

“If they have to act as a fiduciary by law, that changes everything,” Joyce said. “Right now, the incentives are to make money for the [pharmacy benefit manager] ... but if they have to act in the best interest of the clients they would be legally liable for the things that they do.”

Pharmacy benefit managers have come under fire in Congress for engaging in opaque business tactics that artificially drive up the cost of some drugs. The Federal Trade Commission, which was investigating their practices last year, published a report stating that pharmacy benefit managers actively tried to avoid regulation by moving portions of their business overseas.

Consolidation has also led to practices like patient steering, Joyce said. Three pharmacy benefit managers dominate the industry: CVS Caremark, Express Scripts and OptumRx represent more than 80% of the market.

Drug spending has risen 56% since 2017

Pressure has been growing on politicians nationally in recent years to take action on drug prices, which are one of the primary drivers of increased medical costs. In just one year, between 2022 and 2023, drug spending in the U.S. increased 13.6%, according to a study on national pharmaceutical trends. Other studies indicate that Americans pay nearly three times as much as people in other countries for the same drugs.

In California, prescription drug spending has increased 56% since the state first began tracking data in 2017. Spending between 2017 and 2023, the most recent year data is available, jumped by nearly $9 billion, according to a state report on drug costs.

President Donald Trump this week also signed an executive order demanding that manufacturers lower the price of prescription drugs in the next 30 days or face new limits on what the federal government will pay, though it’s unclear how it would work.

Sen. Scott Wiener, a San Francisco Democrat, authored the vetoed measure last year and has continued to push forward bills aiming to bring down drug costs. Wiener said in a statement today that Newsom’s announcement is a “solid step” toward improving prescription drug affordability but that more needs to be done.

Wiener reintroduced the bill from last year as Senate Bill 41, which outlines clear prohibitions for pharmacy benefit managers, including forbidding them from requiring patients to fill prescriptions at specific pharmacies. That bill is moving through the Legislature and passed its first committee last month.

Pharmacy benefit mangers "should not pocket rebates they negotiate on behalf of consumers, they shouldn’t steer patients toward more expensive drugs and their affiliated pharmacies in pursuit of profit, and they should compensate pharmacies and doctors fairly," Wiener said in a statement.

Newsom’s announcement also included an effort to expand the role of CalRx, a $100-million state effort to procure and manufacture certain highly used drugs like insulin and naloxone, the opioid reversal medication.

Currently, CalRx is tasked with securing lower prices for generic drugs, but the new proposal would allow the state to pursue cost savings on name-brand drugs. This would give California more flexibility to respond to supply chain issues or “politically motivated” federal restrictions placed on drugs like mifepristone, the abortion pill, according to a statement from Newsom’s office.

In 2023, Newsom ordered state agencies to stockpile 250,000 abortion pills after a federal court ruling in Texas temporarily overturned FDA approval of the drug. That stockpile was depleted in 2024, but the fate of the pill’s usage remains in question as conservative groups continue to pursue legal action to block its use.

This article was originally published on CalMatters and was republished under the Creative Commons Attribution-NonCommercial-NoDerivatives license.

A federal judge has knocked down the core of President Donald Trump's executive order barring federal funding for NPR and PBS, saying it violated the broadcasters' First Amendment rights on its face.

A District Court judge has found that a Trump White House executive order to defund NPR and PBS violated the First Amendment and is therefore "unlawful and unenforceable." It wasn't immediately clear what the decision, which could be appealed by the administration, would mean for the future of federal funding of public broadcasting.

In his ruling, Judge Randolph D. Moss of the U.S. District Court for the District of Columbia, said "the First Amendment draws a line, which the government may not cross, at efforts to use government power — including the power of the purse — 'to punish or suppress disfavored expression' by others."

Moss said the president's executive order, "Ending Taxpayer Subsidies for Bias Media" issued in May of last year "crosses that line."

Trump's executive order stated: "Which viewpoints NPR and PBS promote does not matter. What does matter is that neither entity presents a fair, accurate, or unbiased portrayal of current events to taxpaying citizens." The president's order and materials that accompany it accuse the public broadcasters of ideological bias, in NPR's case due to its news coverage. The networks deny this.

Moss said the order "singles out two speakers and, on the basis of their speech, bars them from all federally funded programs. It does so, moreover, without regard to whether the federal funds are used to pay for the nationwide interconnection systems, which serve as the technological backbones of public radio and television; to provide safety and security for journalists working in war zones; to support the emergency broadcast system; or to produce or distribute music, children's or other educational programming, or documentaries," Moss, who was nominated by President Barack Obama, wrote.

"It is difficult to conceive of clearer evidence that a government action is targeted at viewpoints that the President does not like and seeks to squelch," Moss said.

Under the Constitution, the U.S. government cannot discriminate against people on the basis of the views they express; for news outlets, this extends to news coverage.

Trump's executive order set in motion a series of events that ultimately knocked the Corporation for Public Broadcasting – the congressionally chartered entity through which federal dollars flowed to public media outlets – out of business. For more than a half-century, most federal money for public media has been funneled through the nonprofit Corporation for Public Broadcasting.

The president insisted that all of the $1.1 billion that he and Congress had earlier agreed to set aside for public media outlets, including NPR and PBS member stations. The Republican-led Congress acquiesced. The ruling however would enable a future Congress to resume funding public media if it chose to do so. It also establishes the right of local public media stations that take federal subsidies to make their own programming decisions without government pressure – including on whether to take NPR or PBS shows.

Last August, CPB said it would close its doors after serving as a conduit for federal funding to public broadcasting for decades.

In a statement, NPR said the ruling "is a decisive affirmation of the rights of a free and independent press — and a win for NPR, our network of stations, and our tens of millions of listeners nationwide."

"Public media exists to serve the public interest — that of Americans — not that of any political agenda or elected official. NPR and our Member Stations will continue delivering independent, fact-based, high-quality reporting to communities across the United States, regardless of the administration of the day."

NPR's lawyer, Theodore Boutrous, added: "The Court's decision bars the government from enforcing its unconstitutional Executive Order targeting NPR and PBS because the President dislikes their news reporting and other programming," Boutrous said.

In a statement, PBS, said it was "thrilled with today's decision," calling the president's order a "textbook unconstitutional viewpoint discrimination and retaliation, in violation of longstanding First Amendment principles."

Disclosure: This story was written and reported by NPR Correspondents David Folkenflik and Scott Neuman. It was edited by Managing Editors Gerry Holmes and  Vickie Walton-James. Under NPR's protocol for reporting on itself, no corporate official or news executive reviewed this story before it was posted publicly.
Copyright 2026 NPR

A Mexican man died while being detained at the Adelanto ICE Processing Center last week. He is the fifth person to have died either while in custody at the facility or from health complications linked to its conditions since September 2025.

Department of Homeland Security officials said in a statement that guards found Jose Guadalupe Ramos-Solano unconscious in his bunk bed on March 25. Onsite medical staff performed CPR, according to the statement, and Ramos was taken to a medical center in Victorville where he was pronounced dead at 9:30 p.m.

According to DHS, Ramos was arrested in 2025 in Los Angeles county for possession of a controlled substance and theft of personal property and was convicted later that year. Federal Immigration and Custom Enforcement agents arrested Ramos on Feb. 23 during an operation in Torrance and transferred him to Adelanto.

Ramos also received a complete health and physical evaluation during his intake screening at the Adelanto facility on Feb. 24, which identified that he had several medical issues including diabetes and hypertension.

“He received constant medical care while he was in custody, including daily medication to treat his illness,” reads the DHS statement.

DHS said staff immediately initiated life-saving procedures when he was found unresponsive and emphasized their “commitment to ensuring safe, secure, and humane environments” for people in detention.

But according to the Immigrant Defenders Law Center, detainees who called their rapid response hotline the morning after Ramos’ death said that guards didn’t respond until he was unconscious. According to ImmDef, detainees also witnessed Ramos having trouble breathing and witnessed him removing his shirt because he felt he was suffocating.

For years, immigrant and disability rights groups have raised alarms about the conditions inside the Adelanto ICE Processing Center. Ismael Ayala-Uribe died after being held at Adelanto for about a month last year. A few weeks later, Gabriel Garcia Aviles died from cardiac arrest just one week after being transferred to the Adelanto facility. Alberto Gutierrez Reyes and Irvin Cruz Nape both died after being detained there earlier this year.

Hector Pereyra, the political manager with the Inland Coalition for Immigrant Justice (IC4IJ), said DHS and ICE are depriving people of basic needs.

“What we’re seeing is that people die in immigration detention centers like Adelanto because of the lack of access to medical care,” said Pereyra. “And that’s intentional. The Department of Homeland Security has all the resources in the world to fully fund efficient and comprehensive medical care. And they choose not to.”

Earlier this month, Attorney General Rob Bonta weighed in on a lawsuit against ICE that challenges living and medical conditions at the facility. The ongoing lawsuit seeks to improve these conditions for detainees.

Officials with the Mexican Consulate of Los Angeles said at a Monday press conference that their government is also planning to contribute to the lawsuit and “will exhaust all legal, diplomatic, and multilateral avenues” to ensure accountability.

“We consider it crucial to bring light to this painful reality — individuals who have lost their lives while under the direct custody of immigration authorities and GEO Group,” said Vanessa Calva-Ruiz, a Mexican diplomatic representative. “Nothing justifies immigration processing and detention conditions that result in the deaths of individuals who should have been treated promptly with dignity and humanity.”

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The Supreme Court has ruled that Colorado's law banning conversion therapy "regulates speech based on viewpoint."

At issue was the practice of an evangelical Christian, Kaley Chiles, a counselor who wants to provide talk therapy to teenagers seeking to discuss their sexual orientation or gender identity, including those hoping to "reduce or eliminate unwanted sexual attractions, change sexual behaviors, or grow in the experience of harmony with one's physical body," according to her complaint.

Her lawyer argued that Colorado's law prevents voluntary conversations with minors seeking her help.

The majority opinion states, "the lower courts erred by failing to apply sufficiently rigorous First Amendment scrutiny."

"As applied to Ms. Chiles, Colorado's law regulates the content of her speech and goes further to prescribe what views she may and may not express, discriminating on the basis of viewpoint," the opinion says.

Justice Ketanji Brown Jackson dissented, pointing to precedent on states regulating health care professionals. "Stated simply, the majority has failed to appreciate the crucial context in which Chiles's constitutional claims have arisen," she wrote. "Chiles is not speaking in the ether; she is providing therapy to minors as a licensed healthcare professional."

The court heard arguments on the case in October and appeared to lean toward the therapist at the time.

The case involved a new wrinkle on "conversion therapy." It's generally defined as a treatment used to change a person's attraction to same-sex individuals and to similarly cure gender dysphoria. In whatever form, the therapy has been forcefully repudiated by every major medical organization in the country on the grounds that it doesn't work and often leads to depression and suicidal thoughts in minors.

But during arguments in the fall, Chiles' lawyer, James Campbell, told the justices that the way his client wishes to practice conversion therapy involves no physical restraints or coercion of any kind. Rather, he said her practice involves only talk therapy.

"Ms. Chiles is being silenced. The kids and families who want help — this kind of help that she offers — are being left without any support," he asserted.

The outcome of the case could mean a rollback on conversion therapy bans across the country.

Copyright 2026 NPR

Tuesday is the first time in over 25 years that California and many cities in Southern California will not be celebrating disgraced union leader César Chavez.

Scores of local governments in Southern California have rewritten the holiday and renamed it to “Farmworkers Day,” including Los Angeles County, which heard from Asian American communities across the region. Many who spoke during last week’s Board of Supervisors meeting said they wanted to see farmworkers and other union leaders centered in those conversations.

The move to rename the last days of March came after a New York Times investigation uncovered allegations that Chavez sexually assaulted at least two girls and a woman, including fellow union leader Dolores Huerta.

Chavez was head of the United Farm Workers union and is widely recognized by Latinos and other communities as one of the most influential labor leaders in American history.

One man’s actions do not define this movement, Nina Cabardo of the Pilipino Workers Center wrote in a letter of support for the changes. As local leaders tackle the renaming and redefining of Farmworkers Day, she added, it’s also time for another “long-time injustice” to be rectified.

“This is also the time for Filipino farmworkers and Filipino farmworker leaders' real roles in the farmworker movement to be truthfully uplifted,” Cabardo said. “Leaders like Larry Itliong, Philip Vera Cruz, Pete Velasco, Lorraine Agtang and Luciano Crespo.”

A complicated history

Chavez’s legacy had been complicated for years before the explosive investigation, according to Alexandro José Gradilla, associate professor of Chicana and Chicano studies at Cal State Fullerton.

“People have, in the last 20, 30 years, already been de-centering César Chavez from the 60s and social movements of the farmworkers. It’s because of the history of sabotaging the Filipino workers, the history of being openly and virulently anti-immigrant,” Gradilla told LAist. “So, I don't have to go back and delete or scrub or erase in my PowerPoints any hero worship or adulation of Chavez. That I think has already been done.”

This is a reminder, Gradilla added, that power corrupts.

“Anybody who is put in this position of being viewed as a hero, who is given untapped power, whether they are a person of color, queer, a woman, we are all in danger of falling into that trap,” Gradilla said. “That's the more important lesson that we cannot submit to this cult of personality that can happen. And apparently, in the case of the farm worker movement, that did happen.”

The work to de-center Chavez

Many community members who spoke during public comment at last week’s L.A. County Board of Supervisors meeting were in support of the holiday name change. But many also think the work to de-center Chavez shouldn’t end there.

Community members have also called on leaders to remember the names of the Filipino workers who drove the farmworkers union toward success.

Aquilina Soriano Versoza, executive director of the Pilipino Workers Center of Southern California, said inspiration from the farmworker movement catalyzed the organization.

“ We are a strong organization of strong Filipino domestic workers, immigrant workers,” Versoza said. “We support the inclusion of the community-driven process that centers survivors, and we need to make sure that we rectify that Filipinos are also uplifted in this process, so we honor everyone who should be honored as the Farm Workers movement.”

 Celeste Friedman of the Asian Civil Rights League said history has omitted key components and figures of the farmworker movement.

“While César Chavez is widely recognized, the movement itself was ignited in 1965 by Filipino farm workers led by Larry Itliong and the Agricultural Workers Organizing Committee,” Friedman said. “They initiated the Delano grape strike. Organized, mobilized, and took the first risk. Yet their contributions have been largely underrepresented in our textbooks, public commemorations, and collective memory.”

When the truth of the full history fails to be acknowledged, Friedman added, future generations are denied the richness of solidarity between the Filipino and Latino communities.

Mayra Castañeda, a member of the SEIU United Healthcare Workers, said the name change better reflects the legacy of farmworkers.

“Establishing Farmworkers Day is an opportunity to uplift the collective contributions of farm workers across generations, many of whom remain invisible despite the essential work they do every day,” Castañeda said. “It also helps educate future generations about the ongoing struggles for labor rights, equity and the respect in the field.”

What’s next?

L.A. County officials will report back to the board in the coming weeks with more on renaming streets, buildings, monuments and programs that bear Chavez’s name.