The Brief

Popular weight loss drugs Ozempic and Wegovy would no longer be covered by Medi-Cal under a proposal unveiled by Gov. Gavin Newsom Wednesday in an effort to reduce cost overruns in the state health insurance program.

The costly drugs prescribed to fight obesity have been driving up the cost of Medi-Cal, the state program that provides health coverage for low-income Californians. Eliminating coverage for these drugs would save the state $85 million in 2025-26, and up to $680 million by 2028-29, according to the governor’s office.

Newsom’s proposal will be taken up by the state Legislature as the governor and top legislators tackle a state budget facing a $12 billion deficit.

As proposed, coverage of the drugs would end on Jan. 1, 2026. Medi-Cal patients trying to lose weight would have to pay for the prescriptions themselves, at a cost of more than $1,000 per month, making it unattainable for low-income people.

Some health professionals say the drugs are highly effective at combating obesity, a chronic disease that drives up health care costs because it can lead to many other disorders such as heart disease and diabetes.

An estimated 18 million adults in California are obese or overweight, according to the UCLA Center for Health Policy Research.

“This is a bad decision. The people who are already taking this medication, what’s going to happen to them?” said Liz Helms, president of the California Chronic Care Coalition, a group of health consumer advocacy organizations and providers.

Dr. Wayne Ho, a Los Angeles obesity specialist and researcher, said patients will likely regain the weight they’ve lost, and also lose the health benefits they’ve gained, such as lower blood pressure and cholesterol.

“It is the best tool I have had as a primary care physician in practicing preventative medicine,” Ho said of weight management drugs. For patients on Medi-Cal, he said it can be especially difficult to access obesity specialists and nutritious foods, making their weight loss journey even more difficult.

On the other hand, the California Association of Health Plans said Newsom’s proposal “should send a strong signal to the Legislature that they should reconsider mandating that health plans cover these costly drugs for weight loss without the proper clinical safeguards in place.” 

California is not required by federal law to cover the cost of the weight loss drugs in its Medi-Cal program. Instead, the state opted to include them. Under Newsom’s proposed cuts, when Ozempic is prescribed to treat diabetes, it would still be covered by Medi-Cal.

Newsom’s proposal comes as Wegovy and Ozempic prescriptions among Medi-Cal enrollees are soaring along with overall prescription drug spending. In fiscal year 2023-24, drugs cost Medi-Cal close to $15.2 billion, according to state drug cost reports. That’s about a 10% increase from the previous year.

Between 2022 and 2023, Wegovy prescriptions in the Medi-Cal program jumped from 15,000 to 181,000, data from the U.S. Centers for Medicaid and Medicare Services show. Ozempic prescriptions for diabetes and weight loss rose from 178,000 in 2022 to 480,000 in 2023.

In 2023, the latest year for which data is available, Medi-Cal spent about $733 million on both drugs. (This amount does not include the refunds that Medi-Cal received from pharmaceutical companies as part of rebate programs.)

“This is a bad decision. The people who are already taking this medication, what’s going to happen to them?"LIZ HELMS, CALIFORNIA CHRONIC CARE COALITION In his budget presentation today, Newsom did not mention the drugs. But he said the state had to “tighten things up” in its massive Medi-Cal program so he proposed several restrictions, including a freeze on Medi-Cal enrollments by people who lack permanent legal immigration status. Medi-Cal covers nearly 15 million Californians.

Earlier this year, the state had to backfill a $6.2 billion shortfall in its Medi-Cal budget to pay providers through the end of June. The Department of Health Care Services, which oversees the Medi-Cal program, cited a number of reasons for going over budget, including the state’s expansion to undocumented immigrants and an increase in prescription drug spending.

Ozempic is primarily used to treat Type 2 diabetes, but some doctors prescribe it for weight loss, too. Wegovy is used only for weight loss. Both are manufactured by Danish pharmaceutical company Novo Nordisk, and there are no generic versions.

Semaglutide, the active ingredient in both drugs, works by mimicking the GLP-1 hormone, which helps regulate blood sugar and appetite. In an attempt to contain costs, Medi-Cal already limits the quantity of Wegovy that can be dispensed every 28 days to one carton of four pen injectors. Patients inject themselves once a week.

To qualify for Medi-Cal, a single person’s annual income cannot exceed $21,597. For a family of 4, the threshold is $44,367.

Erica Yee contributed to this report. 

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

A coalition of residents from across the San Gabriel Valley are mobilizing over a battery storage project and possibly more industrial development in the City of Industry they say could pollute communities next door.

A protest is scheduled today in neighboring Rowland Heights, targeting a 400-megawatt battery energy storage facility sited on about 9 acres that was approved by the City of Industry leaders in January.

Such battery energy storage systems, or BESS, are used to keep the power grid stable, especially as renewable energy sources like solar and wind fluctuate. But fires involving lithium batteries at some sites have heightened environmental and public health fears.

Because of the City of Industry’s unusual, sprawling shape stretching along the 60 Freeway, it borders on more than a dozen communities, meaning what happens there can have far-reaching impact.

“Pollution does not end right at the border,” said Andrew Yip, an organizer with No Data Centers SGV Coalition. “Pollution travels.”

Some local activists with the Puente Hills Community Preservation Association have challenged the approval of the battery facility under the California Environmental Quality Act.

Beyond environmental concerns, locals have also been frustrated with how decisions are made by officials in the City of Industry, a municipality that’s almost entirely zoned for industrial use and has less than 300 residents.

Organizers say they’ve struggled to get direct responses from city officials whom they say have replaced regular meetings with special meetings, which under state law require less advance notice.

A city spokesperson has not responded to requests for comment.

The so-called Marici Energy Storage System Facility would be run by Aypa Power. The fact that the battery storage developer is owned by the private equity giant Blackstone, a major investor in AI and data centers, has only fueled concerns that a battery storage facility would lay the groundwork for data center development.

A request for comment from Aypa was not returned.

Today’s protest is taking place at Peter F. Schabarum Regional Park in Rowland Heights across the street from the Puente Hills Mall, a largely vacant “dead” mall, which activists fear could be redeveloped into a data center and bring higher utility costs and greater air and noise pollution.

Yip pointed out that industrial developments make a lot of money for the City of Industry.

“But none of these surrounding communities receive any of those benefits,” Yip said. “Yet we have to put up with all the harmful effects and impacts from this city that does all this development without really reaching out.”

A new trail across the beloved natural area of Elephant Hill in Northeast Los Angeles is officially opening this weekend.

The route is years in the making, and it's a big milestone in the decades-long conservation efforts to preserve this local jewel in the community of El Sereno.

The hiking trail connects one side of Elephant Hill to the other — from the corner of Pullman Street and Harriman Avenue all the way across to Lathrop Street.

It's 0.75 miles in total, but packs a punch.

"It's a pretty straight shot, but because of the terrain — the trail is kind of twisty and curvy. There's switchbacks — and great views," Elva Yañez, board president of the nonprofit Save Elephant Hill, said.

People have always been able to access the 110-acre green space, but Yañez said the new trail provides a safe and easy way to navigate the steep hillsides.

The El Sereno nonprofit has been working for two decades to preserve the land. Illegal dumping and off-roading have damaged the open space over the years. And the majority of the 110 acres are privately owned by an estimated 200 individual owners.

Mountains Recreation and Conservation Authority (MRCA) joined the efforts in 2018, spurred by a $700,000 grant from Los Angeles County Regional Park and Open Space District, in part, to build the trail. The local agency received some $2 million in grants from the Santa Monica Mountains Conservancy to add to the 10 acres of Elephant Hill it manages and conserves. This year, MCRA acquired an additional 12 parcels — or about 2.4 acres.

And the spiffy new footpath — with trail signage, information kiosks and landscape boulders — is not just a long-sought-for victory but a beginning in a sense.

"We know that it means a lot to the community," Sarah Kevorkian, who oversees the trail project for MRCA, said. "We're wrapping up the trail, but it really feels like the beginning of all that is to come."

A hint of that vision already exists — for hikers traversing the new route, courtesy of Test Plot, the L.A.-based nonprofit that works to revitalize depleted lands.

"They're able to see at the end of the trail, at the 'test plot' — exactly what a restored Elephant Hill would look like," Yañez said.

Here's a preview:

It’s about the size of a park bench and made of steel and wood. The bench’s arm rests are formed by the letters “L” and “A” in a design that’s unmistakable to any sports fan. But the welder-artist who created it says it’s not a Dodgers bench.

“This is about civic pride, L.A. pride. I made a design statement saying that it has nothing affiliated with the Dodgers,” said Steve Campos.

Campos grew up near Dodger Stadium, raised by parents who were die-hard Dodgers fans. So much, that they named him after Steve Garvey but that legacy doesn’t keep him from confronting how the Dodgers benefitted from the mass displacement of working-class people from Chavez Ravine after World War Two. That’s why he calls it an L.A. Bench, and not a Dodgers Bench.

The logo may be synonymous with the city's beloved baseball team, but the design of the interlocking letters was used by the L.A. Angels minor league baseball team before the Dodgers moved to L.A. in 1958.

“The monogram was here before the Dodgers,” Campos said.

A second-generation welder

Welding is the Campos family business. His father created gates and security bars for windows and doors for L.A. clients. That was the foundation for the work Campos has done for two decades since graduating from Lincoln High School, L.A. Trade Tech College, and enrolling in a summer program at Art Center in Pasadena.

The inspiration for the L.A. Bench came last year while he was playing around in his shop creating versions of the L.A. logo. A friend he hangs with at Echo Park Lake asked Campos to make him a piece of furniture.

“I was trying to figure out what my friend Curly wanted. He liked Dodgers and drinking and getting into fights, so I was like, 'Let me make something with the LA monogram,'” he said.

Welder-artist Steve Campos created whimsical steel sculptures with the LA logo.

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Courtesy Steve Campos

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It didn’t design itself. He said he had to lengthen the legs on the “A” and lean the back of the “L” in order to make the bench functional. In the process, he’s made a piece of furniture with a ubiquitous logo that he’s embedded with his own L.A. pride, as well as city history past and present.

LA civic pride travels to Japan

Campos vacationed in Japan the last week of April and took advantage of the trip to reach out to people who may be interested in the L.A. Bench. He was caught off guard by people’s reaction when he showed them pictures of it.

“They look at it and they go, 'Oh, Ohtani bench,'” he said.

For them, it’s still a bench embedded with pride, he said, but centered around Dodgers star Shohei Ohtani, an icon in his native Japan.

Campos has made four L.A. benches and is selling them fully assembled, he said, for $2,500 each — taking into account his labor and how costly the raw materials have become. For now, he’s offering the metal parts as a package for $500, which requires the buyer to purchase the wood for the seat and the back — an easy process, he said.

While he has no plans to mass produce the L.A. Bench, he does have one goal in mind that shows how hard it is for him to separate L.A. civic pride and the Dodgers.

“I would love to get a couple of them installed at Dodger Stadium,” he said.

In an attempt to resolve evictions before they go to trial, the Los Angeles County Superior Court has launched new programs that seek to facilitate settlements by providing free attorneys to tenants and financial relief to landlords who are owed back rent.

Presiding Judge Sergio Tapia said these pilot programs are designed to stem the tide of evictions, which have risen sharply since the COVID-19 pandemic.

“We're trying to show litigants across the board, whether it’s tenants or landlords, that the court is the opportunity to try to find resolution faster,” Tapia told LAist.

Both tenant and landlord attorneys agree that settlements can often be the best path for both parties.

One program launched last month in downtown L.A.’s Stanley Mosk Courthouse gives tenants the right to request a mandatory settlement conference overseen by a court-appointed settlement officer.

These tenants, who rarely come to court with legal representation, will be given a free attorney to guide them though the settlement conferences, as long as they earn less than 125% of the federal poverty level.

But lawyers who represent landlords say their clients often feel local government is increasingly putting money toward helping renters, while leaving property owners struggling.

Where does funding come from?

Facing eviction without a lawyer “puts people at such an enormous disadvantage, when landlords normally have lawyers,” said Conway Collis, president of the Mayor’s Fund for Los Angeles, a nonprofit that is helping to fund the Mosk program’s free attorneys.

Other funding comes from Stay Housed L.A., a legal aid partnership funded by the county of L.A. and the city of L.A. through its “mansion tax.”

Landlords will be required to notify tenants about the program in the eviction paperwork they serve to tenants.

Settlement officers come from the court’s pool of temporary judges, who handle lower-level cases, such as traffic infractions. Other officers are retired judges or trained lawyers.

The settlement conferences are being held on the same day as regularly scheduled court hearings, one floor down from the Mosk courthouse’s eviction department.

How are the conferences working so far?

Elena Popp, the executive director of the Eviction Defense Network, which is providing lawyers for the program, said that on one recent day, landlords and tenants were able to reach mutually agreeable settlements in about half the conferences.

“We settled one,” Popp said. “We are very close to settling a second one. The other two are way further apart because the tenant really wants to stay on, but the landlord really wants them to go.”

Settlement deals look different in each case, Popp said. Sometimes they involve landlords letting tenants stay if they pay overdue rent. In other cases, tenants are given additional time to find new housing before they must leave. When settlements are reached, cases are sealed so that evictions won’t be visible on a tenant’s record, a black mark that makes it very difficult to find new housing.

When settlements can’t be reached, landlords and tenants go back upstairs to resume their normal proceedings, Popp said.

No matter how cases are resolved, she said, tenants can’t be expected to navigate legally complex processes on their own.

“One of the things that we stressed when we were setting this up is that you absolutely have to have a lawyer,” Popp said.

Compton program pairs settlements with money to landlords

Another pilot program launched last month at the Compton courthouse offers up to $10,000 to cover rent owed to landlords in cases that settle. Landlords will be required to inform tenants about the settlement conferences. To qualify, either the tenant or the landlord must earn no more than 120% of the area’s median income.

The settlement conferences at the Compton courthouse are overseen by Community Legal Aid of Southern California, and rent relief funding is administered by L.A. County’s Department of Consumer and Business Affairs.

Attorney Aaron Kohanim, who represents landlords, said he advises his clients to settle whenever possible, because going to trial is “a casino — you don't know if you're going to win.”

But he also said landlords generally view taxpayer-funded attorneys for tenants as unfair.

“Only one side gets a piece of that pot,” Kohanim said. “Landlords have to pay out of pocket for their attorneys. And on top of that, they are not allowed to collect rent in the middle of the case, so they're getting beaten by two different angles, versus a tenant who is just living there rent-free and they get a free lawyer.”

Tapia said the programs are currently limited to the Mosk and Compton courthouses because of funding constraints and limited resources. But the judge said if they prove successful, they could be expanded county-wide.

“If we're able to show success, that will allow us to recruit a more robust set of settlement officers to perhaps expand,” Tapia said. “We need to see how this pilot plays out first.”