The Brief

The federal government has announced the results of the latest round of Medicare drug price negotiations: 15 lower drug prices for Medicare to go into effect in 2027.

Medicare will get a 71% discount on Ozempic, Wegovy and Rybelsus, blockbuster drugs for obesity and Type 2 diabetes that have current list prices of around a thousand dollars a month.

The negotiations also included drugs for asthma, breast cancer and leukemia. The discounts ranged from 38% for Austedo, which treats Huntington's disease, to 85% for Janumet for Type 2 diabetes.

"President Trump directed us to stop at nothing to lower health care costs for the American people," said Health and Human Services Secretary Robert F. Kennedy, Jr., in a press release. "As we work to Make America Healthy Again, we will use every tool at our disposal to deliver affordable health care to seniors."

The program that covers drugs for more than 50 million seniors negotiated its first batch of drug prices last year, after the passage of the Biden-era Inflation Reduction Act in 2022.

A provision of that law, passed without Republican support, ended Medicare's 20-year ban on negotiating drug prices.

Negotiations for this second batch of 15 drugs wrapped up at the end of October.

The Centers for Medicare and Medicaid Services (CMS) say the new, lower Medicare prices would have saved the program $12 billion dollars if the lower negotiated prices had been in effect in 2024.

The latest negotiated prices are great news for taxpayers and patients, says Dr. Benjamin Rome, health policy researcher at Brigham and Women's Hospital in Boston. Federal taxpayers fund much of Medicare, but beneficiaries also must pay copays and coinsurance.

"This is more savings than the first round, but a lot of that has to do with the nature of the drugs being negotiated this year and probably some learning from experience," he says.

Drugs were selected earlier this year based on criteria written into the law. They had to have no generic or biosimilar competition, account for a high amount of Medicare spending and be on the market for a number of years.

The lower Ozempic and Wegovy prices follow a separate deal the Trump administration announced on Nov. 6 with Novo Nordisk, which makes both drugs.

That deal was part of the president's push to get drug companies to voluntarily lower their U.S. prices to match those in other developed countries.

But, confusingly, the discounts from the Medicare negotiations were less significant than what Novo Nordisk agreed to give Medicare as part of the Nov. 6 deal.

That previous deal set a price of $245 dollars a month for Ozempic and Wegovy. But according to the negotiated prices announced this week, the prices of Ozempic, Wegovy and Rybelsus — the company's Type 2 diabetes pill — will be $274 a month.

"It's not clear why Novo [Nordisk] would promise a different price in two different venues," Rome says.

In a company statement, Novo Nordisk explained that it "look[s] forward to additional clarity from CMS on how pricing and coverage will work."

The separate Trump Administration deal "reflects a broader effort to expand access to obesity care across Medicare and Medicaid," the statement said.

(The deal expanded access in those two programs to the drugs to people with a body mass index of over 35 and people with BMIs above 27 who have additional health conditions. But the details of exactly how this will work remain unclear.)

The Novo Nordisk statement affirmed that the company is committed to advocating for affordable access to its medications, but "we continue to have serious concerns about the Inflation Reduction Act's impact on patients and remain opposed to government price setting."

AARP, an advocacy group for the 125 million Americans who are 50 and older, was pleased with the results of the negotiations.

"Today's announcement marks yet another significant next step forward in our long-standing efforts to lower prescription drug prices," AARP's CEO Dr. Myechia Minter-Jordan said in a statement.

"Older Americans across the political spectrum consistently say lower drug prices are a top priority, and these negotiated prices will bring meaningful relief to millions of people on Medicare."

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At least seven wildfires burning around Southern California are sending smoke across the region. The South Coast Air Quality Management District has extended a smoke advisory warning of unhealthy air through 4:30 p.m. Wednesday.

What does a smoke advisory mean?

Local health officials send out warnings when the air quality is unhealthy. The advisories encourage people to avoid outdoor activities and take other steps to limit contact with smoky air.

Where are the wildfires?

Wildfires are burning in Ventura, San Diego, Riverside, Santa Barbara and L.A. counties. You can keep tabs on the fires on the CalFire website.

How bad is the air?

Wildfire smoke is generally worse for your health than the kind of “garden variety urban pollution” Angelenos are used to, said Suzanne Paulson, an atmospheric chemist at UCLA. But air quality depends on where you live, and might change from hour to hour. The good news is that low-cost air quality sensors have made it easier to find out just how bad the air is in your neck of the woods. You can check PurpleAir, Clarity, and IQAir for real-time data on pollution levels, often down to the neighborhood level.

How to avoid breathing bad air

Staying indoors in the best way to avoid bad air pollution, Paulson said. You can also try to avoid the worst areas. “So for example, I ride my bike to work. I regularly look at the map and see if the air quality is OK, and sometimes I even change my route,” Paulson said.

The city of Santa Ana is just $85 short of closing what started as a $13 million budget deficit. On the chopping block: after-school programming, park maintenance and more.

The city manager’s office presented another round of cuts to balance the budget at yesterday’s City Council meeting. Officials reported that the current proposal avoids layoffs and furloughs. Most of the cuts will come from the Public Works Department at more than $3 million.

Santa Ana's current budget proposal includes an estimated $85 deficit for the upcoming fiscal year.

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Courtesy of the city of Santa Ana

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More on what’s being cut 

The Police Department is seeing a proposed $2 million in cuts, but could still be allocated $4 million more than last year, according to the budget draft.

The city is looking to cut 20 vacant full-time positions and reduce part-time spending.

Five non-mandated commissions will also be dissolved, including the youth, parks and recreation, and arts and culture commissions. The move will save the city nearly $28,000.

Ambulance services will be cut down from a 24-hour unit to a 12-hour unit, saving $250,000, and fees will increase.

How did we get here? 

At a City Council meeting earlier this month, officials reported that the city’s revenue increased by 3% compared to last year, but spending is up 6%, with hikes in labor and pension/liability costs.

What’s the deal with youth programming? 

The Santa Ana Police Athletic and Activity League, also known as PAAL, costs the city more than $877,000, about 80% of which goes toward salaries for its current fiscal budget.

PAAL costs the city about $5,400 per child, compared to youth programs run by the Parks and Recreation Department, which cost about $100 per kid.

PAAL’s after-school and summer programs serve 87 children, and more than 200 are mentored and coached through its sports programming. The program’s budget will be slashed by about half.

Councilmember Johnathan Ryan Hernandez said this move should not be seen as a cut to youth services.

“Through this new proposed recommendation, we’ll reinstate exercise instruction at four different elementary schools, and we will increase the services from 228 children to 2,200 children,” Hernandez said. “We are not cutting youth services, we're actually adding youth services while saving money for our city.”

Mayor Valerie Amezcua said the library and parks departments can do the same programs, but not the way PAAL does.

“I just want to make sure whatever cuts we're making, that we continue to include our Police Department. To me, that's very important for the public trust,” Amezcua said.

What’s next? 

The city isn’t completely in the clear when it comes to its finances. Measure X, a voter-approved sales tax, will be reduced in 2029, resulting in the loss of at least $30 million in annual revenue before completely expiring in 2039. The City Council, aside from Councilmembers David Penaloza and Jessie Lopez, has supported asking voters if the tax should be made permanent.

A public hearing to review the drafted budget will be held on June 2. Details will be posted on the city’s website.

At least 20 detainees have launched a hunger strike at Desert View Annex, an immigrant detention center in Adelanto, California, where about 400 people are being held.

At a news conference Wednesday, immigrant rights groups, including the Coalition for Humane Immigrant Rights, said the strikers were motivated by the detention center’s inadequate response to life-threatening health conditions among detainees, “decreasing portions of food” as commissary prices rise and “retaliation and suppression” against those who’ve spoken out against conditions inside. The media event included family members and legal representatives, who described hearing from detainees about how the hunger strike began.

The strike follows the recent release of a critical report from the California Department of Justice. Grounded in interviews with 194 detainees across the state, the report details how the surge in immigrant apprehensions strained conditions and access to medical care at all of the facilities operating in California. State investigators also described the recent deaths of multiple detainees.

The annex strikers’ demands include:

• bond reform
• remediation of mold, repair of water infrastructure, clean water and functioning facilities
• timely medical appointments, “appropriate treatment for chronic conditions” and “substantive mental health support”
• “a diet that sustains basic physical health”
• accountability for detainee deaths, including a man who died shortly after being released 
• “The ability to meet collectively, speak with outside advocates, and communicate with family and the public without interference or retaliation.”

Desert View Annex is operated by The GEO Group, a private prison company, under contract with Immigration and Customs Enforcement. No one at the press conference could confirm whether any detainees at the main Adelanto detention facility were on a hunger strike, too.

What is the response from authorities?

In response to a request for comment, The GEO Group referred LAist to the federal government. In an emailed statement, an unnamed Department of Homeland Security spokesperson said: “There is no hunger strike at Adelanto.”

The department also added: “For the record: During hunger strikes, ICE continues to provide three meals a day, delivered to the detained alien’s room, and an adequate supply of drinking water or other beverages.”

The department also said: “It is a longstanding practice to provide comprehensive medical care from the moment an alien enters ICE custody. This includes medical, dental, and mental health services as available, and access to medical appointments and 24-hour emergency care. For many illegal aliens this is the best healthcare they have received their entire lives.”

What do detainees experience?

Caleb Soto, an attorney with the National Day Labor Organizing Network, represents people currently detained at the Adelanto detention center. He said he goes inside the facility every week.

“I watch [detainees] deteriorate week by week,” he said. “The food they're given ... provides almost no nutrition. Medical appointments can take weeks or even months to be approved, and often last 60 seconds ending with the prescription of Tylenol, Advil or even a salt packet. People with serious conditions go untreated, and I've watched people age in front of me in a matter of months.”

Soto also described his experience with the bond system. “Discretionary releases have fallen 87%,” he said. “And for those who do get a bond hearing, the average bond is now over $14,000, which is a stark increase from the previous administration.”

Detainees have filed grievances, raised formal complaints and written officials about the conditions they’re experiencing, Soto added. “A hunger strike is not a first resort," he said. "It's what people do when every other option has been taken from them.”

Detainees say staff use solitary confinement to retaliate against those who speak out against these conditions, and to isolate detainees who are experiencing mental health crises.

Earlier this year, a coalition of immigrant rights groups filed a federal lawsuit on behalf of detainees, calling for conditions at Adelanto to be improved. The coalition has since requested an emergency court order to prevent further harm. A hearing is scheduled for July 10.