The Brief

When A.W.’s husband lost his job, she was thankful the safety net preserved the family’s access to healthcare. Her eldest son had a team of doctors and therapists at Stanford’s specialty gender clinic; losing that support team, she said, would have been traumatic. The clinic accepted Medi-Cal patients.

Now, California is racing to keep children like A.W.’s son from losing access to gender-affirming care after the federal government moved to cut off funding for those services. State lawmakers are scrambling to approve emergency funding in the last days of the legislative session, even as LGBTQ advocates and parents argue California had months to prepare for the change — and may still fail to prevent a gap in care.

This month the Centers for Medicare and Medicaid Services finalized a rule prohibiting federal reimbursement for gender-affirming care for minors. It takes effect Oct. 13. Roughly 1,500 transgender and gender-nonconforming children on Medi-Cal could lose access to puberty blockers, hormones and related care if the state doesn’t act.

Lawmakers want an emergency $10 million to replace the lost federal funds. The money would buy time for the state to create a separate funding pathway for transgender kids that complies with federal rules, though the Department of Health Care Services says that could take up to a year.

A funding pathway would keep state dollars separate from federal dollars, and allow Medi-Cal children to keep receiving care without disruption. Without it, transgender and gender-nonconforming youth could lose access to ongoing medical treatments.

“They’re low-income Californians who need support arguably the most, and Medi-Cal is their lifeline to access that care,” said Assemblymember Chris Ward, a Democrat from San Diego and chair of the LGBTQ caucus, which is fighting for the money. “We need to stand up for them.”

But some LGBTQ organizations and parents, including A.W., doubt California’s Medi-Cal agency can stand-up a separate program for transgender kids in under six weeks. They also say they feel misled by state leaders after months of budget negotiations.

For the past eight months, advocates and medical organizations had warned California’s Medi-Cal agency that the federal government intended to cut off funding for gender-affirming care for minors. They believed state leaders had set aside money to prepare for that outcome during June budget negotiations, but later learned officials did not follow through.

“I thought that when we took our kids to Sacramento to meet with members of the Assembly and Senate that we were advocating for a backfill that would cover kids on Medi-Cal who would lose those federal dollars,” A.W. said. “I’m really disappointed that our coalition spent so much time and effort on something that I’m not sure we’ll reap the benefits of, and that sucks.”

CalMatters is identifying A.W. by initials only to protect the identity of her two children, both of whom are transgender.

Why California wasn’t ready

In December, the Trump administration published preliminary rules targeting payments for gender-affirming services for young people.

Though the rules weren’t finalized until August, advocacy groups spent months with state officials negotiating for a program that would protect transgender children on Medi-Cal, according to budget letters and presentations obtained by CalMatters. They wanted the state to set aside $1 million to create a separate Medi-Cal funding pathway and to use other money to bolster access to care.

Many believed the state had done exactly that in June, when the budget included two pots of money totalling $56 million for gender-affirming services and reproductive healthcare. After the budget passed, advocates learned health and budget officials for Gov. Gavin Newsom had removed language that would have ensured some of the money would be used to create a separate, state-only Medi-Cal funding program for transgender children.

The Department of Health Care Services, which administers Medi-Cal, did not answer questions about why the money wasn’t earmarked for Medi-Cal and whether there would be any gap in services for transgender children. It referred CalMatters to the Department of Finance. A finance department spokesperson said the administration was “aware of this particular issue” but had no updates to share.

Ward said the budget, which addressed California’s fourth consecutive deficit, didn’t have “a nickel to spare,” and because federal rules hadn’t been finalized at the time, the Medi-Cal funding commitment wasn’t locked in.

On social media, the California Department of Health and Human Services pointed to the $56 in the budget, saying it remains “committed to ensuring all people have access to the medically necessary, evidence-based care that will allow them not only to survive, but thrive.”

Arne Johnson, an organizer with Rainbow Families Action, called that statement misleading. “In the end, not a penny of it is going to backfill Medi-Cal at all,” Johnson said.

The money will instead fund infrastructure investments for transgender health clinics as more care gets pushed out of hospitals and into primary care settings under federal threats, and will aid other groups that have lost federal funding, including military families and veterans, according to two sources familiar with budget negotiations.

Many advocacy groups said California’s long-term investment is welcome, but argue the state failed to protect the immediate care of vulnerable children.

“It’s been very frustrating to see California say in many words that it’s supportive of trans people, and be so unprepared for something we all knew was about to happen,” Johnson said.

Laura Sheckler, budget and policy director at the California Primary Care Association, which represents clinics, said the state will have a challenging time creating a program by the time the federal cuts are expected to begin.

“The bigger question is how is California going to ensure that whatever they set up is going to be available on Oct. 13 when these rules go into effect?” Sheckler said.

For one family, Medi-Cal was the safety net

A.W. and her family are bracing for that deadline and what they anticipate will be an inevitable loss of care.

Discovering that her first child was transgender prompted a personal reckoning for A.W. She had spent most of her career working in conservative politics for prominent Republican leaders. At home, though, her first child showed signs of gender dysphoria even as a toddler, pulling bows out of his hair, crying when forced to wear a dress and asking why he couldn’t stand up to pee.

A.W. and her husband chalked it up to tomboy behavior.

“We had zero education or inkling that he might be trans, but as we started educating ourselves and learning more, we realized that he at a very, very young age was verbally communicating with us who he is,” A.W. said.

After the family moved from Virginia to the Bay Area for work, her son, who was 8 at the time, started seeing a therapist. A year and a half later he received his first puberty blocker, and has continued to see therapists and endocrinologists at Stanford ever since. Medi-Cal allowed her son to keep seeing the same doctors when the startup where A.W.'s husband worked went under two years ago.

“I say that (my son) has really opened me up and made me see things and accept things that I didn’t understand,” A.W. said. “For me, it was a huge transformation.”

Just last year, A.W.’s second child also came out as transgender. It was surprising, but both parents say part of parenting is loving their children unconditionally.

Either child losing healthcare — even temporarily — would be devastating, but for her eldest, now 15 and giving himself testosterone injections weekly, the consequences could be permanent.

“A gap in care for my son is a terrible thing. He doesn’t take testosterone and what happens? He would be forced to medically detransition,” A.W. said. “It’s unacceptable that the state wasn’t prepared.”

Supported by the California Health Care Foundation (CHCF), which works to ensure that people have access to the care they need, when they need it, at a price they can afford. Visit www.chcf.org to learn more.

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

Joseph Babbitt of Springfield, Mo. has a pretty good deal when it comes to health insurance. He works as a senior financial controller for West Plains Veterinary Supply, which employs about 50 people and distributes pet food, toys and vet supplies across the region.

Like about 157 million Americans, Babbitt gets insurance through his job. Unlike most Americans, his job has exceptionally generous benefits. "Our owners are very nice — they give all of our employees healthcare and they pay for it," he says. The company offers several different plan options and covers most or all of the monthly premium cost.

So why, even with free premiums, does it still feel like health costs are way too expensive? "Everybody talks about healthcare and how much it's costing them," says Babbitt. He explains that even without monthly premiums, a high deductible can be brutal — that's the amount the patient has to spend out-of-pocket before the insurance company starts paying for doctors visits and procedures, etc.

Now age 60, he remembers a time when it wasn't so bad. "Back in the '90s, our deductibles were $250 [or] $500 — now they're $5,000," he says. "That seems like a lot."

"We are the only country on our planet that forces people into bankruptcy because they get sick," he adds.

The cost of a new car, every year

Healthcare costs are rising fast in the U.S., and even workers with solid healthcare benefits through work are feeling it, according to an annual survey of nearly 2,000 employers about their health benefits. The report was published Thursday by KFF, a nonpartisan health research organization.

"The average health insurance premium for a family of four is now $28,000, which is just a ton of money," says Matthew Rae, associate director for the Health Care Marketplace Program at KFF. "It's basically the cost of a new car every year just to keep a family of four insured." Of that total for family premiums, workers pay about $7,000 per year on average and employers pay the rest.

A glimmer of positivity is that the costs for plans isn't growing as fast as it has in years past, he explains. "We're seeing a 5% increase in family health insurance premiums, which continues a period of modest growth," he says. That increase is roughly on par with worker wages and inflation.

However, "a 5% increase on a big number is still a lot of money," Rae points out. Plus, the growth for the portion of the premium costs that workers pay was 9%. "If this is the beginning of a shift of costs onto workers, that would be a big deal in terms of affordability," he says.

"We are asking people to chip in a lot of money," Rae adds. "Many people are committing a big chunk of their income to health insurance."

The uninsured rate is rising 

Another report published Thursday demonstrates the way these high costs affect people's health. The survey, conducted every two years by the Commonwealth Fund, a nonprofit foundation that supports independent research, is entitled "The State of Health Insurance Coverage in 2026."

Even for workers fortunate enough to have health benefits, "about 43% of them said that they didn't get healthcare because of cost over the past year, and about 31% reported that they had medical debt," says Sara Collins, lead author of the report.

Another key finding was that the overall uninsured rate rose in the last two years. Collins says that's significant but not surprising, because of federal policy decisions like letting extra federal subsidies for people enrolled in Affordable Care Act plans expire, and people losing Medicaid after the pandemic emergency ended.

Federal data shows millions of people have lost health coverage already from either Medicaid or the ACA marketplaces. When work requirements take effect next year, millions more people are projected to lose Medicaid.

"There is a, I think, a strong feeling across the country that something probably does need to be done to the situation that people are facing in their health and health insurance — both on the cost side and then also on these coverage losses," Collins says.

"We asked people whether the federal government has a responsibility to ensure that all Americans have coverage and nearly three quarters said yes to that — that included about 45% of Republicans, 93% of Democrats and 76% of independents."

Copyright 2026 NPR

Mike Obedoza’s Lumpia Smash Burger begins with the flavorful marinade his mother uses for making lumpia, a crispy Filipino spring roll. He folds it into a beef patty, then tops it with a fried lumpia wrapper, creamy avocado slices and fresh jalapeño.

For Obedoza, who grew up in Carson as the son of Filipino immigrants and now resides in Tustin, the burger is more than a winning recipe. “This is me on a plate,” he said.

Fresh off back-to-back Best Burger wins at the Old Towne Burger Fest in Orange County, Obedoza has landed a residency at Grand Central Market in downtown L.A. as Banger Lumpia.

He attributes his current success to the broader Filipino American food moment happening in Southern California, from Lord Maynard Llera of Kuya Lord winning Best Chef: California at the 2024 James Beard Awards to other Filipino food business upstarts' local success, including San & Wolves in Long Beach.

Mike Obedoza works the griddle, making Filipino-American Smashburger dreams come true.

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Courtesy Banger Lumpia

)

“I’m one component of a whole movement that’s happening right now,” he said.

His residency closes this weekend as part of Filipino American History Month, capping off a whirlwind couple of months Obedoza doesn’t take for granted, especially the love he's received from his own community.

“We get a lot of Filipinos that pass by us glowing. … They’re stoked that there’s some Filipino representation,” he said.

Building the burger

Before Banger Lumpia, Obedoza’s pop-up was called Banger, and he folded Filipino flavors like sisig into tacos. Once customers learned the food was Filipino, they kept asking for the classics. “Where’s the lumpia? Where’s the pancit?” he recalled.

Since lumpia filling is marinated ground meat, a burger felt like the natural next step. Obedoza took the marinade from his mother’s lumpia recipe (onions, carrots, soy sauce and fish sauce) and worked it into an all-beef smash patty.

Back-to-back wins: Obedoza’s Lumpia Smashburger took home Best Burger at the Old Towne Burger Fest in 2025 and 2026.

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Courtesy Banger Lumpia

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Jalapeño and avocado add a California finish. “It’s like this perfect blend of being Filipino and Californian,” Obedoza said.

The idea has deep roots in Southern California. Obedoza points to Kogi, the Korean taco truck Roy Choi launched in L.A., which Choi said drew on a kind of local terroir. “I don’t see mustard plants and sheep grazing,” Choi said in a 2014 CNN segment with Anthony Bourdain. “I see barbed wire and telephone poles.”

“It’s a representation of the soil we were raised in," Obedoza said. “I think the Lumpia Smash burger is just my version of that.”

From skater to chef

Growing up in Carson, Obedoza found his creative outlet in rollerblading, competing and filming for sponsors. His favorite skater was Jon Julio, a Filipino American legend of the sport. “That was big for someone, a Filipino growing up in America,” Obedoza said. “I can’t think of anyone else at that time that was a representation of that.”

Obedoza studied hotel and restaurant management at Cal Poly Pomona, where a broken ankle from a skate competition pushed him to get serious about cooking. After graduating in 2007, he completed an accelerated program at the Culinary Institute of America in Greystone in St. Helena. Then, in 2008, he took a trip to the Philippines with his dad that reshaped how he saw himself.

From the skate park to the griddle, Banger Lumpia’s Mike Obedoza puts his whole self on the plate.

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Courtesy Banger Lumpia

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“In the States, I’m Filipino. But when I go there, I’m American,” he said.

Back home, he cooked at hotels including Hyatt and Terranea Resort before moving into marketing and e-commerce. In 2022, he started serving tacos at skate parks under the name Banger. He went full-time in 2023 and has been popping up in L.A. and O.C. ever since.

That same cultural tension carries over into his food. While his Lumpia Smash burger has won praise, Obedoza says some Filipino customers pick apart the more traditional dishes on his menu: the lumpia isn’t made right, they say, the dipping sauce and adobo need more sugar, the adobo isn’t dark enough or has no bone.

“I guess I win on the burgers, but I’ll never win on being Filipino enough,” he said.

He said his cooking reflects his parents’ style and their home region of Central Luzon, north of Manila on the Philippines’ largest island. If it doesn’t match what someone grew up with, he says to get it from their own family.

Despite those differences, Obedoza says that lumpia is “the gateway drug to Filipino food” and hopes that his customers will feel emboldened to try the rest of the menu. He sees the Grand Central Market residency as a test run for an eventual brick-and-mortar. Whatever comes next, he credits one choice: “I went all in on being unique.”

Julia Feinberg feels like she’s living in a sinister version of Groundhog Day. For the second year in a row, California lawmakers have made it tougher for seniors and people with disabilities to qualify for state-funded health benefits.

Feinberg, 37, who has a degenerative neuromuscular disorder, said without Medi-Cal she would be confined to a nursing home rather than living and working as a therapist in Oakland.

“We keep having to have the same fight over and over and over again,” Feinberg said. She requires a power wheelchair and about 19 hours of caregiving each day, which Medi-Cal covers.

California is cutting Medi-Cal after a decade of expansion, part of sweeping federal and state cuts that experts estimate will kick more than 2.2 million Californians off coverage in the next four years, doubling the state’s uninsured rate.

The latest cut came in June, when state leaders approved a budget that will lower the asset limit for low-income seniors and people with disabilities to $21,000 to qualify for Medi-Cal, starting in July 2027. Feinberg, who has built up emergency savings, will have to spend about $10,000 to get under the cap.

In 2024, the state eliminated longstanding Medi-Cal asset limits, but since then lawmakers have chipped away at that policy. At the beginning of this year, state leaders reinstated an asset limit of $130,000, and the June budget lowered it further.

A primary residence and one vehicle are exempt from the new limit, but people 65 and older as well as those with disabilities cannot own a second home or car, and they can’t have more than $21,000 in savings accounts, certain retirement accounts, life insurance policies or even burial plots. They must still meet Medi-Cal income eligibility limits of about $1,800 a month for a single person.

Advocates say the rules unfairly target older people and those with disabilities.

“It’s really expensive to be disabled,” said Elizabette Guéçamburu, 44, who like Feinberg has spinal muscular atrophy and requires a power wheelchair as well as daily caregiving.

Guéçamburu said she’s saving up for a used wheelchair-accessible van, which costs about $75,000. Home modifications such as adding ramps and making bathrooms accessible also cost tens of thousands of dollars, none of which are covered by Medi-Cal. Guéçamburu said those expenses would be impossible to afford if she couldn’t save.

Guéçamburu lives on her family’s farm in Patterson where they grow walnuts, almonds and alfalfa. She works part time as the farm’s bookkeeper. In 2024, doctors diagnosed Guéçamburu’s father with prostate cancer, and he could no longer act as her caregiver. The same year, California eliminated asset limits for people with disabilities and seniors — Guéçamburu cried, able to qualify for Medi-Cal for the first time.

“The timing was a godsend,” she said.

Now, her aging father is unable to take care of her should she lose Medi-Cal, and Guéçamburu is struggling to figure out what to do with money left to her by her grandmother. She’ll likely have to put it into a special needs trust controlled by a family member and give up financial independence. She also had her family strike her from inheriting any portion of their 100-year-old farm. Private home care costs thousands of dollars a month, making it hard for lower- and middle-income people to pay for it out-of-pocket.

“I have to surrender our legacy just to have medical security and have the ability to live my life,” Guéçamburu said.

Asset limit flip-flop

Gov. Gavin Newsom eliminated Medi-Cal asset requirements in 2024 after a yearslong campaign by senior and disability rights advocates. In a statement before the elimination, Newsom said he was proud of the “bold investments” his administration was making to “protect life savings and homes.”

But two years later, faced with a $12 billion budget shortfall, Newsom proposed reinstating the former $2,000 limit, arguing that more than twice as many people enrolled as previously estimated. The Legislature opposed that proposal and compromised at the current higher limit of $130,000, lowering it again to $21,000 starting next July.

Lindsay Imai Hong, California director for Hand In Hand, an advocacy group supporting families that need caregiving, said organizers are looking to the next governor for change.

“We would love to see the asset test permanently taken off of the chopping block,” Imai Hong said.

Republican gubernatorial candidate Steve Hilton said in a statement to CalMatters that he opposes asset limits. He criticized the state for extending other Medi-Cal benefits beyond what it could afford, including coverage for immigrants without legal status.

“Seniors and people with disabilities shouldn’t lose their coverage because they’ve managed to save some money. They’ve done the responsible thing. Why punish them for it?” he said.

Democratic gubernatorial candidate and front-runner Xavier Becerra did not answer specific questions about the asset limit policy, but a campaign spokesperson blamed the Trump administration’s federal cuts for “squeezing” California’s Medi-Cal program.

Becerra will be “focused on protecting access to care and demand savings that are real, measurable and sustainable,” spokesperson Johnathan Underland said. On the campaign trail, Becerra has called himself California’s next “healthcare governor” and has previously floated raising taxes to reverse Medi-Cal cuts, but has not released detailed health policy plans.

Camille Nguyen, an attorney with the Legal Aid Society of San Mateo County, said most people who struggle to stay under the limit have little financial security.

“They have all of their life savings in cash savings instead of a house. That's their retirement. That is the amount they are expecting to live off of for the rest of their life,” Nguyen said.

State data shows about 600 people lost Medi-Cal when California reinstated the $130,000 limit. Advocates expect many more to lose Medi-Cal at the lower limit, but the state never released budget estimates before lawmakers approved the $21,000 limit. If the state reinstated the much lower $2,000 limit, the Department of Finance estimated 62,000 seniors and people with disabilities would lose Medi-Cal over two years.

Limit fuels anxiety, anger among people with disabilities

Feinberg said the prospect of losing Medi-Cal is especially scary because she would also lose access to a special disability program that pays for extra caregiving hours and has a multiyear waitlist. Caregivers help Feinberg get in and out of bed, dress and prepare her meals.

Before the limit was erased in 2024, Feinberg said she checked her bank account every day to make sure the balance was low. At the time, Feinberg was a graduate student and did not earn very much money. Now, as a licensed therapist Feinberg has been able to squirrel away some money.

“I don’t want to spend down that money. I want to save that for retirement, maybe buying a house in the future,” Feinberg said. “The prospect of not being able to have a nest egg is very unsettling.”

Guéçamburu said she’s angry and frustrated that the state views services for people with disabilities as expendable.

“It’s exhausting to have to justify your existence every legislative cycle,” she said.

Supported by the California Health Care Foundation (CHCF), which works to ensure that people have access to the care they need, when they need it, at a price they can afford. Visit www.chcf.org to learn more.

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