The Brief

Cynthia Williams is furious with U.S. House Republicans willing to slash Medicaid, the government-run insurance program for people with low incomes or disabilities.

The 61-year-old Anaheim resident cares for her adult daughter, who is blind, and for her sister, a military veteran with severe post-traumatic stress disorder and other mental health conditions. Medi-Cal, the state’s version of Medicaid, pays Williams to care for them, and she relies on that income, just as her sister and daughter depend on her.

“Let’s be real. We shouldn’t have to be here tonight,” Williams told a raucous standing-room crowd of over 200 people at a recent town hall. “We should be home, spending time with our loved ones and our families, but we’re here. And we’re here to fight, because when politicians try to take away our healthcare, we don’t have the option to sit back and let it happen.”

The House last month approved a Republican budget plan that could shrink Medicaid spending by $880 billion over 10 years, only partially paying for an extension of expiring tax cuts from President Donald Trump’s first term, plus some new ones he has promised, totaling as much as $4.5 trillion.

A spending cut of that magnitude would have a huge impact in California, with nearly 15 million people — more than a third of the population — on Medi-Cal. Over 60% of Medi-Cal’s $161 billion budget comes from Washington.

Attendees applaud speakers during a Tustin town hall last month organized to protest potential cuts to Medicaid.

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Jenna Schoenefeld

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KFF Health News

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Williams was among about a dozen providers, patient advocates, disabled people and family members who stood up one after the other to tell their stories. Rep. Young Kim, a Republican whose district includes this relatively affluent Orange County city, declined an invitation for her or a staff member to attend. But her constituents delivered their message loud and clear to her and the other Republicans in Congress: Hands off Medicaid.

Josephine Rios, a certified nursing assistant at a Kaiser Permanente surgical center in Irvine, said her 7-year-old grandson, Elijah, has received indispensable treatments through Medi-Cal, including a $5,000-a-month medication that controls his seizures, which can be life-threatening. Elijah, who has cerebral palsy, is among the more than 50% of California children covered by Medi-Cal.

“To cut Medicaid, Medi-Cal, that’s like saying he can’t live. He can’t thrive. He’s going to lie in bed and do nothing,” Rios said. “Who are they to judge who lives and who doesn’t?”

Josephine Rios, speaking at the Feb. 20 town hall in Tustin, worries about her grandson who has cerebral palsy and relies on Medi-Cal.

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Jenna Schoenefeld

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Two-thirds of Californians across party lines oppose cuts to Medi-Cal, according to a new survey by the California Health Care Foundation and NORC at the University of Chicago.

The town hall here was one of three organized by Fight for Our Health, a coalition of health advocacy groups and unions, to target Republican House members whose California districts are considered politically competitive. The other two were in Bakersfield, part of which is represented by Rep. David Valadao, and Corona, home to Rep. Ken Calvert. Multiple other town halls and protests have sprung up across the country in recent weeks.

The coalition has reprised a campaign — part of a broader national movement — that fought against the GOP’s unsuccessful 2017 effort to repeal the Affordable Care Act.

The Republicans’ loss of House control in the 2018 midterm elections has been widely attributed to their stance on healthcare. Valadao was among the GOP members who lost their seats in 2018, though he took his back two years later.

Still, he voted for the House budget proposal last week, despite the fact that about two-thirds of the population in his district is on Medi-Cal — the highest in the state — and even though he is one of eight GOP House members who sent a letter to House Speaker Mike Johnson warning about the “serious consequences” of deep cuts to Medicaid. Valadao’s office did not respond to requests for comment.

Calvert, who’s been in the House for 32 years and eked out reelection last November, also voted for the budget, as did Kim. All nine GOP members of California’s congressional delegation supported it, as did all House Republicans except one.

A woman protests Medicaid cuts outside the Tustin town hall.

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Jenna Schoenefeld

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KFF Health News

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Critics of the budget plan say it helps the rich at the expense of society’s most vulnerable — an argument that was vigorously repeated at the Tustin town hall. But supporters of the plan say that extending the tax cuts, key provisions of which are set to expire at the end of this year, would avoid a large tax hike for average Americans and benefit low-income families the most.

“American families are facing a massive tax increase unless Congress acts by the end of the year,” Calvert said in a statement to KFF Health News before the vote. He vowed the GOP would not touch Social Security or Medicare. He did not offer similar assurances on Medicaid, but said, “We are not interested in cutting the social and healthcare safety net for children, disabled and low-income Americans. We are focused on eliminating waste, fraud and abuse.”

The House budget proposal does not specify spending cut details, though it instructs the Energy and Commerce Committee, which oversees Medicaid and Medicare spending, to cut $880 billion — a large chunk of the up to $2 trillion in total cuts. The GOP’s razor-thin majority means Johnson will have a narrow path to get a more detailed budget passed. Republican support, whether from fiscal hawks who want deeper spending cuts or House members worried about slashing Medicaid, could ebb and flow as the details are hashed out.

Moreover, the House must reach a compromise with the Senate, which has passed a much narrower budget resolution that leaves the big tax cuts out for now.

Like Kim, Valadao and Calvert declined invitations to attend or send staffers to the town hall meetings in their regions. At the Tustin meeting, multiple speakers chided Kim for her absence. At one point, the large screen behind the podium flashed a picture of an empty chair with the words, in large block letters, “Congresswoman Kim, we saved you a seat.”

Kim spokesperson Callie Strock said in an email that Kim and her local staff had preexisting commitments that night. She added that Kim is “committed to protecting and strengthening our healthcare system.”

But those in attendance were clearly worried.

“It’s a moral obligation for all of us to look at the most disadvantaged people in our country and take good care of them,” said Beth Martinko, whose 33-year-old son, Josh, has autism and relies on Medi-Cal for his care. “This has no place in politics.”

A program supporting the mental health of young survivors of last year’s firestorms will receive $2.2 million in state funding, according to Governor Gavin Newsom.

The money will go to UCLA’s Sound Body Sound Mind program. They’ll provide an app for students and families with guided training on mental health topics. The funding will also go towards workshops and curriculum for staff at 33 schools in Altadena and the Pacific Palisades focused on resiliency.

Matt Flesock, executive director of UCLA’s Sound Body Sound Mind program told LAist the work will support the mental health of students who were hit by the back-to-back traumas of the COVID-19 pandemic and last year’s historic firestorms.

“Their entire formative years in school have experienced really, really tremendous disruption. And that’s what made this so pressing and so important,” Flesock said.

What does a resiliency curriculum look like? 

Dr. Catherine Mogil, associate professor of psychology at UCLA, said the curriculum that schools will go out to the dozens of fire-affected schools is called FOCUS: Families Overcoming Under Stress. The trauma-informed, reliance-focused curriculum has been used at hospitals with kids with medical traumas and has been specially tailored for fire-related stress.

The curriculum will include teaching kids the concept of a ‘feeling thermometer’ that can help them identify and regulate emotions when they are more manageable rather than in the red zone.

“Kids who have a wider emotional vocabulary and can talk to adults about how they’re feeling and how they might want to manage uncomfortable feelings or manage stress,” Mogil said.

Coping skills taught might include breathing exercises, knowing when to reach out to a friend, or having an internal mantra.

Mohil said the program will also include workshops for teachers and parents on opening up difficult conversations with kids: How do you answer the difficult questions when you may not know the answers? How do you re-instill safety when you yourself may feel unsafe?

The state estimates some 30,000 students will benefit from the program over the next two school years.

The U.S. and Mexico are speeding up plans to clean the Tijuana River and considering interim steps to protect public health, U.S. Environmental Protection Agency Administrator Lee Zeldin said at a San Diego meeting with local leaders and Congress members last week.

“This is a nonpartisan, bipartisan effort to work together for a very common important good for millions of Americans who have been waiting for this relief for decades,” Zeldin said.

Sewage pollution from the cross-border river has plagued Imperial Beach, Coronado and other parts of southern San Diego County for decades, sickening swimmers and surfers, forcing the closure of local beaches and endangering Navy Seals who train in Coronado.

As the Tijuana population grew and wastewater plants on both sides of the border failed, hundreds of millions of gallons of raw sewage gushed into the ocean. The polluted river also emits airborne chemicals including foul-smelling hydrogen sulfide gas, which causes respiratory problems and other ailments among people in neighboring communities.

After decades of neglect and worsening pollution, Mexican and U.S. officials have made recent strides toward a solution. Last year the countries struck two more agreements that spell out the infrastructure upgrades needed to control pollution. The federal government has dedicated $653 million to the problem, said Rep. Scott Peters, a San Diego Democrat, who called Tijuana River pollution “the biggest environmental catastrophe in the Americas.”

Despite President Donald Trump’s cuts to other federal programs and his conflicts with California, money has continued to flow for Tijuana River cleanup. Democrats and Republicans who met Thursday said they agreed on the urgency of the problem and need for investments to solve it.

“You wouldn't know which party we all were part of based on our conversation,” said Rep. Mike Levin, a Democrat who represents San Clemente and Carlsbad. “That's unusual. It's refreshing, but I think it's also necessary to solve a problem of this magnitude.”

What's happening now

This year the U.S. repaired the failing South Bay International Wastewater Treatment Plant and expanded its capacity from 25 million to 35 million gallons of wastewater per day. The next phase will boost the plant’s capacity to at least 50 million gallons per day.

In April, Mexico repaired its Punta Bandera plant near the border, reducing sewage flows into the ocean.

More improvements are coming soon, Zeldin said. One project under construction will prevent 5 million gallons per day of sewage from entering the Tijuana River, while another would divert 10 million gallons per day of treated effluent from the river, he said.

“There are several additional projects, half a dozen I have listed here, scheduled for completion in 2026,” Zeldin said. “Again, we are monitoring it every week, throughout the week. We are confirming and verifying that this work is progressing.”

Zeldin said he’s working to make sure Mexico provides money it committed to cleaning up Tijuana River sewage, expedites infrastructure upgrades and establishes what he called a “permanent 100 solution” to increase wastewater capacity for future growth in Tijuana.

“I've been down and seen actual constructions, and I now am confident that if we continue to press our partners ... we'll be able to have the reforms that we need to keep our beaches open to keep our Navy Seals safe,” he said.

The long-term outlook

Officials acknowledged that improving sewage treatment facilities won’t immediately resolve existing health problems caused by chronic air and water pollution, and said more funding is needed to keep the plants in working order.

San Diego County has distributed air purifiers to households near the Tijuana River, is launching a health study on its effects and seeking funds to fix a site known as the Saturn Boulevard hot spot, where culverts churn polluted river water to release airborne toxins.

Zeldin said public health solutions aren’t part of the current package, but said he would be happy to add them if Congress devotes money to that purpose. Levin, who serves on the House Committee on Appropriations, said he’ll seek suggestions from local stakeholders about health needs in communities near the Tijuana River.

“I am very open to any and all suggestions around federal appropriations to deal, not only with the ongoing public health crisis, but also the damage that has been done in years past,” Levin said.

Levin said he’ll also seek money for maintenance and operations of the expanded sewage treatment plants. The original projects covered construction costs but not ongoing expenses, which eventually left the plants in disrepair, he said.

“We're going to keep at it until the problem is fixed, until the beaches are open, until our Seals can train safely and until our service members and border patrol and everyone else in the community doesn't have to deal with water pollution and air pollution,” Levin said. “It's just critically important for the quality of life for all San Diegans.”

In the fall of 2023, the California Legislature tasked the state’s fire safety regulators with writing a report that some housing affordability advocates say could make it easier to build bigger, airier and better lit apartment buildings in California’s housing-strapped cities.

The Office of the State Fire Marshal was given until Jan. 1, 2026 to come up with a report on single-stair apartment buildings — a type of mid-sized multifamily development legal in much of the world, but effectively banned across most of North America.

More than a month later, single-stair advocates are still waiting on that report — though a draft version obtained by CalMatters hints that the office may be considering a modest change to the state building code.

“They were given a deadline,” said Stephen Smith, founder of the Center for Building in North America, which advocates for cost-reducing changes to building regulations.

That safety-minded code is meant to provide residents with multiple escape routes in the event of a fire. But it has also become a focal point of criticism among a growing number of housing advocates, architects and urbanists, who say it raises the costs of multifamily construction, limits where apartments can be built, pushes developers toward darkened studios and away from family-sized apartments and provides limited health and safety benefits.

“I know there’s been a real desire among politicians in California to change the state’s image as a slow moving state, but in this case I don’t see it,” said Smith, who was also a member of the working group of fire service professionals, building code experts and housing advocates tasked with writing the first draft of the report for the state Fire Marshal. The group’s last meeting was on November 4.

“This report is still under review and we will publish the report as soon as it is approved for publication,” said Wes Maxey, CAL FIRE’s assistant deputy director of legislation, in an email. He would not say when the report is expected to be released or what the hold up is all about.

The state legislature regularly assigns research reports of this kind to various corners of the state bureaucracy — and, as CalMatters has reported before, the state bureaucracy regularly blows past its assigned deadlines.

But the single-stair analysis has garnered considerable interest outside of Sacramento.

Current rules in California (with the one, recent exception of Culver City) require apartment buildings higher than three stories to have at least two staircases connected by a hallway.

The Legislature was clearly interested in raising that height limit when it ordered the report in the first place.

“Many European countries allow buildings with single staircases and have better records on fire safety than the United States,” said Assemblymember Alex Lee, a Milpitas Democrat, urging a “yes” vote on his bill in the summer of 2023. “I believe having the Fire Marshal conduct the study will start the conversation about leveraging existing fire and emergency response technologies and strategies to maximize housing projects.”

Local fire marshals, fire chiefs and fire fighting unions have, by and large, opposed easing staircase requirements in the building code wherever they’ve been proposed.

The final report is likely to disappoint either those organized fire services, a politically powerful constituency, or “Yes In My Backyard” advocates that have found an ally in Gov. Gavin Newsom.

A draft version of the report circulated among stakeholders in late October included a half-hearted endorsement of a change to the state building code. If the State Fire Marshal recommends new policy, the draft reads, the change should only be from a three-story maximum up to four. Any new four story single-stair structures should also be restricted in size and abide by a number of other added safety-oriented restrictions, the report added.

Culver City, west of downtown Los Angeles, passed a single-stair ordinance last year to nix the second-stair requirement in certain apartment buildings up to six stories. Six stories is also the cut-off in the four other jurisdictions that go above three: New York City, Seattle, Honolulu and Portland, Oregon.

The draft report, which is not final, also went out of its way to emphasize “the near unanimous feedback from California Fire Departments who are opposed to permitting single-exit stairway construction … greater than 3 stories.”

Whenever it is finalized and published, the report won’t have the force of law. But should state legislators opt to take up the issue in the future, its final recommendations are likely to carry weight with undecided lawmakers.

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

Ghislaine Maxwell, the former girlfriend of Jeffrey Epstein, declined to answer questions from House lawmakers in a deposition Monday, but indicated that if President Donald Trump ended her prison sentence, she was willing to testify that neither he nor former President Bill Clinton had done anything wrong in their connections with Epstein.

The House Oversight Committee had wanted Maxwell to answer questions during a video call to the federal prison camp in Texas where she's serving a 20-year sentence for sex trafficking, but she invoked her Fifth Amendment rights to avoid answering questions that would be self-incriminating. She's come under new scrutiny as lawmakers try to investigate how Epstein, a well-connected financier, was able to sexually abuse underage girls for years.

Amid a reckoning over Epstein's abuse that has spilled into the highest levels of businesses and governments around the globe, lawmakers are searching for anyone who was connected to Epstein and may have facilitated his abuse. So far, the revelations have shown how both Trump and Clinton spent time with Epstein in the 1990s and early 2000s, but they have not been credibly accused of wrongdoing.

Dressed in a brown, prison-issued shirt and sitting at a conference table with a bottle of water, Maxwell repeatedly said she was invoking "my Fifth Amendment right to silence," video later released by the committee showed.

During the closed-door deposition, Maxwell's attorney David Oscar Markus said in a statement to the committee that "Maxwell is prepared to speak fully and honestly if granted clemency by President Trump."

He added that both Trump and Clinton "are innocent of any wrongdoing," but that "Ms. Maxwell alone can explain why, and the public is entitled to that explanation."

Maxwell's appeal hits pushback

Democrats said that was a brazen effort by Maxwell to have Trump end her prison sentence.

"It's very clear she's campaigning for clemency," said Rep. Melanie Stansbury, a New Mexico Democrat.

Asked Monday about Maxwell's appeal, the White House pointed to previous remarks from the president that indicated the prospect of a pardon was not on his radar.

And other Republicans push backed to the notion quickly after Maxwell made the appeal.

"NO CLEMENCY. You comply or face punishment," Republican Rep. Anna Paulina Luna, wrote on social media. "You deserve JUSTICE for what you did you monster."

Maxwell has also been seeking to have her conviction overturned, arguing that she was wrongfully convicted. The Supreme Court rejected her appeal last year, but in December she requested that a federal judge in New York consider what her attorneys describe as "substantial new evidence" that her trial was spoiled by constitutional violations.

Maxwell's attorney cited that petition as he told lawmakers she would invoke her Fifth Amendment rights.

Family members of the late Virginia Giuffre, one of the most outspoken victims of Epstein, also released a letter to Maxwell making it clear they did not consider her "a bystander" to Epstein's abuse.

"You were a central, deliberate actor in a system built to find children, isolate them, groom them, and deliver them to abuse," Sky and Amanda Roberts wrote in the letter addressed to Maxwell.

Maxwell was moved from a federal prison in Florida to a low-security prison camp in Texas last summer after she participated in two-days of interviews with Deputy Attorney General Todd Blanche.

The Republican chair of the committee, Rep. James Comer of Kentucky, had also subpoenaed her at the time, but her attorneys have consistently told the committee that she wouldn't answer questions. However, Comer came under pressure to hold the deposition as he pressed for the committee to enforce subpoenas on Bill Clinton and former Secretary of State Hillary Clinton. After Comer threatened them with contempt of Congress charges, they both agreed to sit for depositions later this month.

Comer has been haggling with the Clintons over whether that testimony should be held in a public hearing, but Comer reiterated Monday that he would insist on holding closed-door depositions and later releasing transcripts and video.

Lawmakers review unredacted files

Meanwhile, several lawmakers visited a Justice Department office in Washington Monday to look through unredacted versions of the files on Epstein that the department has released to comply with a law passed by Congress last year. As part of an arrangement with the Justice Department, lawmakers were given access to the over 3 million released files in a reading room with four computers. Lawmakers can only make handwritten notes, and their staff are not allowed in with them.

Rep. Jamie Raskin, the top Democrat on the House Judiciary Committee, spent several hours in the reading room Monday morning. He told reporters as he returned to the Capitol that even if all the House members who triggered the vote on releasing the files "spent every waking hour over at the Department of Justice, it would still take us months to get through all of those documents."

Democrats on Raskin's committee are looking ahead to a Wednesday hearing with Attorney General Pam Bondi, where they are expected to sharply question her on the publication of the Epstein files. The Justice Department failed to redact the personal information of many victims, including inadvertently releasing nude photos of them.

"Over and over we begged them, please be careful, please be more careful," said Jennifer Freeman, an attorney representing survivors. "The damage has already been done. It feels incompetent, it feels intimidating and it feels intentional."

Democrats also say the Justice Department redacted information that should have been made public, including information that could lead to scrutiny of Epstein's associates.

Rep. Thomas Massie, a Kentucky Republican who sponsored the legislation to force the release of the files, said that after reviewing the unredacted versions for several hours, he had found the names of six men "that are likely incriminated by their inclusion." He called on the Justice Department to pursue accountability for the men, but said he could potentially name them in a House floor speech, where his actions would be constitutionally protected from lawsuits.

Massie, along with California Democratic Rep. Ro Khanna, said they also came across a number of files that still had redactions. They said that was likely because the FBI had turned over redacted versions of the files to the Justice Department.

Khanna said "it wasn't just Epstein and Maxwell" who were involved in sexually abusing underage girls.

Release of the files has set in motion multiple political crises around the world, including in the United Kingdom, where Prime Minister Keir Starmer is clinging to his job after it was revealed his former ambassador to the U.S. had maintained close ties to Epstein. But Democratic lawmakers bemoaned that so far U.S. political figures seem to be escaping unscathed.

"I'm just afraid that the general worsening and degradation of American life has somehow conditioned people not to take this as seriously as we should be taking it," Raskin said.
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