The Brief

Few voters likely expected President Donald Trump in the first weeks of his administration to slash billions of dollars from the nation’s premier federal cancer research agency.

But funding cuts to the National Institutes of Health were presaged in Project 2025’s “Mandate for Leadership,” a conservative plan for governing that Trump said he knew nothing about during his campaign. Now, his administration has embraced it.

The 922-page playbook compiled by the Heritage Foundation, a conservative research group in Washington, says “the NIH monopoly on directing research should be broken” and calls for capping payments to universities and their hospitals to “help reduce federal taxpayer subsidization of leftist agendas.”

Universities, now slated to face sweeping cuts in agency grants that cover these overhead costs, say the policy will destroy ongoing and future biomedical science. A federal judge temporarily halted the cuts to medical research on Feb. 10 after they drew legal challenges from medical institutions and 22 states.

Project 2025 as prologue

The rapid-fire adoption of many of Project 2025’s objectives indicates that Trump acolytes — many of its contributors were veterans of his first term, and some have joined his second administration — have for years quietly laid the groundwork to disrupt the national health system. That runs counter to Trump’s insistence on the campaign trail, after Democrats made Project 2025 a potent attack line, that he was ignorant of the document.

“I have no idea what Project 2025 is,” Trump said Oct. 31 at a rally in Albuquerque, New Mexico, one of many times he disclaimed any knowledge of the plan. “I’ve never read it, and I never will.”

But because his administration is hewing to the Heritage Foundation-compiled playbook so closely, opposition groups and some state Democratic leaders say they’re able to act swiftly to counter Trump’s moves in court.

They’re now preparing for Trump to act on Project 2025 recommendations for some of the nation’s largest and most important health programs, including Medicaid and Medicare, and for federal health agencies.

“There has been a lot of planning on the litigation side to challenge the executive orders and other early actions from a lot of different organizations,” said Noah Bookbinder, president of Citizens for Responsibility and Ethics in Washington, a watchdog group. “Project 2025 allowed for some preparation.”

The plan, for example, calls for state flexibility to impose premiums for some beneficiaries, work requirements, and lifetime caps or time limits on Medicaid coverage for some enrollees in the program for low-income and disabled Americans, which could lead to a surge in the number of uninsured after the Biden administration vastly expanded the program’s coverage.

“These proposals don’t directly alter eligibility for Medicaid or the benefits provided, but the ultimate effect would be fewer people with health coverage,” said Larry Levitt, executive vice president for health policy at KFF, a health information nonprofit that includes KFF Health News, the publisher of California Healthline. “When you erect barriers to people enrolling in Medicaid, like premiums or documenting work status, you end up rationing coverage by complexity and ability to pay.”

Congressional Republicans are contemplating a budget plan that could result in hundreds of billions of dollars being trimmed from Medicaid over 10 years.

Project 2025 called for expanding access to health plans that don’t comply with the Affordable Care Act’s strongest consumer protections. That may lead to more choice and lower monthly premiums for buyers, but unwitting consumers may face potentially massive out-of-pocket costs for care the plans won’t cover.

And Project 2025 called for halting Medicaid funding to Planned Parenthood affiliates. The organization, an important health care provider for women across the country, gets roughly $700 million annually from Medicaid and other government programs, based on its 2022-23 report. Abortion made up about 4% of services the organization provided to patients, the report says.

The administration’s steps to scrub words such as “equity” from federal documents, erase transgender identifiers, and curtail international medical aid — all part of the Project 2025 wish list — have already had sweeping ramifications, hobbling access to healthcare and eviscerating international programs that aim to prevent disease and improve maternal health outcomes.

Under a memorandum issued in January, for example, Trump reinstated and expanded a ban on federal funds to global organizations that provide legal information on abortions.

Studies have found that the ban, known as the “global gag rule” or “Mexico City Policy,” has stripped millions of dollars away from foreign aid groups that didn’t abide by it. It’s also had a chilling effect: In Zambia, one group removed information in brochures on contraception, and in Turkey, some providers stopped talking with patients about menstrual regulation as a form of family planning.

Project 2025 called on the next president to reinstate the gag rule, saying it “should be drafted broadly to apply to all foreign assistance.”

Trump also signed an executive order rolling back transgender rights by banning federal funds for transition-related care for people under age 19. An order he signed also directed the federal government to recognize only two sexes, male and female, and use the term “sex” instead of “gender.”

The Project 2025 document calls for deleting the term “gender identity” from federal rules, regulations, and grants and for unwinding policies and procedures that its authors say are used to advance a “radical redefinition of sex.” In addition, it states that Department of Health and Human Services programs should “protect children’s minds and bodies.”

“Radical actors inside and outside government are promoting harmful identity politics that replaces biological sex with subjective notions of ‘gender identity,’” the Project 2025 road map reads.

Data disappears

As a result of Trump’s order on gender identity, health researchers say, the Centers for Disease Control and Prevention took down online information about transgender health and removed data on LGBTQ+ health. A federal judge on Feb. 11 ordered that much of the information be restored; the administration complied but added notices to some webpages labeling them “extremely inaccurate” and claiming they don’t “reflect biological reality.”

The CDC also delayed the release of information and findings on bird flu in the agency’s Morbidity and Mortality Weekly Report. Federal workers have said they were told to retract papers that contain words such as “nonbinary” or “transgender.” And some hospitals suspended gender-affirming care such as hormone therapy and puberty blockers for youths.

Advocacy groups say the orders discriminate and pose barriers to medically necessary care, and transgender children and their families have filed a number of court challenges.

Lawyers, advocates, and researchers say implementation of many of Project 2025’s health policy goals poses a threat.

“The playbook presents an antiscience, antidata, and antimedicine agenda,” according to a piece last year by Boston University researchers in JAMA.

The Project 2025 blueprint sets out goals to curb access to medication abortion, restructure public health agencies, and weaken protections against sex-based discrimination. It would have seniors enroll by default in Medicare Advantage plans run by commercial insurers, in essence privatizing the health program for older Americans. And it calls for eliminating coverage requirements for Affordable Care Act plans that people buy without federal subsidies, which, insurance experts say, risks leaving people underinsured.

“It’s the agenda of the Trump administration,” said Robert Weissman, a co-president of Public Citizen, a progressive consumer rights advocacy group. “It’s to minimize access to care under the guise of strict work requirements in Medicaid, privatizing Medicare and rolling back consumer protections and subsidies in the Affordable Care Act.”

The White House didn’t respond to a message seeking comment. Conservatives have said implementation of the project’s proposals would curb waste and fraud in federal health programs and free health systems from the clutches of a radical “woke” agenda.

“Americans are tired of their government being used against them,” Paul Dans, a lawyer and former director of Project 2025, said last year in a statement. “The administrative state is, at best, completely out of touch with the American people and, at worst, is weaponized against them.”

Dans did not return messages seeking comment for this article.

The Heritage Foundation has sought to separate itself and Project 2025 from Trump’s executive orders and other initiatives on health.

“This isn’t about our recommendations in Project 2025 — something we’ve been doing for more than 40 years. This is about President Trump delivering on his promises to make America safer, stronger and better than ever before, and he and his team deserve the credit,” Ellen Keenan, a spokesperson for Heritage, said in a statement.

Versions of the document have been produced roughly every four years since the 1980s and have influenced other GOP presidents. Former President Ronald Reagan adopted about two-thirds of the recommendations from an earlier Heritage guide, the group says.

In some instances, the Trump administration hasn’t just followed Project 2025’s proposals but has gone beyond them.

The document called on the next president to scale back and “deradicalize” the U.S. Agency for International Development, an independent federal agency that provides foreign aid and assistance, including for many international health programs. The administration hasn’t just scaled back USAID. Trump adviser Elon Musk bragged on his social media platform, X, that his Department of Government Efficiency fed the agency “into the wood chipper,” physically closing its offices and putting nearly all its staff on administrative leave while ending funding for its programs and disseminating misinformation about them.

But the administration risks waning public support if it adopts the project’s goals to upend U.S. healthcare and health policy. Almost 60% of voters said they felt negatively about Project 2025 in a September poll by NBC News.

“Project 2025 was never a thought exercise; it was always a blueprint,” said Ally Boguhn, a spokesperson for Reproductive Freedom for All, an abortion rights group. “We’re only a few weeks into his presidency, and it’s setting the groundwork for even more.”

This article was produced by KFF Health News, a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF — the independent source for health policy research, polling, and journalism.

After copper wire theft left the Sixth Street Bridge in darkness for years, the city of Los Angeles has hired a Pasadena-based engineering firm to restore the lighting, a move aimed at improving safety for Boyle Heights and the surrounding neighborhoods.

City officials contracted Tetra Tech to relight the bridge, which has been plagued by copper wire theft since its opening in 2022. The outages have frustrated residents and commuters who use the bridge to walk, run, bike and drive between downtown LA and the Eastside.

Aging infrastructure, copper wire theft and delayed repairs led to nearly 2,000 streetlight service requests in Boyle Heights in 2024. Nearly seven miles of copper wire have been reported stolen from the Sixth Street Bridge.

Tetra Tech began working on the project’s design in January and is scheduled to restore the wiring to all lights along the bridge, including along roadways, barriers, ramps, stairways and arches before the 2028 Olympic and Paralympic Games come to Los Angeles that summer, according to a Feb. 18 news release from Councilmember Ysabel Jurado’s office.

The firm – which was selected by the city’s Bureau of Engineering – will fortify the pull boxes, service cabinet and conduits to protect against copper wire theft. Tetra Tech will also install a security camera system to deter vandalism and theft.

“When our streets are well-lit, our neighborhoods feel safer and more connected,” Jurado said in the news release. “The Sixth Street Bridge plays a vital role in connecting Angelenos between the Eastside and the heart of the City.”

Jurado – who pledged to look into fixing the Sixth Street Bridge lights when she was elected in 2024 – said the partnership with Tetra Tech “moves us one step closer to restoring one of the City’s most iconic landmarks as a safe, welcoming public space our communities deserve.”

According to officials, the total contract value with Tetra Tech is $5.3 million, which includes work on the Sixth Street Bridge as well as the Sixth Street PARC project, which encompasses 12 acres of recreational space underneath and adjacent to the bridge.

The PARC project will make way for sports fields, fitness equipment, event spaces and a performance stage. PARC’s grand opening is anticipated later this year.

Because the work for the PARC project and the bridge is connected, the Board of Engineers recommended using the existing PARC contract with Tetra Tech to ensure completion ahead of the 2028 Games, officials said.

The cost for the design work on the bridge alone is roughly $1 million.

On Thursday, Jurado announced that her streetlight repair crew had restored lighting and strengthened infrastructure for more than 400 streetlights across her district, including Boyle Heights, Lincoln Heights, and El Sereno. Next, they plan to tackle repairs in downtown L.A.

For the last 70 years, the  27th Street Bakery hasn’t just been the go-to place for people who want to spend less time in the kitchen — it’s become a staple in South Central, providing jobs and security for people living in the neighborhood.

The bakery is Black-owned and in its third generation as a business. It’s co-owned by sisters Denise Cravin-Paschal and Olympic gold-medalist Jeanette Bolden-Pickens, as well as her husband Al Pickens.

“My grandfather employed a lot of people around here as he was growing his business and so have we,” Cravin-Paschal told the LA Local. “They feel that this is a safe place to come. We have the respect of being here for 70 years and so we enjoy it.”

The bakery sits on Central Avenue, the focal point of Black Los Angeles between the 1930s and 1960s. As segregation laws were struck down, Black people in LA began to move elsewhere and took their businesses with them. The bakery, though, is still Black-owned and operating 70 years later.

Today it is considered the largest manufacturer of sweet potato pies on the West Coast, the bakery’s website states. Last year, the city and District 9 Councilmember Curren Price Jr. presented the bakery with a plaque that reads: “A Walk Down Central Avenue — A legacy of community: powered by the people and its places.”

It hangs on the wall in the bakery’s lobby along with several other photos and recognitions they’ve received over the years.

“Our goal is to keep this legacy alive and we’re celebrating 70 years of being here in business. We are so grateful to the community,” Bolden-Pickens said.

In celebration of its anniversary, a sign in the bakery says it is offering one slice of sweet potato pie for 70 cents on Saturdays starting this weekend through Oct. 31.

The bakery was a restaurant at first bringing Southern flavor to LA

The bakery began as a restaurant in the 1930s on Central Avenue founded by Harry and Sadie Patterson, according to the family and Los Angeles Conservancy. Back then, Central Avenue was the epicenter of LA’s Black community and Patterson, who came from Shreveport, Louisiana, decided to bring his Southern recipes to life in Los Angeles.

The restaurant later became a bakery in 1956, according to the bakery’s website. Patterson’s daughter Alberta Cravin and her son Gregory Spann took over the bakery in 1980. After Spann passed away, Cravin’s daughters — the sisters who are current owners — took over the family business. Five other relatives also help them out, Cravin-Paschal said.

These days, the bakery is open Tuesday through Saturday each week and the bulk of their customers are other businesses. They serve nearly 300 vendors including convenience stores like 7-Eleven, Ralphs grocery stores, Smart & Final, ARCO gas stations, restaurants and other mom-and-pop stores. Louisiana Fried Chicken has been a customer since 1980, Cravin-Paschal said.

An average delivery today is usually 45 dozen pies and they also ship orders out of state, Cravin-Paschal said.

She also told The LA Local they have six full time employees and most of them have worked for the bakery at least 25 years.

“I like working here, I like the people,” Maximina “Maxi” Rodriguez, a longtime employee, told The LA Local. After 32 years at the bakery, she said she plans to retire in June. “I’m going to miss it.”

Rodriguez said working at the bakery is a family affair for her, too. Her sister, Guadalupe Garibaldi, has worked at the bakery for over 40 years and her niece, Yoselin Garibaldi, is now a cashier and driver.

Patterson’s lessons inspired 3 generations to keep the business running

For Bolden-Pickens and Cravin-Paschal, running the bakery is a labor of love. Both told The LA Local that their grandfather taught them to stay true to the fresh ingredients they use and not to cut corners.

These lessons helped Bolden-Pickens in her life before taking over the family business. She won a gold medal as part of the U.S. 4×100 meter relay team in track and field during the 1984 Olympics.

“What I learned from being an Olympian is that it takes a lot of hard work. I learned that from my grandfather,” she said.

Bolden-Pickens said it hasn’t been easy running the business, but they’ve been able to stay afloat because of the lessons learned from their grandfather.

“I remember during the pandemic, we actually had to go to the egg farm and stand in line for a couple of hours just to get the eggs that we needed,” Bolden-Pickens said. “We use the best spices. We make our own vanilla.”

Cravin-Paschal said after the death of their brother Gregory Spann, who was the main baker for nearly two decades, they struggled for a few years to keep the recipe and taste consistent. But eventually they figured it out.

“We had a little rough spot because we all know the recipes but you have to put it together (correctly),” Cravin-Paschal said. “Now we’re back to the original taste.”

As marijuana use among teens has grown in the past decade, researchers have been trying to better understand the health risks of the drug. Now, a new longitudinal study finds that cannabis use among adolescents increases risks of being diagnosed with bipolar and psychotic disorders, as well as anxiety and depression, years later.

"This is very, very, very worrying," says psychiatrist Dr. Ryan Sultan at Columbia University, a cannabis researcher who wasn't involved in the new study published in the latest JAMA Health Forum.

Strong study design

Researchers analyzed health data on 460,000 teenagers in the Kaiser Permanente Health System in Northern California. The teens were followed until they were 25 years old. The data included annual screenings for substance use and any mental health diagnoses from the health records. Researchers excluded the adolescents who had symptoms of mental illnesses before using cannabis.

"We looked at kids using cannabis before they had any evidence of these psychiatric conditions and then followed them to understand if they were more likely or less likely to develop them," says Dr. Lynn Silver, a pediatrician and researcher at the Public Health Institute, and an author of the new study.

They found that the teens who reported using cannabis in the past year were at a higher risk of being diagnosed with several mental health conditions a few years later, compared to teens who didn't use cannabis.

Teens who reported using cannabis had twice the risk of developing two serious mental illnesses: bipolar, which manifests as alternating episodes of depression and mania, and psychotic disorders, such as schizophrenia which involve a break with reality.

Now, only a small fraction — nearly 4,000 — of all teens in the study were diagnosed with each of these two disorders. Both bipolar and psychotic disorders are among the most serious and disabling of mental illnesses.

"Those are the scarier conditions that we worry about," says Sultan.

Silver points out these illnesses are expensive to treat and come at a high cost to society. The U.S. cannabis market is an industry with a value in the tens-of-billions — but the societal cost of schizophrenia has been calculated to be $350 billion a year.

"And if we increase the number of people who develop that condition in a way that's preventable, that can wipe out the whole value of the cannabis market," Silver says.

Depression and anxiety too

The new study also found that the risk for more common conditions like depression and anxiety was also higher among cannabis users.

"Depression alone went up by about a third," says Silver, "and anxiety went up by about a quarter."

But the link between cannabis use and depression and anxiety got weaker for teens who were older when they used cannabis. "Which really shows the sensitivity of the younger child's brain to the effects of cannabis," says Silver. "The brain is still developing. The effects of cannabis on the receptors in the brain seem to have a significant impact on their neurological development and the risk for these mental health disorders."

Silver hopes these findings will make teens more cautious about using the drug, which is not as safe as people perceive it to be.

"With legalization, we've had a tremendous wave of this perception of cannabis as a safe, natural product to treat your stress with," she says. "That is simply not true."

The new study is well designed and gets at "the chicken or the egg, order-of-operations question," says Sultan. There have been other past studies that have also found a link between cannabis use and mental health conditions, especially psychosis. But, those studies couldn't tell whether cannabis affected the likelihood of developing mental health symptoms or whether people with existing problems were more likely to use cannabis — perhaps to treat their symptoms.

But by excluding teens who were already showing mental health symptoms, the new study suggests a causal link between cannabis use and later mental health diagnoses. Additional research is needed to understand the link fully.

'Playing with fire'

Sultan, the psychiatrist and researcher at Columbia University, says the study confirms what he's seeing in his clinic — more teens using cannabis who've developed new or worsening mental health symptoms.

"It is most common around anxiety and depression, but it's also showing up in more severe conditions like bipolar disorder and psychosis," he says.

He notes that mental health disorders are complex in origin. A host of risk factors, like genetics, environment, lifestyle and life experiences all play a role. And some young people are more at risk than others.

"When someone has a psychotic episode in the context of cannabis or a manic episode in the context of cannabis, clinicians are going to say, 'Please do not do that again because you're you're you're playing with fire,'" he says.

Because the more they use the drug, he says the more likely that their symptoms will worsen over time, making recovery harder.

"What we're worried about [is if] you sort of get stuck in psychosis, it gets harder and harder to pull the person back," says Sultan. "Psychosis and severe mood disorders, particularly bipolar disorder are like seizures in your brain. They're sort of neurotoxic to your brain, and so it seems to be associated with a more rapid deterioration of the brain."

Some electric bikes in California could soon require license plates under a proposed state bill aiming to address the rise in electric bike related injuries.

AB 1942 or the E-bike Accountability Act, would apply exclusively to Class 2 and Class 3 electric bikes.

Class 2 bikes can be operated without peddling until it reaches the speed of 20 mph.

Class 3 bikes reach a max speed of 28 mph; motor assist could only kick in with peddling.

The bill would also require owners to carry proof of ownership and would direct the Department of Motor Vehicles to establish a registration process. It was introduced by Assemblymember Rebecca Bauer-Kahan of Orinda in Contra Costa County earlier this month.

E-bike injuries spiked 18-fold between 2018 and 2023, according to state traffic data.

The bill may be heard in committee March 16.