The Brief

One year after UnitedHealthcare's CEO was shot and killed, the crisis in U.S. health care has gotten even worse — in ways both obvious and hidden.

People increasingly can't afford health insurance. The costs of both Obamacare and employer-sponsored insurance plans are set to skyrocket next year, in a country where health care is already the most expensive in the developed world.

Yet even as costs surge, the companies and the investors who profit from this business are also struggling financially. Shares in UnitedHealth Group, the giant conglomerate that owns UnitedHealthcare and that plays a key role in the larger stock market, have plunged 44% from a year earlier. (It was even worse before a rally in UnitedHealth shares on Wednesday.)

"UnitedHealth's reputation in the investment community, before December 4 last year, was [as] a safe place to put your money. And that basically got all blown up," says Julie Utterback, a senior equity analyst who covers health care companies for Morningstar.

Then, on Dec. 4, 2024, UnitedHealthcare CEO Brian Thompson was shot on a Manhattan street on his way to an investor event. The shocking act of violence sparked a widespread consumer outcry over U.S. health care costs and denied claims, and plunged UnitedHealth Group into a public relations disaster.

But that was only the start of the business woes for the company and its entire industry — which are facing regulatory scrutiny, tightening margins, and investor skepticism. Many of UnitedHealth's top competitors have also seen their shares suffer in the past year, at a time when the stock market in general has been hitting tech-driven record highs. The S&P 500's healthcare index has lagged the larger market. And some Wall Street analysts are bracing for another rocky year in the business of health care.

"Near term, there's a lot more volatility to come," says Michael Ha, a senior equity research analyst who covers health care companies for investment bank Baird.

Dec. 4 started to reveal the depth of U.S. health care problems

This wide-ranging crisis for both consumers and businesses underlines the brokenness of the U.S. health care system: When neither the people it's supposed to serve nor the people making money from it are happy, does it work at all?

"We're really at an inflection point," says Katherine Hempstead, a senior policy officer at the Robert Wood Johnson Foundation and the author of a book about the insurance industry.

"Every segment of the health insurance business right now is stressed," she adds.

These stresses became brutally visible a year ago — and persist today. Luigi Mangione, the 27-year-old suspect in Thompson's killing, was in court this week for hearings ahead of his trial.

But the crisis in U.S. health care is much bigger than his case. Here are three main ways it's playing out this year, from Main Street to Wall Street.

Prices are going up — and people are getting ready to go without medical care

No matter how you get your health insurance, it will likely cost more next year.

For the roughly 24 million people who get their insurance through the government's health care exchanges, Affordable Care Act subsidies are set to expire at the end of the year — sending premiums soaring. Another 154 million people are insured through their employers — and premiums for those plans are also set to skyrocket.

Costs are increasing for several reasons: Drug companies have developed more effective cancer treatments and weight-loss drugs, which they can charge more for. More people are going back to the doctor after the pandemic kept them away, which is creating more demand and allowing providers and hospitals to increase prices. And some hospitals, doctors' offices, insurance companies and other businesses within the health care system have merged or consolidated, often allowing the remaining businesses to raise prices for their services.

The end result is that nearly half of U.S. adults expect they won't be able to afford necessary health care next year, according to a Gallup poll published last month.

Jennifer Blazis and her family are among them.

"It just always blows me away, how much I have to consider cost when something happens with the kids," the 44-year-old nonprofit worker and mother of four told NPR this fall in an interview for its Cost of Living series.

Blazis and her family live in Colorado Springs and get their insurance through her husband's small property-management business. She says she's postponing leg surgery that would address a condition that's causing her pain, but which her doctors say is not yet urgent.

"We wait to go to the doctor because we know if we do, we're going to get hit with just a massive bill," Blazis says. "And this is with … a really good health insurance plan that our [family] company pays a ton of money for."

Yet even the biggest businesses selling these services are struggling

Some of those increased costs are also hitting insurers — even the ones that also control other parts of the health care ecosystem.

UnitedHealth Group is far more than just the owner of the largest U.S. health insurance company. It's one of the largest companies in the world, and it's involved in almost every part of how Americans access health care — from employing or overseeing 10% of the doctors they see to processing about 20% of the prescriptions they fill.

It's also one of the most influential stocks on Wall Street. UnitedHealth Group is one of 30 companies that makes up the blue-chip Dow Jones Industrial Average — so what happens with its shares helps determine what happens with the overall stock market.

The company has had a miserable year on both fronts. The reasons come down to profits, more than PR: UnitedHealth and its competitors have been facing rising costs in the Medicare Advantage businesses that allow private insurers to collect government payments for managing the care of seniors.

These programs were once widely seen as moneymakers for big health insurers, but now they've gotten UnitedHealth embroiled in financial and regulatory trouble, including a Department of Justice investigation into its Medicare business. The company abruptly replaced its CEO in May, a few months before it acknowledged that it was facing the government probe.

Now UnitedHealth is trying to get rid of about 1 million Medicare Advantage patients — and otherwise move on from the past year's many problems.

"We want to show that we can get back to the swagger the company once had," Wayne DeVeydt, UnitedHealth's chief financial officer, told investors last month.

One prominent investor is betting it can: In August, Warren Buffett's Berkshire Hathaway disclosed that it had bought more than 5 million shares in UnitedHealth Group. The news helped lift the stock from its depths — but it still has a long way to go for both its share price and its profits to recover from this year's slump.

Chief Executive Stephen Hemsley acknowledged as much in October, promising investors "higher and sustainable, double-digit growth beginning in 2027 and advancing from there."

Spokespeople for UnitedHealth declined to comment for this story.

Wall Street used to think health care was safe. It's waiting for a turnaround

Health care spending accounts for about a fifth of the U.S. economy, making the for-profit companies that earn this money some of the most powerful in the world.

That's helped their appeal to investors, who traditionally tend to consider health care stocks "defensive," or safe, investments. That appeal sometimes overrides the industry's current financial challenges: In the past month, as Wall Street had its now-quarterly panic over the artificial intelligence bubble, health care stocks actually outperformed the broader market for a few weeks.

Still, health care is massively lagging the market in the long term.

Morningstar's Utterback is optimistic that the industry can eventually turn around its deeper financial, regulatory and reputational problems. She even calls most health care stocks "undervalued" currently — but she warns that investors will have to have a lot of patience if they want to see bets on the sector pay off.

"My explicit forecast period is 10 years. It's not three," she says. "There's a murky outlook here for the next couple years, at least."

Copyright 2025 NPR

One of Broadway’s most popular shows in years, Oh, Mary! is now at the Ahmanson Theatre through Dec. 6. It stars drag performer extraordinaire Alaska Thunderf*ck 5000, known mononymously as Alaska.

Alaska caught up with LAist host Julia Paskin to talk about taking the Tony Award-winning dark comedy on the road, how competing on RuPaul's Drag Race has changed over the years, and where to see a great drag show in Los Angeles.

A role she was made for

The list of actors who have played the titular role of Mary ranges from seasoned comedians, like show creator Cole Escola, to Jane Krakowski and Bowen Yang, the latter of whom is currently on an extended Broadway run.

Jane Krakowski during her broadway run in "Oh, Mary!"

(

Emilio Madrid

/

Center Theater Group

)

“It's going on my tombstone,” Alaska said. “Like, it's the biggest deal ever.”

The role not only has big proverbial shoes to fill, but also requires donning a large, heavy hoopskirt for a costume. That was not a problem.

“If you ever just wanna, like, change your entire personality, just put on a hoopskirt,” she said. “It really changes the way you move and the way you kinda act and the way you stand. That's drag, I guess, because drag is sort of transforming based on what you're putting on your body, and it really does change everything.”

The higher cost to compete on Drag Race 

Speaking of drag, Alaska initially rose to fame appearing on Season 5 of RuPaul’s Drag Race in 2013 and the second season of the All Stars spinoff in 2016, which she won. Longtime fans of the reality show can confirm a lot has changed over the years with the competition becoming more expensive and queens investing in pricey, commissioned costume pieces and drag accessories.

Alaska said she’s grateful she competed when she did.

“I got in under the wire,” Alaska said. “I got onto that show back when you could show up with a bag of dirty laundry and you could do pretty well. When I went on that show the first time, I was borrowing stuff from other girls. I really just went to the thrift store and got some stuff. I had my friends make some stuff with me as well.”

She says the pressure is also more intense with the audience expecting a high production quality.

“The viewership is so knowledgeable about fabrics, and designers, and fashion, and polish and wig lines,” Alaska added. “That's good. I mean, I think that it's a pendulum, and it swings back and forth. Yes, we love to see exquisite, fabulous costumery on Drag Race. But, we also like to see some, stupid, silly drag as well.”

Where to catch great drag in LA 

Alaska recommends Meatball’s Phat Slut show at Precinct in downtown L.A., and added "anything happening at Precinct is going to be unique, fierce, fun, and just like an excellent vibe.”

Another top recommendation is “The Golden Girls Live” from drag queens Jackie Beat and Sherry Vine.

“It happens in a very small room,” Alaska said. “So you're literally sitting onstage with the Golden Girls. There's really nothing like it.”

You can see Alaska in Oh, Mary! at the Ahmanson Theatre and when her Revolution Tour stops in at Pacific Electric May 8, 2027.

Rhea Borja and her husband, Eric Wee, bought their home in Altadena in 2022. After the January 2025 Eaton Fire, it still stood, in a pocket of other homes that also survived.

At first, that was a relief. As many fire survivors have found, though, remediating smoke damage has been nearly as daunting as rebuilding a home that burned.

That has been true for Borja and Wee too. They’ve been living in Northern California since the fire, while they work to get their home cleared of the toxic remnants of the smoke.

The Eaton Fire destroyed 9,414 structures, including homes and businesses. For the thousands of structures were left standing, Gov. Gavin Newsom signed laws in September setting new rules for smoke damage cleanup.

What has that looked like in practice? Three Eaton Fire survivors spoke with LAist recently about the challenges they’ve faced.

Remediation challenges

Rhea Borja stands in her driveway just a month or so before the January 2025 fire. All of the houses behind her across the street burned down, including all the trees and greenery.

(

Rhea Borja

)

On the blocks around Borja’s home, the frames of homes being rebuilt are taking shape. But her home has stood empty for 22 months.

“It has been an enormous test of patience,” she said.

Her home has gone through four remediations. The lead test results after the most recent remediation cleared EPA standards. Since then, Borja has had a new HVAC system installed.

Next up, re-insulating the attic.

She’s hoping to be back in Altadena early next year but recognizes there’s still a lot to do, including remediating the front and back yards. She’ll have to pay for those projects out of pocket.

“I miss Altadena. I miss Los Angeles. I miss being by the San Gabriel Mountains,” Borja said. “So I just feel kind of removed from the area, and sometimes it almost just seems like a dream.”

A hallway in Rhea Borja’s home after it was remediated for a third time in June 2026.

(

Rhea Borja

)

Rhea Borja removed the remediator’s tape and plastic covering over a living room window of her Altadena home in mid October.

(

Courtesy of Rhea Borja

)

Simon Perry and his partner have two properties in Altadena that still require remediation.

One is their home right outside of the fire zone, and the other is a rental property right in the middle of it.

At Perry’s home of 15 years, the contamination was off the charts.

“To give you an indication of how badly contaminated it is, the attic crawl space tested at 3,391 units of lead,” Perry said. “So there's 50 times the safe level of lead in the crawl space of the attic.”

Perry had intended to retire the week of the Eaton Fire. He postponed that while he dealt with the fire’s aftermath — spending hours itemizing personal items, then throwing them away.

By the end of September, he and his partner moved for the fourth time since the fire.

Before that move, their temporary home was “full of cardboard boxes and boxes full of stuff, you know, because everything is in transition and has been in transition for 20 months,” he said.

A return home

After 19 months of being displaced, Susan Mohini Kane, husband Bernard Kane and their cat returned to Altadena.

Being displaced was unsettling, but Kane said she learned a lot.

Susan Mohini Kane shared this photo with LAist from March 2026 after most of her home’s contents were removed. The walls were cut up for rewiring.

(

Susan Mohini Kane

)

Susan Mohini Kane and her husband Bernard Kane began moving in over the summer. A friend gifted her hand-sewn quilt to replace one they lost to smoke damage.

(

Susan Mohini Kane

)

“More things happened every day that I didn't expect,” Kane said. “They ended up, basically, having to tear our house down.”

The walls of the Kane home were removed and then replaced. They filled and hauled bags of fire-damaged goods out of their home.

Now that she’s back, Kane is excited to return to her work as a voice teacher, singer and songwriter.

Susan Mohini Kane and her husband Bernard Kane are happy to be back in their home after 19 months of remediation and repairs after the Eaton Fire.

(

David Rodriguez/LAist

)

She wants people who didn’t experience the wildfire to know what people are still going through nearly two years later.

“We're still here. We're still suffering. We're still needing so much help,” she said.

The nation’s largest physician group has backed a near complete ban on the most popular countertop material, which is linked to an aggressive lung disease disabling and killing stoneworkers in California and other states.

The American Medical Association has adopted a new policy opposing the manufacturing, importation, distribution, sale, fabrication and installation of high-silica engineered stone products across the U.S. Doctors in California hope that the declaration by the AMA, which counts more than 250,000 physicians and medical students as members, will spur greater regulation of the factory-made material and promote the use of safer alternatives.

“Workers are developing an incurable lung disease that can progress to respiratory failure and sometimes, death, often at a young age among workers,” AMA Board Member and radiation oncologist Sheila Rege said in a statement. “Silicosis is preventable, and the most effective way to prevent silicosis is to use safer countertop materials containing less than 1% crystalline silica with appropriate dust control measures.”

The move could boost a push by California regulators to phase out the use of engineered stone with more than 1% crystalline silica to make countertops and other construction surfaces. A state workplace standards board is poised to vote on a first-in-the-nation emergency regulation next month. Australia was the first country to ban engineered stone slabs in 2024.

More than 680 stoneworkers in California have contracted silicosis after inhaling toxic silica dust generated when cutting or polishing engineered stone, also known as artificial stone or quartz.

Most of them are Latino men who say they didn’t know about the hazards of handling artificial stone until they or co-workers felt shortness of breath and other worsening symptoms.

Dozens of workers have died, while 75 have undergone lung transplants since 2019, according to the California Department of Public Health. Physicians in Colorado, Florida, Illinois, Texas and other states have reported cases as well, though California is the only state systematically tracking the disease in the industry.

“Having personally gone through the illness caused by artificial stone, I believe that eliminating the use of artificial stone would be a good decision,” said Lopez, a former stoneworker in the Bay Area who underwent a double lung transplant in March after years at a job cutting engineered stone into kitchen and bathroom countertops.

“Health must take precedence over commercial interests,” the father of four added. KQED is not using Lopez’s full name, as he fears losing vital medical care if arrested by immigration authorities.

Major manufacturers of high-silica artificial stone have sought to place the blame for rapidly rising silicosis cases on countertop fabrication employers who fail to follow safety precautions. Cambria, the largest U.S.-based producer of the material, has pushed for a bill in Congress that would immunize manufacturers and distributors from hundreds of lawsuits by sick workers seeking damages.

Meanwhile, the International Surface Fabricators Association, which is supported by Cambria and other manufacturers, has petitioned California regulators to require countertop fabricators to be certified to do business, instead of restricting their use of artificial stone.

ISFA CEO Laurie Weber doubted that a ban would benefit most workers, since “unlicensed, uninspected operators who cut stone unsafely today would continue to cut whatever comes next the same way.”

“ISFA respects the medical community’s concern for workers and calls for a solution that protects them now, licensing and verified compliance for every shop that cuts stone,” Weber said in a statement. “Silicosis is real, it is devastating and it is preventable. We respect the physicians and researchers who have treated these workers and sounded the alarm. Our disagreement is not with the medicine. It is with the idea that a product ban on fabrication, by itself, will protect the people doing this work.”

California, which has more protective silica regulations than federal standards, already requires fabricators to cut the material under a layer of water to reduce airborne dust, and provide workers with sophisticated masks and ventilation systems.

But the rules are expensive and difficult to implement, and Cal/OSHA inspectors have found most fabrication businesses they’ve visited had violations. In addition, mounting evidence shows that workers can get sick even at sophisticated shops complying with the current regulations. Within the next decade, between 1,000 to 1,500 stoneworkers in California could develop silicosis, leading to roughly 285 deaths, according to Cal/OSHA. The state is home to about 5,000 countertop fabrication workers, predominantly Latino immigrants.

Dr. Robert Blink, a San Francisco-based occupational medicine physician urging California to ban high-silica artificial stone, said AMA’s resolution will help increase awareness about its hazards, and increase potential regulation by federal OSHA, other states and even Congress, which is expected to tie or break a record number of physician representatives next year. The material is safe for consumers once installed.

“This is recognition by the larger house of medicine that the material cannot be safely used.” said Blink, a former president of the Western Occupational and Environmental Medical Association. “We’ve certainly been trying to raise the alarm because this is a deadly epidemic that is killing people.”