The Brief

Michael Liu grew up in Toronto, Canada, then moved to the U.S. for college and medical school because, to him, America was the premiere destination for fulfilling his aspirations to become a physician and researcher.

"You know, in chase of the American Dream, and understanding all the opportunities — that was such a draw for me," says Liu, who attended Harvard University. He is now 28 and has deep personal and professional roots in Boston, where he's an internal medicine resident at Mass General Brigham.

But this spring, he was shaken by the Trump administration's cuts to scientific research at the National Institutes of Health and staff at the Department of Health and Human Services. "That was a really striking moment for me," Liu says. "It made me question where, professionally, it made most sense for me. I still have strong connections to Toronto and mentors."

Then, in September, Liu was doing rounds with two doctors from Mexico and Costa Rica, when the administration hiked fees nearly 30 fold for H1B visas, which are for highly trained professionals, to $100,000. He watched his colleagues' tearful reactions to the sudden uncertainty that thrust on their careers, knowing that employers like hospital systems are unlikely to be able to afford to pay for such dramatic increases.

"It was terrible to see," Liu says. He has a green card, having married an American citizen earlier this year. But, he says, the Trump administration's actions affect him.

"It feels like my contribution is — just because I was not born in this country — less valued," Liu says. "I really hadn't thought so deeply about going back home before, but definitely it's been much more top of mind."

A rural workforce

Immigrants make up about a quarter of all the country's doctors, and the U.S. health care system depends heavily on them. There are roughly 325,000 physicians — not including nurses or other critical health care workers — living and working in the U.S., who were born and trained elsewhere.

In rural communities, and in some subspecialties of medicine, the reliance on immigrant physicians runs much higher. In primary care and specialties like oncology, for example, foreign-born doctors account for about half of the workforce.

Meanwhile, health care is already burdened by retirements and burnout. Many experts say recent immigration and health policies are only making it harder — and less appealing — for foreign-born talent to augment the short-staffed American health system.

"This is a real pivotal moment right now where decades of progress could be at risk," says Dr. Julie Gralow, chief medical officer at the American Society of Clinical Oncology.

She says policies defunding everything from scientific research to public health have damaged the U.S.'s reputation to the point where she hears from hospitals and universities that top international talent are no longer interested in coming to America. "Up until this year, it was a dream — a wish! — that you could get a job and you could come to the U.S. And now nobody wants to come."

Gralow says, meanwhile, other countries like China, Denmark, Germany and Australia are taking advantage by recruiting international talent away from the U.S. — including American-born doctors and medical researchers — by promising stable grant funding and state-of-the-art facilities abroad.

American patients will feel the rippling impact from that, Gralow says, for generations.

Immigrant physicians have historically found jobs in U.S. communities with serious health care staff shortages to begin with, so those places also stand to see more impact from curtailed international hiring, says Michael Liu, the Boston medical resident.

He points to his own recent co-authored research in JAMA estimating that 11,000 doctors, or roughly 1% of the country's physicians, currently have H1B visas. "That might seem like a small number, but this percentage varied widely across geographies," he said, and they tend to congregate in the least-resourced areas, reaching up to 40% of physicians in some communities.

"High poverty counties had a four times higher prevalence of H1B physicians; we also saw that same pattern in rural communities," he says. (Many physicians and physician residents may have different kinds of visas, such as J1Bs, and others.)

Groups like the American Medical Association have asked the administration to exempt physicians from the new H1B fees. HHS did not respond to requests seeking comment about recent visa policies and health care workers, though some opposition has seemingly softened the president's position.

A history of immigration

For the past six decades, immigrants have contributed heavily to the U.S.'s reputation as the undisputed world leader in health research and practice. In pay and prestige, the U.S. has been unparalleled, helping attract the world's best talent — at the expense of their home countries.

That began in 1965, during a period of expanding federal investment in public health and scientific research, spurred by international competition and fueled by Cold War rivalries over events like the Soviet launch of Sputnik. That year, Medicare and Medicaid were created, and with them, sudden demand for doctors, says Eram Alam, a professor of science history at Harvard.

"Overnight, you have 25 million — approximately — people who can now access health care services," Alam says. Passage that year of the Hart-Celler Immigration and Nationality Act opened U.S. borders to doctors and other people with in-demand skills, says Alam, who recently published a book, The Care of Foreigners, about the history of immigrant physicians in the US.

Over the following decade, the U.S. granted visas to 75,000 physicians, and by 1975, roughly 45% of all U.S. doctors were immigrants, Alam says. The U.S.'s first-rate reputation allowed it to attract more physician talent than America could educate and train: "There were more immigrant physicians that were entering the labor force per year than there were U.S. trained physicians that were joining," she says.

Now, Alam says, the U.S. is undoing a lot of that, as it dismantles its global leadership role in medicine and science, and narrows its borders.

Copyright 2025 NPR

Advocates for transgender youth vowed to keep fighting Wednesday after the U.S. Supreme Court blocked — at least temporarily — a California policy protecting the privacy of transgender students in K-12 schools.

The court ruled in favor of a group of parents near San Diego who argued that the state’s policy violates their right to religious freedom and due process. The policy barred school districts from requiring teachers to “out” transgender students to their parents, unless the students gave permission.

“The court’s ruling is shocking and alarming,” said Shannon Minter, legal director of the National Center for LGBTQ Rights, which is based in Sacramento. “It’s part of a larger effort by this court and the administration to eliminate any protection for transgender people.”

The case was originally filed in 2023 by the Thomas More Society, a public interest law firm that focuses on religious issues. It stems from a state policy related to students’ privacy rights.

A federal district court judge initially ruled in favor of the parents with children in the Escondido Union School District in north San Diego County, and then the Ninth Circuit Court of Appeals paused the ruling while the state prepared an appeal. The parents asked the Supreme Court to lift the pause, which it did on Tuesday. The appeal is still pending before the Ninth Circuit.

‘A watershed moment’

Attorneys for the Thomas More Society called it the greatest victory for parental rights in a generation.

“This is a watershed moment for parental rights in America,” said Paul Jonna, special counsel at the Thomas More Society. “The Supreme Court has told California and every state in the nation in no uncertain terms: you cannot secretly transition a child behind a parent’s back.”

The ruling undermines California’s Safety Act, which bars school districts from adopting “forced outing” policies and was hailed as a major victory for transgender rights when Newsom signed it in 2024.

Sonja Shaw, president of the Chino Valley Unified school board, described the Supreme Court’s ruling as “a massive victory.” Chino Valley was among a handful of districts in 2023 that enacted policies requiring teachers to divulge to parents if a student changes their gender identity.

“The Supreme Court has affirmed what we’ve always known to be true: policies deceiving parents are wrong, and they can not be allowed to stand,” said Shaw, a candidate for state superintendent of public instruction. “This win came from brave teachers and parents who refused to stay silent.”

California Attorney General Rob Bonta acknowledged the ruling was a setback.

“We are disappointed with the Supreme Court’s decision,” Jordan Blue, a spokesperson for Bonta, said. “We remain committed to ensuring a safe, welcoming school environment for all students while respecting the crucial role parents play in students’ lives.”

California has been on the forefront of transgender rights, especially for young people. The state has existing laws requiring teachers to use students’ preferred pronouns; schools are required to offer gender-neutral bathrooms; and sports teams and clubs must be open to all students. Those policies remain in place.

Still, this week’s ruling was significant, said Jorge Reyes Salinas, spokesperson for Equality California, the state’s largest LGBTQ advocacy organization.

“Everyone is heartbroken,” Reyes Salinas said. “Although it’s not surprising. It’s just a continuation of the vile attacks we’ve seen on transgender youth. It’s even more important now that California strengthens its laws protecting trans people.”

Minter, at the National Center for LGBTQ Rights, said that the ruling may have a narrow focus, but it sends a chilling message to transgender young people, who already face higher rates of anxiety and depression than their peers.

Minter said the transgender community will continue fighting for their rights.

“Most people in this country do not support what’s happening to transgender people,” Minter said. “We will fight every inch of the way until all people are treated with the basic decency they deserve.”

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

A Carson couple was on suspicion of elder abuse and fraud Wednesday after raiding four unlicensed care homes they say are operated by the pair, according to authorities.

Gary Hogg, 80, and Alicia Hogg, 72, are suspected of operating a network of care homes without proper licenses or training, where residents faced physical and financial abuse, according to the Los Angeles County Sheriff's Department.

The department and other agencies served search warrants at four locations in the city that they said were believed to be unlicensed care homes. Deputies rescued at least three people believed to have been neglected.

The operation stemmed from a tip received last month, the department said.

Last week, authorities served a search warrant at an alleged unlicensed care home on the 200 block of W. 234th Street in Carson. During that search, officials rescued seven other residents who they say were malnourished and neglected, according to the Sheriff’s Department.

Some were transferred to local hospitals and others are being moved into licensed care facilities.

It’s unclear how many unlicensed care homes the pair are suspected of operating or how many people, if any, still reside in those homes.

This story first appeared on The LA Local.

A Westlake resident died early Saturday while in Immigration and Customs Enforcement custody at the Adelanto immigration detention facility, according to a GoFundMe page created for his family.

Alberto Gutierrez Reyes was detained by ICE on Jan. 9 in Echo Park, according to the fundraiser. He became seriously ill while in custody and repeatedly requested medical attention, the organizer said.

“Despite his repeated requests for medical attention, he was denied the care he desperately needed. Tragically, Alberto passed away at 1 am today, leaving his wife and young son facing an unimaginable loss,” fundraiser organizer Karina Cruz said.

Councilmember Eunisses Hernandez said in a statement on Instagram this is the “9th known death in ICE custody this year.”

Hernandez criticized federal immigration authorities and the Trump administration in her statement and said the immigration detention system “cannot be reformed” and “must be abolished.”

Updated: 3:35 p.m. March 3

“The Trump administration does not value human life. They are using our federal tax dollars to bankroll detention and a deadly deportation machine instead of funding healthcare, food, housing, education, and the systems that actually keep people alive,” she said.

The fundraiser describes Gutierrez Reyes as the family’s sole provider and says his death has left his wife and son facing both emotional and financial hardship. Donations will help cover funeral expenses and support the family.

Patricia Martinez, Gutierrez Reyes’ wife, told Univision that a representative for the Mexican Consulate called her Friday morning to say her husband was dead. Authorities did not say how her husband died or where his body was being held.

“We haven’t seen his body, we haven’t seen anything,” Martinez told the news station at a memorial over the weekend.

It was not immediately clear what medical treatment Gutierrez Reyes requested or what preexisting health conditions he had while in custody. A spokesperson for ICE could not be reached for comment.

A representative for The GEO Group, the private prison operators who oversee the Adelanto facility, directed all questions to ICE.

In January, a group of Adelanto detainees sued the federal government on behalf of anyone denied basic medical care in the facility. A man suffering a seizure went without oxygen as guards watched him convulse on the floor, and another was not given antibiotics for a severe staph infection that led his finger to burst, according to the proposed class action lawsuit.

The complaint says the for-profit detention center operated by GEO Group has a long history of unsafe and abusive conditions. The facility’s population spiked from just a handful of detainees to nearly 2,000 in a matter of months after federal immigration raids resumed last year.

Last summer, as reports mounted of federal immigration agents taking Costa Mesa residents off the streets, leading others to hole up in their homes, the City Council decided to do something. They voted 5-0 (two other council members were absent) to donate $100,000 in city funds to help families affected by the ICE raids with food and basic needs. They also asked city officials to look into allocating money for legal defense.

Many at the meeting, in the audience and behind the dais, felt good about the outcome: the advocates thought they finally had a solid source of funding for the relief effort, which was already underway through small donations and their own out-of-pocket costs, and council members felt they were providing tangible support for the city’s large immigrant population.

More than 1 in 5 Costa Mesa residents is foreign-born, according to Census data, and more than one-third of residents are Latino, who've born the brunt of President Donald Trump's mass deportation campaign.

The goodwill didn’t last long. The language used to earmark the funds was intentionally vague, meant to keep the small, politically divided city out of the crosshairs of the Trump administration and local MAGA activists. Before the smoke cleared, the relief measure would lead to a rift in the city’s tight-knit volunteer network, demands for accountability, and, among the would-be beneficiaries, a feeling of increasing abandonment by local government.

Here’s what happened.

It started with volunteers delivering food

When ICE raids intensified in Southern California, the streets of Costa Mesa’s largely Latino westside started emptying out. Tamale vendors stayed home. Kids on summer break stopped riding bikes around their neighborhoods.

“This has been the saddest summer of my life,” Councilmember Manuel Chavez said at a City Council meeting in August.

Chavez represents District 4, which is predominantly Latino.

“It is noticeably a lot quieter in my community and time and time again at community events I go to it’s very clear there’s a visible lack of our Latino brothers and sisters,” he added.

At the time, a group of volunteers had been busy organizing a mutual aid effort to deliver food boxes and other necessities to residents who either feared leaving their homes, or had lost a breadwinner to deportation. Adam Ereth, executive director of the Someone Cares Soup Kitchen, let the volunteers use the nonprofit’s facilities to pack the food boxes, and passed on some of the soup kitchen’s leftover food donations.

Ereth also offered up the nonprofit as a conduit through which individuals could donate money directly to the food box effort. Ereth kept track of the privately donated funds, which totaled around $14,000, he said, and used it to reimburse volunteers for purchasing tortillas, beans, meat and fresh produce for the boxes.

Like much of the local response to the surge in ICE raids, the mutual aid effort was scrappy. Which is why the organizers began to lobby City Council members — some of whom were part of the mutual aid group — for a more reliable source of funding.

“After a while I was like, you know, I can't spend $240 on chorizo twice a month. I need to get reimbursed,” said Haley Horton, one of the organizers.

At the Aug. 5 City Council meeting, Mayor John Stephens proposed that the city help fund the relief effort, along with legal defense for families facing deportation. Residents recounted the devastating impact the raids were having on the community.

“I was listening to the public speak about it,” Stephens later told LAist. “And I was thinking, you know, we could do more.”

Around the same time, local governments in L.A. County and other parts of Orange County, including Santa Ana and Anaheim, were setting up funds to help immigrant families with groceries, rent and legal defense against deportation. (The governor recently announced the state’s own $35 million investment in humanitarian aid and legal defense for immigrant residents; Irvine is also now funding immigration legal aid.)

Ultimately, Costa Mesa's City Council allocated funds to two local nonprofits to help affected families with food, rental assistance and other needs: $50,000 would go into a relief fund run by a local church; the other $50,000 would go to the Someone Cares Soup Kitchen “to provide daily meals and groceries to impacted residents,” according to a staff report at a subsequent council meeting.

There was no contract, and no requirement to account for how the money was spent, a city spokesperson confirmed.

Horton and the other volunteers working on the food box program were elated. Among them was Brooke Grey, who heads the local chapter of the group Food Not Bombs.

“ When the city approved that money, despite all the awfulness that's happening, it was a very joyous moment,” Grey said. “It's knowing that … we're in this together to help,” she said.

But the good vibes were short-lived.

A Costa Mesa volunteer preps food boxes for delivery for ICE-affected families.

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‘I didn’t want ICE going to the soup kitchen’

The Someone Cares Soup Kitchen started 40 years ago in Costa Mesa when its founder, Merle Hatleberg, literally made a pot of soup for hungry children. Today, the nonprofit provides a free hot lunch to around 300 people daily, including seniors, veterans, unhoused residents and anybody else who shows up — all served out of a former Chinese restaurant in central Costa Mesa.

The organization took in around $975,000 in donations and fundraising efforts in fiscal year 2024, according to its most recently available tax filing.

Debbee Pezman, Halteberg’s daughter, now chairs the soup kitchen’s board of directors. She said she was hesitant about accepting the city’s $50,000 donation when approached. She knew the mutual aid effort was already operating out of the kitchen. But it was under the radar, and she didn’t want the organization to be “in the spotlight,’” she recalled recently.

“I didn’t want ICE going to the soup kitchen,” Pezman said. Plus, she added, her board was wary of singling out a particular group for help.

“We support people in need, not only the immigrants in need,” Pezman said.

Still, in neighborhoods around the soup kitchen, ICE enforcement was having increasingly devastating consequences for the city’s immigrant residents. In October, a Costa Mesa resident named Gabriel Garcia Aviles died in a hospital in Victorville after being picked up in a raid and detained at the Adelanto detention center. As families sought to decrease the chance of being separated, some parents quit their jobs and stopped going outside, including to buy groceries and visit the doctor.

“It’s absolutely horrific,” Councilmember Andrea Marr said of the arrests and deportations. “We’re talking about families who have been involved in their communities, moms cooking for school events. These are not other people, this is very much the fabric of the community."

Increasing the economic squeeze, as of January, the state no longer allows adults without legal immigration status to enroll in Medi-Cal.

“All of the doors are closing,” said Juana Trejo, a long-time leader in Costa Mesa’s Latino community. “It’s like we’re imprisoned.”

As concern kept rising, the soup kitchen accepted the city funds — on the condition that the money not be earmarked for a specific purpose.

That’s when the rift began.

A debate over the council’s intent

Volunteers who’d been buying supplies and packing boxes for delivery said they assumed the $50,000 from the city would replenish dwindling private donations. 

Ereth, who’d opened the nonprofit’s doors as a staging center for the mutual aid effort, saw it differently. He turned down those requests.

Tensions grew between Ereth and the mutual aid organizers. At the end of 2025, Ereth closed down the delivery program.Horton, the volunteer who helped start the program, was livid.

“I had to go into a room, I had to cry, I had to scream,” she told LAist. Horton and other mutual aid leaders estimate that the city funds could have fed 200 families for two years.

The fundamental disagreement comes down to this:

Mutual aid volunteers said they believed the $50,000 was made available specifically, to deliver groceries to families directly affected by the immigration crackdown.

Ereth said there was no expectation that the money be used for that narrow purpose. “The city decided to solicit us to give us a gift based on the work we’ve been doing for the past 40-plus years,” he said of the soup kitchen’s long-standing role in Costa Mesa. “It happened to be during the time federal enforcement activity was taking place pretty forcefully.”

Councilmember Arlis Reynolds, who helped launch the food box effort, was dismayed by Ereth’s interpretation of why the city awarded immigrant relief funds to the soup kitchen.

“We were intentionally vague based on what I thought was a pretty clear understanding,” she told LAist.

Marr agreed. “I think (Ereth) took advantage of a loophole,” she said, adding “he should have known” what the money was intended for.

That vague language, however, also allowed Ereth to use the funds as he saw fit.

Reynolds conceded that “technically (Ereth) is correct that he got city funds with zero written restraints.” But, she added, “if I knew that he was going to change the model, I would not have voted to give the funds.”

How best to help?

Ereth defended his use of the city funding for the soup kitchen’s overall operations.

“We’re a longterm organization in the community,” Ereth said, “when times get tough, we’re looking to remain as an institution, rather than just addressing an acute need that pops up.”

Ereth said it was unsustainable to continue delivering food boxes to ICE-affected families because of the large number of people and resources required. He also noted that the soup kitchen had invested its own staff time and resources into the delivery effort, including electricity, gas and most of the donated food that went into the boxes.

Some City Council members agree with Ereth’s position, including Stephens, the mayor. He told LAist the city funding for the soup kitchen had “absolutely” gone to its intended use.

“The Someone Cares Soup Kitchen has been a part of the Costa Mesa community for decades — they serve lots of populations in need, including this group impacted by ICE activity,” Stephens said.

He and soup kitchen leaders say the dispute boils down to miscommunication, and a dispute over how best to help. Pezman, the board chair, said instead of delivering boxes, the soup kitchen is providing groceries for pick-up twice a month, to about 40 families.

“I’m sure there are people who are fearful and not coming out of their house,” Pezman said, “but there are also people who are coming out of their house.”

She said the nonprofit leaders never intended to cause friction. “I do feel like what the soup kitchen did was on board and correct and communicated all the way through to the city,” said Pezman. But, she added, “if the city said, ‘We would like you to return the funds,’ we’d just return the funds.”

Sheryl Long helps stack food boxes in the back of a minivan for delivery to ICE-impacted families.

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Calls for accountability, as mutual aid moves on

Today, many involved in the mutual aid effort in Costa Mesa would like to just move on from the incident. Others are demanding more accountability.

“In my mind, it’s a huge injustice,” said Trejo, the community leader. “We’re going to be a little more careful in the future about who we put our confidence in.”

Another activist, Grey from Food Not Bombs, has repeatedly asked the City Council to investigate how the money was spent.

“There’s no accountability,” she said. “It creates a distrust in the community.”

Meanwhile, Councilmember Reynolds has asked city officials to look into how families who were receiving boxes last year can access food paid for with the ICE relief funds. She told LAist she saw “no incremental benefit as intended” from the city’s donation to the soup kitchen. Rather, she said, Ereth’s decision to end the food delivery program “created a huge amount of confusion, frustration, and service gaps to families we intended to serve.”

When Ereth ended the food delivery program in December, the mutual aid leaders vowed to find another way to keep it going, but it was unclear how, without a reliable fiscal sponsor. They spent the next few months fundraising and looking for new partners.

Then, on Valentine’s Day, more than a dozen volunteers met at a warehouse in Costa Mesa to load beans, rice, chorizo, tomatoes, limes and more into cardboard boxes and IKEA bags. Other volunteers then pulled up into the alley to collect the boxes and distribute them to 150 needy families.

The goal is to increase the number of recipients to 200, which the organizers estimate will cost $4,000 per monthly delivery. Fundraising is ongoing.

“There's no way this can end,” Horton said. “There's too many people who care.”