The Brief

In 2024, Kaiser Permanente announced the rollout of Abridge. Described in a press release as “ambient listening technology,” the AI-powered scribe is designed to help clinicians including mental health providers securely capture clinical notes during patient visits.

But what the description fails to indicate is that the tool records entire medical appointments, including deeply personal mental health sessions.

During these sessions, mental health professionals are required to obtain patients’ consent before using the tool. However, as shared by multiple providers, that consent process does not include explanations about how the information is handled. Nor does it say how long and where recordings are stored, or who has access to the data.

This happens in part because that information has not been shared with providers, despite their attempts to obtain it.

‘Empty assurances’

Ilana Marcucci-Morris chose not to use the platform with her patients. She is a licensed clinical social worker with Kaiser psychiatry in Oakland. She is also a member of a bargaining committee. In that role, she regularly meets with various Kaiser representatives, including Northern California’s director of mental health.

Marcucci-Morris describes how, during those meetings, she and other committee members have asked questions about patient privacy protections, HIPAA compliance, and the safeguards in place for the use of these technologies.

According to her, the response from leadership has often been empty assurances: “We are compliant. That’s it. That’s all you need to know. We vet the technology, therapist. Don’t worry. That’s not your job. We have tech experts. That’s their job,” Marcucci-Morris said in an interview with American Community Media.

“They won’t show us, right? And my feeling is, if you have nothing to hide and you’re doing it totally […] ethically, then you would show us, prove it. They can’t, and they won’t, and they declined to when we ask.”

Ligia Pacheco is a psychiatric social worker who provides remote therapy services for Kaiser patients in Southern California. She said Kaiser also refused her requests to provide further explanations.

In an interview with American Community Media, Pacheco recalled how a coworker once raised concerns to a supervisor. The response: that “it’s unprofessional for you to provide your personal beliefs on AI in our work setting.”

For Pacheco, “that leads to just low morale, no space to advocate for patients. We’re supposed to be the voice of patients who are coming in their most vulnerable state. And we can’t even be that voice for them, so we feel discouraged.”

'Patient after patient after patient'

Providers have been required to see more patients in recent years. That creates intense pressure to keep up with documentation and workloads, Marcucci-Morris highlighted.

“You’re just like seeing patient after patient after patient after patient with barely enough time to go to the bathroom, eat a snack […] get some fresh air,” she said.

According to Marcucci-Morris, refusing to manage the increased patient volume can be treated as a failure to meet job expectations. It may also lead to disciplinary action.

As a union steward, she said she often represents colleagues during workplace investigations related to delayed documentation or difficulties managing heavy caseloads. In those situations, she said management frequently recommends the use of Abridge to save time and avoid further discipline.

In her view, the providers she knows who use the technology are not doing so because they support or trust it. Rather, it is because they feel pressured to protect their jobs and comply with workplace demands.

“I consider that to be coercive because you’re putting someone in a position to either lose their job or use the software. That’s another choice that’s under duress,” she explained.

Provider, patient concerns

Brian Hoberman is chief information officer for The Permanente Medical Group. In a Kaiser press release, he said, “Abridge’s advanced technology supports our doctors’ well-being by reducing the documentation burden.”

He added, “We implemented this new technology after careful review and diligent testing and found it to be well received by patients and doctors…”

For at least one patient interviewed for this story such assurances fall short.

“I fear that this kind of information that’s being recorded now can get into the wrong hands,” said the patient, who asked not to be identified for privacy reasons. “I may not want my employers, I may not want my family members, I might not want people to know some of these very kind of intimate conversations and deep conversations I have with my doctors [and] with my mental health provider.”

Adriana Webb is a social worker at Kaiser Panorama City in Los Angeles. “I work with patients who have sensitive medical diagnoses, like […] HIV and AIDS, and a lot of times my patients don’t even want that in their chart.”

A spokesperson for Kaiser Permanente insisted in an emailed response to American Community Media that clinicians are required to gain patient consent prior to using Abridge. “No one is recorded without their knowledge and consent,” the statement read.

It added that recordings are stored for no longer than 14 days, and that data processing meets all HIPAA requirements as well as Kaiser Permanente’s own privacy and security standards.

“Abridge helps clinicians spend more time focused on patients and less time on administrative tasks,” it said.

Weaponizing mental health data

According to Nicole Alvarez, senior analyst for technology policy at the Center for American Progress, “a record of someone’s lowest moments can be used against them in ways that, you know, […] a high blood pressure reading cannot.”

She said mental health data can be especially sensitive because of the stigma surrounding mental health conditions. For patients, that stigma carries real-world consequences in areas such as employment, child custody cases, immigration matters, and security clearances. She emphasized that, like other forms of personal data, mental health information can be weaponized against individuals.

Agreements between health systems and AI vendors can vary widely, she said. This includes terms related to whether audio recordings or transcripts can be used to train AI models, whether patient data is de-identified, how long the data is retained, whether it can be shared with other clients, and what happens to the information once a contract ends.

Kaiser insists any data it collects is not used to train AI models.

Still, in Alvarez’ experience, patients often have little visibility into these arrangements. She argued that health systems have a responsibility to clearly disclose how patient information is being handled and used.

Alvarez also emphasized that, in most cases, patients have the right to refuse recordings. But, she said, the opt-out process is not always clearly presented. According to her, consent options may range from direct questions at check-in to language buried in intake paperwork, making it important for patients to carefully review forms and disclosures.

She said meaningful consent requires patients not only to know they are being recorded and that they can decline, but also to understand how their information may be stored, shared, or used afterward.

Coercive consent

Pacheco experienced this during a personal appointment at Kaiser. Her doctor did not ask for permission to use the app and instead informed her that it would be used. After a moment, she decided to refuse the platform’s use. Although the doctor stopped the recording, she felt a noticeable discomfort in the doctor’s demeanor afterward.

She later decided to change doctors.

Situations like this are a concern for Marcucci-Morris, who said the company’s approach to obtaining consent for the use of Abridge during appointments can feel manipulative and coercive. In her view, providers are trained to present the tool in a way that places the needs of patients and doctors in opposition to one another.

She explained that patients are often told the system will help doctors with documentation, reduce burnout, and allow them to spend more time with their families. As a result, patients may feel guilty declining the use of the tool because they do not want to make their provider’s job harder.

She believes this framing pressures patients into agreeing rather than allowing them to make a fully comfortable and independent decision.

According to Kaiser, Abridge is available in “40 hospitals and more than 600 medical offices in eight states and the District of Columbia,” part of a larger embrace of AI technology by the health care industry. Abridge operates in more than 14 languages.

American Community Media reached out multiple times to Abridge AI Inc. for comment but received no response. According to the company’s website, Abridge describes itself as a “Business Associate” to providers. Patients are advised to consult providers’ privacy policies for information on how their data is protected.

“Therapy is most effective in privacy and when trust is achieved through two human beings,” said Marcucci-Morris. For her, “healing occurs when human empathy is offered sincerely as part of any sort of mental health treatment relationship.”

She added, “I believe recording a therapy session changes human behavior. It changes the patient’s demeanor.”

Roxsy Lin is a California Local News Fellow with the UC Berkeley Graduate School of Journalism.

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

The Los Angeles Department of Water and Power officials said crews made significant progress overnight to repair a rupture in a 100-year-old water main in West Hollywood that caused a massive sink hole and severe flooding in the area on Thursday.

Repairs included cutting and removing a 25-foot-long section of the broken pipe and putting a replacement in place.

LADWP officials said the pipe will be repressurized, checked for leaks, and tested for regulatory compliance. It will need to be refilled before street paving.

The department doesn't have a specific completion date for the fix.

Sunset Boulevard between Sherbourne Drive and San Vicente Boulevard is still closed to traffic. Nearby streets have limited access, including at Cynthia and San Vicente, for public safety.

A map of road closures provided by LADWP as of July 18.

(

Courtesy LADWP

)

Where things stand for local businesses

Dialog Cafe on Holloway Drive said on Instagram on Thursday that the cafe sustained significant damage and didn't know when it can reopen.

And Book Soup reported on social media Saturday that they remained closed. The said they hope to reopen within a few days, noting the "the neighborhood remains inaccessible except to residents."

Republicans are leaning into immigration enforcement as one of their top campaign issues this midterm cycle — despite a rocky start to the year for messaging on the president's top policy.

An NPR analysis of advertisement data from the firm AdImpact shows that when it comes to immigration, Republicans are spending more money and running more ads than Democrats are. The data set includes ads purchased from January through June, before immigration enforcement officers shot and killed people in Maine and Texas this month.

These political ads offer one indication of where each party sees its momentum going with voters, as candidates across the country gear up for the general election in November. The data suggests Republicans see immigration as a winning issue: Since the start of the year, Republicans and their supporting organizations have run nearly 300 ads nationwide that either include a mention of immigration or are solely about immigration. This compares to 62 ads from Democrats and their supporting organizations.

"Republicans stood up for Americans. Democrats sat down for illegals. Thomas Massie sides with these radical-left lunatics," reads one ad funded by the MAGA KY PAC, a political action committee that was set up to defeat Republican Rep. Thomas Massie in the primary. The ad cost over $831,000; Massie, a frequent critic of President Trump, went on to lose his race to Trump-endorsed candidate Ed Gallrein.

Among the most expensive was a $928,000 ad buy in the Michigan governor's race.

"No greater example of waste, fraud, and abuse in Michigan than using our tax dollars to give benefits to illegal immigrants. As governor, I'll be incredibly supportive of ICE coming here and removing these fraudsters," says Republican candidate Perry Johnson, who calls himself a "MAGA Conservative" and has pitched his business approach to running a state.

Immigration was a winning issue for Republicans in the 2024 elections, with themes like increasing border security and reducing crime.

"Campaigns are not trying to change minds. They're trying to shape what the election's about. They're trying to energize the voters they already have," said Cameron Shelton, a professor of political economy at Claremont McKenna College. "If Republicans are investing much more heavily in immigration advertising, one interpretation is that they believe immigration is exactly that kind of [mobilizing] issue in today's electorate."

Immigration and enforcement are among the top issues for both parties

Most of the ads have run during the primary season, which is now more than half over. Since more than 90% of seats up for grabs in gubernatorial, House and Senate races are considered safe for one party or another, the primary campaign has become decisive for many candidates nationwide.

Some Democrats became more vocal on the issue of immigration at the start of 2026, particularly in states that were seeing intense waves of enforcement. Democrats in New Jersey, Illinois and Minnesota, for example, referenced the administration's tactics in their calls to "abolish ICE," or Immigration and Customs Enforcement, and argued the administration had gone too far.

The Illinois Future PAC ran two ads, each worth more than $800,000, earlier this year to support Juliana Stratton's stance on abolishing ICE. The current lieutenant governor later won the Illinois Democratic primary for Senate.

But months into the year, Democrats have prioritized other topics, often to differentiate themselves from members of their own party, like on healthcare, while Republicans are keeping immigration-related themes on Americans' screens.

During the primary season, Shelton said, campaigns are testing out the issues they think might matter through the general election.

For both parties, "Donald Trump" is the top subject in TV ad buys, according to data from AdImpact. "Immigration" is the issue with the second-highest spending for Republicans; for Democrats, "ICE" is the third-highest, after "healthcare."

"It's a signal to donors, it's a signal to activists, to interest groups, to local candidates. It helps coordinate a lot of the actors that we think of as the party," Shelton said. "That's another reason why some of these early ads are interesting, because they are signals of the direction that is trying to be set out."

Republicans link top issues to immigration

Between January and June, Republicans outspent Democrats on immigration-related political advertising by about $36 million. Republican ads focused on immigration, which total $53 million in spending, have aired across the country in 88 races and 27 states. Ads for Democratic candidates, which total $17 million, have run in 20 races and 11 states, primarily those that have seen increased immigration enforcement action like California, New York and Illinois.

"Republican candidates have a large menu of issues we are on the right side of that are all very popular amongst voters," said Mike Marinella, national press secretary at the National Republican Congressional Committee. He listed the border, crime and the economy as issues that Republican candidates can connect to immigration.

"Immigration intersects with each of them," he said. "The most effective message depends on the district and how those issues are affecting that particular community," he added.

Zach Lahn, who won the GOP primary bid for Iowa governor, spent about $475,000 on an ad in May that vowed to ban H-1B visa holders from being hired by Iowa government agencies and universities, linking immigration and economic concerns.

Crossings at the border have plummeted since Trump took office. Marinella said candidates are still keeping the issue of border security top of mind for their voters.

A majority of the ads promoting Republican candidates include keywords such as "securing the border" and discuss border wall funding and crime. Some also go a step further to talk about specific proposals supported by the administration, such as limiting commercial driver's licenses and supporting the SAVE America Act, which would require stricter proof of citizenship to vote.

For example, in Florida's 19th congressional district, Jim Oberweis, one of several candidates vying for the GOP seat, spent $880,000 on seven ads that advocated for ending birthright citizenship.

Democrats lean into pro-immigration statements

Ads promoting Democratic candidates, on the other hand, shy away from specific policy proposals. Instead, they include criticism of incumbents for recent votes on bills that have provided funding to immigration officers or expanded the scope of who could be detained. Others focus on personal connections to immigration, proposals to limit enforcement and general pro-immigrant statements.

"Democrats are finding their voice on immigration after a rough few years during the Biden administration," said Frank Sharry, senior fellow at Third Way, a centrist think tank. "I don't think they'll be running a bunch of ads on it. I do think they'll be speaking to the issue and winning the argument, which is more important than whether they run ads on it or not."

A poll from Gallup released in July shows that most Americans think immigration is a good thing, and a majority support some form of pathway to citizenship rather than a blanket deportation policy — though there are sharp differences by party. A majority of Republicans favor hiring more Border Patrol agents, deporting anyone without legal status and banning sanctuary cities.

Republican ads broadcast during Senate races in Ohio, Texas and Alaska and gubernatorial contests in New York and Iowa are already starting to target Democrats. Strategists said this trend suggests how each party may lean into immigration leading up to the November election. But they also caution against reading too much into advertisements to gauge party strategy.

"Back in the day, ads were king. Now you have so many diverse streams of information arriving to people on their phones that it's just not the same," Third Way's Sharry said, noting interviews, debates, and other forms of public statements aren't captured in the ad data.

Copyright 2026 NPR

Making daylight saving time permanent moved a step closer to reality this week, when the House of Representatives voted overwhelmingly to pass a measure to eliminate the annual clock-changing ritual.

But some Orthodox Jewish organizations are fighting to prevent the bill from becoming law.

The measure, called the Sunshine Protection Act, passed in a 308-117 vote in the House on Tuesday (July 14). It now heads to the Senate, where its passage is uncertain. President Donald Trump has championed the effort, describing on his Truth Social account moving the clocks forward and back as a "ridiculous, twice yearly production."

If passed, the bill would give Americans an extra hour of sunshine in the evenings during the winter. But it would also push winter sunrises one hour later. That's of concern to Orthodox Jews, who pray three times a day, beginning with the Shacharit morning prayer service, which by tradition cannot begin in the dark.

"The bottom line is, if prayers have to start an hour later that will have a direct effect on people getting to work and on when schools can start," said Rabbi A.D. Motzen, national director of government affairs for Agudath Israel of America, an organization representing U.S. Orthodox Jews.

A constellation of other Orthodox Jewish groups also opposes the measure, including the Orthodox Union and the Coalition for Jewish Values.

In Jewish law, some prayers, such as those in the morning service, can only be said communally, in a quorum of 10 Jewish adults, called a minyan. That requirement means going to synagogue every morning before heading out for work or school and saying prayers, such as the Shema, the central prayer of Jewish life, collectively. The morning service typically lasts 35 minutes but on some occasions can last close to an hour.

"It becomes a communal issue when, for example, a synagogue that has had a morning prayer service for 100 years suddenly does not have a quorum of 10 men who can show up at the prayer time close to 9 o'clock because they have jobs," Motzen said.

Motzen, who works in the Washington, D.C., office of Agudath Israel, said the organization already has the support of Sen. Tom Cotton, R-Ark., who last year objected to fast-tracking the bill.

Orthodox Jews make up only 9% of the estimated 5.8 million Jewish adults in the U.S., according to Pew Research Center. Larger Jewish groups have not publicly taken a position.

Congress has grappled with turning back the clocks many times. In 1974, it tried to abandon clock-switching, but repealed the law a few months later following public outcry. In 2022, the Senate unanimously passed a measure making daylight savings time permanent, but the bill died in the House.

Orthodox Jews are not the only constituencies opposed to the change. Some medical and health advocates argue that the human body's internal clock is better aligned with the sun during standard time rather than daylight saving time. School boards and parents are also concerned about children walking to school in pitch-black conditions during winter mornings.

That latter concern, which Motzen described as a safety issue, is one Orthodox Jews share as well.

Making daylight saving time permanent would make sunrise after 8 a.m. in most parts of the country, and after 9 a.m. in a few select places. For example, according to a list compiled by Agudath Israel, sunrise would take place after 9 a.m., (and as late as 9:13 a.m.) for 55 days a year in South Bend, Indiana. In Detroit, Michigan, sunrise would take place after 9 a.m. for 23 days a year.

Hawaii and most of Arizona abide by standard time year round, as do Puerto Rico, Guam, American Samoa, the U.S. Virgin Islands and the Northern Mariana Islands.

This story was produced through a collaboration between NPR and Religion News Service.
Copyright 2026 NPR

Updated July 18, 2026 at 14:11 PM ET

After Medicaid officials improperly shared data about millions of people in January with immigration officials, ICE then shared that data with the data analytics firm Palantir, according to new court filings. Palantir operates an app called ELITE that is used by ICE agents to show the addresses of noncitizens who may be subject to deportation.

That revelation was made public in a motion filed Thursday by more than 20 Democratic attorneys general who sued the Trump administration last year over its data-sharing agreement between the Centers for Medicare and Medicaid Services and ICE.

Palantir said in a statement to NPR that the dataset in question had been purged.

U.S. District Judge Vince Chhabria in California ruled in December that health officials could share with ICE certain details from Medicaid data about immigrants without lawful status from the states that had sued, such as home addresses, dates of birth and immigration status.

Chhabria, who was appointed by former President Obama, then temporarily paused data sharing between CMS and ICE for immigration enforcement purposes in late May after federal officials admitted CMS had shared data with ICE in January that went beyond what the court order allowed. One dataset of refugees in Minnesota included U.S. citizens, and another that was transferred on Jan. 7 contained data of millions of people, including those in the country legally.

ICE was supposed to delete the improperly shared data. Chhabria set a hearing for August to further clarify his order and clear up ambiguity regarding which categories of noncitizens' data could be lawfully shared with ICE.

But in recent days, federal officials have admitted to additional instances of improper data sharing.

In a court filing last week, the Justice Department said that CMS again inadvertently reshared with ICE the dataset with millions of names that CMS had first improperly shared with ICE in January. The government said the error occurred during an effort to share data from states not involved in the lawsuit.

Alberto Briseno, a section chief for ICE's Homeland Security Investigations, wrote in a declaration that ICE personnel deleted the file after it was discovered and it was not used for law enforcement purposes.

Then Briseno revealed that a day later, the agency had done a broader search and discovered that half a dozen users still had a copy of the Jan. 7 dataset.

In that most recent declaration, Briseno said he was not aware of any additional copies of the dataset, but said the recent searches have "highlighted technological difficulties of making a representation that every possible variation of the file has been searched for and located." He added, "ICE will continue to make good faith efforts to delete any copies that may be found in the future."

Meanwhile, the Department of Justice is asking the judge to expand his order to allow ICE to receive data on a broader category of noncitizens – to potentially include all immigrants who are not legal permanent residents, citizens or have another form of permanent status.

"ICE's inability to identify Medicaid records in its possession undercuts any claim that the agency should be entitled to more access to that data," the Democratic attorneys generals wrote in their motion filed late Thursday.

Their motion continued, "Each successive revelation of a violation of the Order makes it more difficult for Plaintiff States to have confidence in Defendants' ability to maintain and secure this data in compliance with the Order, and more difficult for Plaintiff States to communicate assurances to Medicaid providers, enrollees (and their counsel), and the public at large about the privacy and confidentiality of their healthcare data."

Palantir provided the following statement to NPR: "Our customers control their own data and manage access to that data. When Palantir employees are granted access to a customer's dataset, it is solely to help integrate and analyze that data — which is what our software does — not to store it or use it for our own purposes. Palantir can confirm that the dataset in question was purged pursuant to government instruction."

DHS didn't immediately return a request for comment about its transfer of data to Palantir.

According to a declaration filed by California deputy attorney general Anna Rich, when plaintiffs asked what federal officials did to ensure Palantir and other contractors had purged the data, defendants responded that the data had been shared over a Microsoft Teams chat and the shared data was deleted from the chat. Rich shared in her declaration a document turned over in discovery from federal officials that shows a redacted transcript of what appears to be ICE personnel asking Palantir to delete the file.

In an April 30 hearing, Chhabria had warned the federal government would not be able to continue using Medicaid data for deportation efforts if it continued improperly sharing the data of citizens and legal immigrants.

"If the federal government cannot be sufficiently careful then it can't use the information, ok?" Chhabria had said.

Copyright 2026 NPR