The Brief

There are about 2,700 unhoused people living in Skid Row and only three dedicated places where they can sit down in the shade, grab a drink of chilled water and cool down from the summer heat.

The 24-hour climate stations are spread within the downtown Los Angeles neighborhood where the temperature this week was expected to reach a high of 91 degrees.

That’s not enough stations, authorities say, to help keep unhoused people from getting sick or dying of heat-related illness.

“Maybe if these stations were like, on every block, that would make a real difference,” said Sade Kammen, of the nonprofit WaterDrop LA. “But when people have to walk blocks to get a cup of water in the blazing hot sun it defeats the purpose.”

Since 2021, the city has allocated more than $6 million for the climate stations — formerly called cooling stations — including a nearly $2.5 million grant this year, according to the Los Angeles Homeless Services Authority. The agency distributes the funding to the nonprofit Urban Alchemy to operate the climate stations.

There are three permanent stations in Skid Row (the third was added last week):

• Towne Avenue (between 5th Street and 6th Street)
• San Pedro Street (between 6th Street and 7th Street) 
• Maple Street (corner at 5th Street)

But for the thousands of unsheltered residents of Skid Row who lack sufficient access to water and shade, advocates say they need dozens more climate stations to address the need.

Kirkpatrick Tyler, chief of community and government affairs at Urban Alchemy, said there are no plans to add more climate stations in Skid Row at this time. Instead, he said, the focus should be on creating more public spaces for unsheltered people.

“How do we take all of these buildings inside of the Skid Row community and figure out how to make them accessible spaces?” he said.

An ongoing crisis of resources

The World Health Organization recommends a minimum of four gallons of water per day to meet the minimum daily water needs for drinking and sanitation during an emergency situation. Unhoused people in Skid Row, where the latest point-in-time count showed there were 2,695 unsheltered people on any given night, have access to about half of that, according to Water Drop LA.

Skid Row is considered an urban heat island by Environmental Protection Agency standards, meaning it gets hotter than areas with more greenery and lacks shade, averaging a 3.5% canopy coverage throughout the 54-block area. The nonprofit American Forests recommends a minimum of 15% canopy coverage in urban areas to alleviate the heat island effect.

“At the heart of it, unhoused people simply lack cool places to go,” said Sherin Varghese, a volunteer for Ktown for All.

The downtown climate stations have pop-up canopies that provide some shade, but some advocates for the unhoused say they are not enough to actually cool people down.

“I personally think it's bullshit that you’re expected to think there’s a cooling center that’s outside on the sidewalk,” said Adam Smith, an organizer at Los Angeles Community Action Network. “A cooling center to me would be like indoors with air conditioning.”

Smith also noted that as of Monday morning, two of the three climate stations did not have ice to chill the water, or fans to cool off residents.

From cooling to climate stations

After a grueling heatwave in September 2020 — when temperatures soared into the triple digits downtown — Tom Grode and other advocates for the unhoused launched the Skid Row Cooling Resources Coalition. They proposed the cooling station idea to the mayor’s office.

The city approved nearly $400,000 for a pilot program of four cooling stations (though the proposal requested six) in summer 2021, according to the Los Angeles Homeless Services Authority.

“It was a huge success. We thought — this is really working and people are really loving this,” said Grode, co-founder of Skid Row Cooling Resources. “Let’s figure out how to expand it and add way more stations.”

But the next year, in 2022, the mayor’s office reduced the number of stations from four to two, citing budget issues. The Homeless Services Authority reported that the city allocated $745,570 for the program that year.

In 2023, when funding from the mayor’s office shot up to nearly $2.5 million, L.A. officials said communication problems between the Homeless Services Authority and Urban Alchemy led to delays, and the two stations didn’t open up until the end of August.

Two more stations opened in September.

At that point, Grode said, communication from the government agencies running the program to Skid Row Cooling Resources dwindled, and advocates became frustrated.

“They stopped talking to us or taking our suggestions,” he said. “It became very City Hall based rather than neighborhood based.”

Grode said part of the issue is that the temporary cooling stations became permanent– year-round heating and cooling areas staffed around the clock by Urban Alchemy. Operating them 24 hours a day, seven days a week significantly increased costs, which made it more difficult to add more stations.

“There are good things about it, but what’s happening now is different than the reason it was created in the first place,” he said. “This is a cautionary tale of what happens when a grassroots collaborative effort full of energy does a great job and the government takes control of it.”

Tyler, of Urban Alchemy, said the organization had no choice but to make the stations permanent because daily set up and break down required too much labor.

“That was not feasible,” he said. “Now, the stations also are a safe place for people to go at night, which is just an added benefit.”

No more stations planned for Skid Row

L.A. Mayor Karen Bass did not specify whether the city plans to expand the climate stations.

“The City of Los Angeles is taking immediate action to ensure Angelenos are safe from the heat — and that includes more than opening cooling centers on Skid Row,” Bass wrote LAist in an email. “Urgent work is continuing to bring unhoused Angelenos inside and into housing. The heat and safety are top concerns.”

On Thursday, Gov. Gavin Newsom issued an order to state officials instructing them to clear out homeless encampments. This comes after a recent Supreme Court ruling granted cities more power to cite and fine people who sleep outside in public places.

In a statement, the governor called on local officials to “do their part.”

L.A. Mayor Karen Bass slammed the court's ruling, and said in a statement after Newsom’s order that homelessness had decreased in the city for the first time in years because of a “comprehensive approach that leads with housing and services, not criminalization.”

The mayor continued: "Strategies that just move people along from one neighborhood to the next or give citations instead of housing do not work. We thank the Governor for his partnership thus far and hope that he will continue collaboration on strategies that work.”

A hazardous materials team will begin working Monday to remove neutralized methyl methacrylate from two of three tanks at the GKN aerospace facility in Garden Grove.

Some 50,000 Orange County residents were evacuated for several days last month after one of the tanks overheated on May 21, causing fears of an explosion or a leak through the Memorial Day weekend.

The clean-up will be done in phases, until Thursday, “with multiple layers of safety protocols and oversight measures in place,” according to a press release from the Orange County Health Care Agency.

Containers that support temperature control and secure transportation will be used in the operation.

Cleanup was initially scheduled to begin June 4, but was postponed after officials said "needed resources" were unavailable.

Orange County District Attorney Todd Spitzer launched an investigation into the incident last month. The FBI and Environmental Protection Agency also seized evidence at the facility earlier this month.

Methyl methacrylate produces a fruit-like odor, Orange County Health Care Agency said residents may notice the scent during the operation. The agency said levels will remain below thresholds that could pose health risks.

Officials say environmental protection will be in place throughout the week. Air will be continuously monitored through both mobile and fixed equipment at the fence line of the facility and in the community. Air and odor monitoring based on wind conditions will also be done. Work will occur only during the daylight hours until Thursday.

The California Department of Corrections and Rehabilitation is restricting access to rehabilitative programming for incarcerated people as it clamps down on overtime spending before the end of its financial year.

Hundreds of rehabilitative programs operate throughout California prisons, including restorative justice, violence prevention, higher education, creative arts expression and entrepreneurial training.

The rollback began earlier this month and will end June 30, according to documents obtained by CalMatters. Corrections spokesperson Terri Hardy described the limitations as a “cost-saving measure.” The department did not respond to a detailed list of questions, including which prisons and programs have been affected.

The department’s overall budget has remained about flat since 2022, around $18 billion a year despite recent cuts that include five prison closures.

Lawmakers at budget hearings earlier this year pressed Corrections Secretary Jeff Macomber to tighten spending as the department asked for additional $91 million in ongoing funding to cover unbudgeted personnel costs. The department last month also proposed an additional $100 million in workers compensation.

The California Correctional Peace Officers Association, the union that represents state prison guards, did not respond to CalMatters’ requests for an interview.

Tony Tafoya, who’s been incarcerated since 2012, said he’s never seen anything like this happen before. Tafoya said the scale-back has had the biggest impact on college classes. He’s currently enrolled in Mount Tamalpais College at San Quentin but said his math class has missed out on 12 days of instruction.

“I feel like I’m falling behind,” he said. “There’s a lot of healing that comes from going to school. It provides humanity. It makes me feel like I’m actually seen as a person. I feel like that’s what’s being missed out on.”

Programs at Pleasant Valley State Prison in Coalinga have also been interrupted, including a civic education pilot program. The program, run by the organization Initiate Justice, includes just over a dozen incarcerated people who helped draft legislation to improve social emotional learning in the K-12 school system. Assembly Bill 1851, authored by Democratic Assemblymember Mike Gipson from Gardena, is sailing through the Legislature and scheduled for an upcoming education committee hearing Wednesday.

Antoinette Ratcliffe, executive director of Initiate Justice, said the group “thrives off of active and live discussion, off of meaningful exploration.” The severing of that connection disrupts the learning experience and practical application of the programming, she said.

“We have made it a goal across the Legislature to make rehabilitative programming a priority, so to continue to see disruptions like this feels counter to what we agreed upon as a state,” she said. “It feels like a let down.”

Other advocates have echoed those sentiments. Danica Rodarmel, a criminal justice reform lobbyist, said any disruption in people’s ability to access programming impacts their mental health and well being. The completion of a program or certificate, she said, is often a determining factor in people’s ability to be granted parole.

“Limiting people’s ability to engage in pro-social activities is contradictory to the goals of maintaining safe prisons both for the people who are incarcerated but also for the people who work there,” she said.

It's tick season, possibly the worst in a decade.

More and more Americans are being exposed to these parasites as climate change expands the range where they can survive. That means more people are also exposed to the bevy of health conditions they can cause, such as Rocky Mountain spotted fever, the alpha-gal-triggered red meat allergy and, most common of all, Lyme disease.

For Lyme disease, there may be some additional protection on the horizon. Pharmaceutical companies Pfizer and Valneva announced this spring that they plan to seek regulatory approval for a vaccine to protect against Lyme disease. A previous vaccine for Lyme became available in the late 1990s but was pulled only three years later due to lawsuits, public fear of side effects and a lack of interest.

It's unclear whether this latest stab at a Lyme disease vaccine will get a warmer reception if it's approved, especially in the post-COVID era of vaccine skepticism.

For a sense of how it might go over with rural populations at high risk of Lyme, KFF Health News spoke with a group of hunters.

Few people spend more time in the woods exposed to ticks. At the same time, as a collective, hunters  skew conservative, rural and male, according to a survey from the Theodore Roosevelt Conservation Partnership. And these are identities associated with increased hesitancy about or resistance to vaccines, according to Ashley Kirzinger, associate director for Public Opinion and Survey Research at KFF, a health information nonprofit that includes KFF Health News.

Targets for ticks

Left untreated, Lyme can cause a variety of symptoms, from fevers, chills and headaches to arthritis, shooting pains and inflammation of the brain and spinal cord, according to the Centers for Disease Control and Prevention.

About 476,000 people in the U.S. may be diagnosed and treated for Lyme disease each year, the CDC says. That's at least in part because the range of places where cases have been reported has "expanded significantly" since 1995.

So would hunters get the Lyme vaccine if it became available?

"Given my proclivity for the outdoors, absolutely," said Jess Manganelli, one of seven hunters (and one hiker) who spoke with KFF Health News on a recent Saturday at the Busch Shooting Range in Weldon Spring, Mo., just outside of St. Louis.

Of the eight, Manganelli, who had been hunting turkeys the weekend before, was the most positive about the vaccine. Six others said they would consider it but would want more information about its safety and effectiveness, as well as their risk for contracting the disease.

But Manganelli was the only one who believed she may have previously contracted Lyme disease, although she was never formally diagnosed with it. Two years ago, she experienced muscle weakness, tiredness, fatigue, swelling and headaches after a tick bite, but when she went to urgent care, she was told they didn't test for Lyme.

Nearly all the hunters knew someone who had had Lyme disease — an old roommate, a family member, friends, a former student. Lyme can be difficult to diagnose and to treat and is often misdiagnosed at first. Many of the hunters witnessed their acquaintances navigating those challenges and struggling with sometimes debilitating symptoms.

An illness with lingering effects

That familiarity among the hunters in Missouri was unsurprising to author and conservationist Steven Rinella, host of the hunting show MeatEater.

"I'm a turkey hunter. In talking about turkey hunting, you talk about ticks as much as you talk about turkeys," Rinella said. "Just the nature of turkey hunting puts you into exposure. You're sitting for long periods of time, trying to use vegetation for concealment."

In fact, both Rinella and his older son contracted Lyme disease 13 years ago during a bluegill fishing trip in the Hudson Valley in New York. His son developed Bell's palsy, a sudden paralysis on one side of the face, but recovered quickly after a course of oral antibiotics. Steven Rinella's symptoms, on the other hand, lingered for months, leaving him unable to walk down stairs without a handrail or to ride a bike. He ended up receiving intravenous antibiotic treatments for a month.

"I thought my life had changed," Rinella said, "but I recovered, as far as I know."

That experience is one reason Rinella said he would absolutely consider getting a Lyme vaccine if it proved safe and provided considerable protection against the disease. Unlike with some other diseases, prior infection does not provide permanent immunity, so a person who has had Lyme could still benefit from a vaccine.

Knowledge of similar challenges influenced the thinking of the hunters in Missouri as well.

Jeremy Hollingshead said he may be less inclined to take a vaccine owing to his former roommate's experience with Lyme disease, which is not to say the experience was pleasant. In fact, Hollingshead said he thinks his old pal is still dealing with lingering effects of it 10 years later. But Hollingshead has spent his whole life in the woods, and of hundreds of people he knows who have done the same, he knows of only one of them contracting Lyme.

"I know it was a bad outcome for him," Hollingshead said, but he thinks the odds of getting Lyme himself seem pretty slim.

Meanwhile, Julian Barnes said seeing a relative struggle with Lyme makes him more open to a potential vaccine. It took a long time for doctors to come to that diagnosis, and finding a good treatment has been equally difficult.

"I would say I am vaccine-hesitant, generally speaking," Barnes said. "But Lyme, I've seen the way it affects people in my life. ... I would definitely have to really understand the vaccine, how it works."

An unclear path for a new vaccine

The new, four-dose vaccine candidate technically missed one of the bars set out in trials because not enough participants contracted Lyme. Still, the companies say it's about 75% effective in reducing cases, and they plan to submit it to regulators for approval. A Pfizer spokesperson said there were no updates on their regulatory efforts when contacted by KFF Health News in June.

Health and Human Services Secretary Robert F. Kennedy Jr. was a noted anti-vaccine activist before taking over as head the agency that oversees vaccine approvals, and he's remade it in ways that have prompted some vaccine makers to pull back on development.

But he's also been an advocate on Lyme disease. In May, he announced an initiative to combat Lyme disease. And during his Senate confirmation hearings, he said his family had been deeply affected by Lyme disease and that nobody would work harder than he would to find a vaccine or treatment.

If the vaccine is ultimately approved by the FDA, an endorsement from Kennedy would go a long way, according to KFF's Kirzinger, particularly among supporters of his Make America Healthy Again movement, who tend to be more vaccine-skeptical.

"They trust him as much as they trust their own doctors to tell them what to do with their health and for health information," Kirzinger said. "If he comes out as a strong proponent of this vaccine and says, 'Look what my administration did, and we made this available,' I would imagine there would be less vaccine resistance among that group."

Only one of the hunters who spoke with KFF Health News said they definitely would not be interested in a Lyme vaccine if it became available.

"I kind of hand it off to God and the body he gave me. I'm pretty durable," JP Cummings said. But even though he's not interested in it for himself, he's curious to see what his fellow hunters do as more information comes out.

"Hunters care about the wildlife; hunters care about health," Cummings said. "They love the wildlife, they love their deer, and they love their fellow hunters."

KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF.

Far more people than previously known have dropped Affordable Care Act health insurance for 2026, according to data released Friday.

Five million fewer people are currently enrolled in ACA marketplace plans compared to the record high reached last year. More than 1 million fewer people picked a plan for 2026, and then 4 million more either disenrolled or failed to pay their premiums and, therefore, dropped coverage.

Prices in the market skyrocketed after President Donald Trump and Republicans in Congress failed to extend extra financial help for enrollees last year. The Department of Health and Human Services published a report about the data on its website Friday.

The report says 19.2 million people are currently enrolled in ACA insurance now.

At its high, 24.2 million people were in the ACA marketplace in 2025, according to government figures.

The steep drop in enrollment reflects what insurers, administrators and other health policy experts expected earlier this year. After initial sign ups were lower than last year, they predicted the picture would get worse as time went on and people found they could not afford to pay their premiums.

"The main takeaway is that enrollment is down 13% from last year," explains Cynthia Cox, director of KFF's Program on the ACA. "While the Trump administration attributes this drop in enrollment to their attempts to address fraud, this coverage loss happened at the same time millions of people faced double- or even triple-digit increases in their premium payments with the expiration of enhanced tax credits."

The idea that the growth in enrollment was due to massive fraud is a theory advanced by the Paragon Health Institute, a conservative think tank influential in the Trump administration.

Many health policy experts are skeptical. They say the increase in enrollment during the pandemic is not suspicious. It was a predictable consequence of Congress's investment of billions of federal dollars in making premiums more affordable — the enhanced premium tax credits.

"The marketplace doubled in size during the period when there were enhanced subsidies because the coverage was much more affordable and much more appealing to people," Cox says.

This year's drop in enrollment is also predictable, given that premium costs doubled, on average, from 2025 to 2026. The costs went up after Republican lawmakers let the enhanced premium tax credits expire; Democrats shut down the government in October 2025 trying to negotiate an extension of the credits that would have kept prices low.

"When their costs went up, many of them dropped their coverage," Cox says.

She adds that while fraud is a real problem in the ACA marketplaces, as it is in all insurance markets, she thinks it does not account for all of the drop in enrollment.

Stacey Pogue, senior research fellow at the Georgetown Center on Health Insurance Reforms, agrees.

"I don't see data that point to that conclusion that a 5 million-person drop can be explained by allegations of fraud," she says. "There's lots of evidence pointing to people making decisions based on what they can pay each month."

The higher health insurance costs are tough for consumers in an economy still plagued by overall inflation. As congress let the prices go up, people made tough decisions about family budgets, where to work, whom to marry and more.

It's also a problem for insurance companies, several of which have announced they will not be participating in ACA markets next year, including Cigna.

"If there are fewer customers, then that makes the market less appealing to insurance companies," Cox says.

That's especially true because the people dropping their coverage tend to be healthier people. If too many healthy people drop out of the markets, there's a danger that the markets could enter a "death spiral."

Cox says she's not worried about a death spiral at this point.

"I think there are still enough people buying ACA marketplace coverage and that's going to keep these markets working," she says. "At this point, we don't see any parts of the country that are at risk of having no insurance company. If that were to happen, that would be what a death spiral might look like."

Even so, the premiums for these plans are on track to keep rising, which could continue to pummel consumers navigating high health care costs. Enrollment in the marketplaces may continue to shrink too. According to a recent analysis from Pogue at Georgetown, early insurance rate filings for 2027 show that rates will be going up again next year.