The Brief

California has been preparing to fill a budget gap for gender-affirming care procedures after the federal government pulled the funds under the direction of President Donald Trump and Mehmet Oz, administrator of the Centers for Medicare & Medicaid Services.

LAist crunched the numbers to see if the state has budgeted enough, and here’s what we found.

Youth on Medi-Cal bill $1 million yearly for hormones

People under 18 covered by Medi-Cal filed about $1 million in claims in 2025 for hormone replacement therapy and puberty blockers, according to data California’s Department of Health Care Services. That accounted for about 4,000 claims.

Some providers that take trans youth patients on Medi-Cal, like Children’s Hospital Los Angeles’ trans youth clinic, closed last year, though many doctors still were able to write out prescriptions that lasted patients for months after that.

Some care remains covered 

Medi-Cal also covered 4,800 claims for about 1,500 Medi-Cal members under 18 in 2025 for “doctor visits, counseling, surgeries, speech therapy, and other services,” totaling $6.4 million. Gender-affirming surgeries are only recommended for minors in rare circumstances.

However, the restrictions in the federal Medicaid rule only affect puberty blockers, hormone replacement therapy and surgeries, according to health policy organization KFF, so services like mental health treatment would still be reimbursable with federal funds. The rule, which would take effect Oct. 13, also lets states pay for minors’ gender-affirming hormone treatments and surgeries themselves.

The state has already set aside two pots of money to close gaps in funding for gender-affirming healthcare services: a $30 million fund for gender-affirming care and abortion services, and a $26 million trust fund specifically for trans healthcare. California Health & Human Services Agency leaders anticipate the funds will cover these Medi-Cal services over the next three years.

Medi-Cal’s budget

The overall Medi-Cal program budget during this period was almost $200 billion, according to state data. Transgender youth health services, including mental health services, make up just 0.004% of the plan’s budget.

Medi-Cal administers both the federal Medicaid program and the Children’s Health Insurance Program (CHIP) under a Medicaid expansion allowed for by the Affordable Care Act.

“The federal rule applies solely to federal Medicaid and CHIP funding; California will determine any adjustments needed to align with federal requirements,” California Department of Health Care Services spokesperson Anthony Cava said in a statement. “California remains committed to safeguarding access to medically necessary care for Medi-Cal members, including gender-affirming care.”

Medi-Cal agencies like L.A. Care have stated that they are continuing to cover gender-affirming care services.

Issues may still arise

While they celebrated the establishment of the fund, trans healthcare advocates have noted that some issues may arise due to providers who are unsure how the new state rules apply.

The California Legislative LGBTQ Caucus has also said it’s bracing for future budget years to be “even more challenging as federal funding cuts and attacks on targeted investments to marginalized communities continue to threaten critical services.”

Meanwhile, California Attorney General Rob Bonta has denounced the restrictions on federal funding since they were first floated last year. A lawsuit has not yet been announced, but a spokesperson for his office told LAist, “We are closely reviewing the final rule.”

After homelessness advocates pushed a Los Angeles City Council member to change how the city treats encampments in his district, the full City Council voted Tuesday to selectively stop enforcing a law that bans unhoused people from sleeping in certain areas.

A controversial policy

One of the city’s most controversial enforcement laws on homelessness is found in section 41.18 of L.A.’s municipal code. It allows local elected leaders to establish zones where unhoused people cannot sit, lie down, sleep or keep belongings on sidewalks or other public areas.

What's new?

Councilmember Hugo Soto-Martinez — who represents a district including Hollywood, Silver Lake and Echo Park — recently introduced a motion to remove some of the 41.18 districts established by his predecessor, Mitch O'Farrell.

On Tuesday, the council voted 10-3 to allow some zones to be erased in Soto-Martinez’s district. The zones include underpasses in Silver Lake, underpasses in Echo Park and 101 Freeway overpasses in Hollywood.

Soto-Martinez said he believed today’s measure was the first effort to have 41.18 zones removed rather than put in place.

The debate

Supporters of 41.18 have said the policy allows officials to keep encampments away from schools, parks and other areas deemed “sensitive” by the city, enabling parents to keep their children away from encampments and helping to keep important pedestrian infrastructure clear.

Critics have said the policy doesn’t reliably keep encampments away from sensitive sites because people simply return after sweeps that don't offer them housing.

In Tuesday’s meeting, Soto-Martinez said enforcement in some of these areas leads to unhoused people losing their belongings, becoming lost to outreach workers and sometimes getting arrested.

“To me, that is a policy that does not work,” Soto-Martinez said in Tuesday’s meeting. “In our district, these zones were making it harder to do the things that do work.”

Councilmember Nithya Raman, now running for mayor, has also argued the policy is ineffective, saying it merely moves encampments to other blocks without getting people into housing.

A 2023 report from L.A.’s lead homelessness agency, first covered by LAist, concluded that the policy hadn’t kept most areas clear of encampments, and was “generally ineffective” at connecting people to housing.

Dissenting votes

Some council members strongly defend using 41.18 in their districts. Three voted against rescinding the zones in Soto-Martinez’s district.

Monica Rodriguez, council member for a district that covers much of the northeast San Fernando Valley, said during Tuesday’s meeting that “41.18 was never intended to be the solution to our homeless problem. In fact quite the opposite. It’s just about protecting public spaces for families who want to be able to take their kids to the park and not have to be exposed to it.”

El Niño is officially with us, and it’s looking like it’s likely going to be a doozy.

The natural global climate pattern temporarily warms the eastern tropical Pacific, causing extreme weather patterns across the globe. A strong El Niño has historically, though not always, been associated with very wet winters here in Southern California.

“ We are now explicitly expecting the strongest El Niño event ever observed,” said UCLA climate scientist Daniel Swain. “ There will be a strong tilt in the odds towards wet, perhaps even very wet conditions in Southern California.”

Maybe you remember the very wet El Niños of years past — 1982 and 1997. Both were historic events that led to billions of dollars in damage and dozens of deaths.

“This is highly likely to exceed what occurred in [1982 or 1997], and by a considerable margin,” Swain said.

The good news? You still have time to prepare.

Experts emphasize that people need to develop an understanding of their personal risk, talk to neighbors who may have experienced flooding in the past and consider getting insured.

Know your risk

The Federal Emergency Management Agency, or FEMA, compiles flood risk maps (you can also use this L.A. County map here).

Be aware that they are not comprehensive and can be out-of-date. Also, they include only risk from coastal flooding, such as tides and waves, as well as from rivers, creeks, channels and levies, which risk spilling over after back-to-back severe storms.

But the maps don’t include flood risk from short, heavy downpours or mudflows in recent burn zones, said Brett Sanders, a professor leading UC Irvine’s Flood Lab. So even if your home is not within an official flood zone, you could be at risk.

“What used to be grasslands and open space has been covered more and more by asphalt and concrete,” Sanders said. “And so more and more water runs off and these flood risks are increasing.”

Flooding diverts traffic on a Long Beach street in 2024.

(

Eric Thayer

/

Associated Press

)

His lab has been working to figure out how to develop more comprehensive flood maps, to better determine risks and reflect changes brought on by a warming climate.

But Sanders said one of your best bets to prepare is low-tech: speak with neighbors or officials who know your local area, and remember how past severe rain events have affected your street or neighborhood. For example, if you live at the base of a hill, or in a basement or ground-level apartment, you’re more likely to see some water flow. That historical memory can help you develop a plan for a worst-case scenario.

“Some common sense local awareness from people is really valuable,” Sanders said. “Talk to somebody that's been around for a while. Ask them, ‘Do you remember floods happening here in the past?’ Or, ‘What happened in 1997 when we had our last really wet El Nino?’”

Once you know, consider filling sand bags ahead of time, keep drainages around and on your house clear, and think about how flooding may affect your travel routes.

People who live in recent wildfire burn areas are likely through the worst of it, Swain said.

“ I think the initial highest risk period will have passed by this winter,” he said.

Still, mudflow is possible. So remember how mud flowed during the storms soon after the 2025 L.A. fires and make sure you have what you need to protect your property and evacuate safely if needed.

Consider flood insurance

Homeowners and renters should take a moment to read their current insurance policies closely. Most homeowners insurance, as well as renters insurance, does not include coverage for flooding (water damage coverage is not flood coverage). Less than 2% of Californians have flood insurance at all.

If you don’t have it, get a quote, said Amy Bach, director of United Policyholders, a nonprofit that advocates for insurance consumers. Flood insurance is usually a lot cheaper than typical insurance.

“ Don't make a decision not to carry flood insurance without getting a quote,” she said. “Find out how much it would cost before you decide.”

If you do get flood insurance, it’ll take about a month to kick in, so you want to start looking now before the official start of the wet season in October.

You can get flood insurance through the National Flood Insurance Program, or some private companies. United Policyholders has a variety of resources to figure out which product is right for you. Bach also pointed to a tool by the California Department of Insurance to compare various insurers based on complaints against them, as well the Federal Alliance for Safe Homes, which can help you identify your risks.

“If it rains, it can flood,” Bach said. “And that is more true today than it used to be.”

This story first appeared on The LA Local.

Hundreds of East Los Angeles households near the site of the Lineage warehouse fire will begin receiving a one-time $200 utility credit on their Southern California Edison bills after weeks of pressure from residents and L.A. County Supervisor Hilda Solis to extend relief beyond Boyle Heights. 

Lineage, the owner of the cold-storage warehouse, initially provided $50,000 in utility assistance to 218 Los Angeles Department of Water and Power customers in Boyle Heights. Residents in unincorporated East L.A., including some who live just blocks from the warehouse, were not included in that support. 

Last week, David Eisenhauer, a representative with Southern California Edison (SCE), told Boyle Heights Beat that Lineage provided $26,600 to cover $200 credits for 133 households in East L.A. These residents live within a boundary designated as Zone 2, which stretches between Indiana Street and Hicks Avenue, and Union Pacific Avenue and the 5 Freeway. SCE said customers living within the boundary will receive an automatic $200 credit applied to their accounts. 

The expansion came after Solis called on Lineage to provide East L.A. residents with the same level of support that was given to the city.

“Lineage has a responsibility to provide fair and equitable support to everyone affected by this disaster, including delivering the remaining $25,000 in utility assistance that was allocated for East Los Angeles residents,” Solis said in a statement to Boyle Heights Beat. 

“After learning that Lineage was working with the Los Angeles Department of Water and Power to provide utility assistance to Boyle Heights residents, I made clear that East Los Angeles residents deserved the same level of support through Southern California Edison,” Solis said. 

On Monday, a Lineage representative told the Beat that the relief had been expanded to cover hundreds more households in East L.A., extending as far as Herbert Avenue. The company has not yet determined the exact amount of support it will provide and some SCE customers’ credits are still being distributed.

The utility assistance comes as residents continue to report higher electricity bills after relying on air purifiers and air conditioners to cope with the stench of rotting food inside the warehouse and poor air quality following the June 17 warehouse fire. 

Why some residents qualify and others don’t

The boundaries of Lineage’s relief programs have been a source of confusion for residents. 

At a virtual community meeting hosted by the mayor’s office last Thursday, a resident sent in a question asking, “Why are not all residents affected by the fire and stench eligible for financial assistance?”

Officials have used a map dividing the area around the warehouse into Zones 1, 2 and 3, with the zones representing the areas closest to the fire. It is unclear who created the map and how those boundaries were established. 

A map of Zones 1, 2 and 3 used by Lineage to determine the type of support offered to households closest to the Lineage warehouse.

(

Courtesy of Lineage

)

Lineage has used the map to determine which households are eligible for various forms of relief, including air purifiers, air conditioners, housing support, grocery vouchers, cash assistance and utility credits. 

For weeks, residents have called for broader relief, saying the effects of the fire and lingering odors have affected not only homes close to the warehouse, but neighboring areas as well. 

In response, Jenny Delwood, deputy chief of staff to L.A. Mayor Karen Bass said that while the areas closest to the warehouse had been prioritized, “… Bass and her partners from the county and city are working to raise additional funding to provide more utility assistance and additional bill payments for a larger geographic area.”

Details on expanded support for households outside of the boundary were not immediately available.

How to know if you qualify: 

According to SCE, customers living between Indiana Street, Herbert Avenue, Union Pacific Avenue and the 5 Freeway will begin receiving an automatic credit to their account.

No further action is required from qualified customers.

LADWP customers living between Los Palos Street, Indiana Street, Union Pacific Avenue and Beswick Street received an automatic credit to their account on July 31.

What support is available for residents who live outside of the boundary?

SCE customers can apply for:

• A number of income-based programs with discounts, including the California Alternate Rates for Energy and Family Electric Rate Assistance. 
• Payment plans, including a long-term installment plan, so customers can spread their balance over time with manageable payments, and the Budget Billing Plan, which helps spread energy costs more evenly throughout the year. (For customers within the impact boundary who enter into a long-term installment plan, the down payment for a new payment plan will be waived.) 
• The Energy Assistance Fund, which provides one-time bill assistance of up to $200. SCE works with United Way and over 80 community-based organizations to provide the assistance but customers need to apply directly through the organization. To find the partner organization closest to you, click here.
• Customers in areas affected by the fire can get more information on SCE’s support programs here.

LADWP customers can request:

• Payment arrangements: No down payment, no interest, no fees; A long-term payment option that divides the total account balance evenly across a specified number of billing periods.
• Payment extension: A short-term payment option that gives customers additional time, up to one billing period, to pay their full balance.
• Level pay: A billing option that helps you plan by providing predictable monthly bills based on average usage. You can also roll in past-due balances.

To inquire about these programs, call 1-800-DIAL-DWP, visit a customer service center or use the online form on LADWP.com/ContactUs.

LADWP customers can also apply for the Low Income Home Energy Assistance Program (LIHEAP) through the Maravilla Foundation. But the Maravilla Foundation website says that due to reduced government funding and high demand, fewer applications are being accepted. To qualify for LIHEAP, the monthly income for a family of four must not exceed $6,407.16. A full list of requirements and application instructions can be found here.