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One of the great ironies of Gov. Gavin Newsoms on-again, off-again push to make health care available to all Californians is that, to hear him tell it, it worked too well. That successan unexpectedly high number of Californians who signed up to see a doctor under Newsoms expansions of Medi-Calis now cited as one of the reasons Newsom wants to back away from the program he loudly championeda cornerstone of his election and re-election campaigns. The proposed move to roll back Medi-Cal access, announced Wednesday as part of the governors revised 2025-26 state budget, will have profound repercussions for many of the estimated 1.6 million undocumented immigrants who use the safety net program. It left the director of one California immigrant rights group outraged, as he put it. Newsoms explanation for the cuts is prosaic: The state is facing an additional $12 billion budget deficit, bringing the total to $39 billion, and the money has to come from somewhere. Modifying a program that benefits undocumented people is probably also politically expedient, although you wont find Newsom acknowledging that. And there is the ongoing pressure from Washington, D.C., for states to quit providing health care to their undocumented populations. What it actually means for California is harder to gauge. The governors office says the proposed Medi-Cal changes will save $5.4 billion by fiscal year 2028-29. But budget figures cant predict what happens when people who work and live in California get sick and cant afford to receive care, nor how hospitals will handle a likely surge in emergency room visits by patients who put off health issues until they become severepatients whom the hospitals by law cannot refuse, even if they have no ability to pay. * * * Newsoms proposal will freeze Medi-Cal enrollment for undocumented adults (age 19 and older) beginning next year. It also would charge $100 a month to those already in the program, even though by definition Medi-Calthe states version of Medicaidis designed for those whose earnings are so close to the poverty level that any medical expense is likely to be too much. Given the states financial picture, some have argued that the Medi-Cal cuts couldve been worse. Newsoms office was quick to point out that no ones coverage is being cut off, and theres truth in that. But the key word in the conversation is undocumented. Under Newsom, the state dramatically expanded health coverage for undocumented residents, a program first begun under Gov. Jerry Brown to cover those under age 19. Newsom has used a series of moves to extend that Medi-Cal coverage to Californians of all ages regardless of their immigration status, and he has touted it as a fulfillment of his campaign promise of universal health care. In truth, Newsom originally campaigned for office as a strong advocate of single payer health care, a very different program. Under single payer, a lone (usually government-run) entity provides for and finances health care for all residents. That position won Newsom the support of powerful nurses unions and helped him get elected. But once in office, the governor, whose heavy political contributors have also included Blue Shield and the California Medical Association, quietly backed away from the issue. Newsom chose instead to try for a mix of public and private insuranceincluding the Medi-Cal expansionso that almost all the states residents have some form of coverage, even if, as critics have consistently pointed out, the insurance is often too expensive for many Californians to actually use. The effect of the Medi-Cal expansions regardless of immigration status has been significant, and it shouldnt be dismissed. It isnt a perfect system; more than half a million undocumented Californians still earn too much to qualify for Medi-Cal yet dont have employer-based coverage, rendering them effectively uninsured, according to research by the University of California, Berkeley, Labor Center. But by bringing so many of the states residents under the Medi-Cal umbrella, the program has offered care to people who live and work in the state. Undocumented workers paid $8.5 billion in state and local taxes in 2022, according to the Institute on Taxation and Economic Policy, and theyre the source of more than half a trillion dollars of products in California, either by direct, indirect, or induced production levels. Although no one can factor that output into a state budget, keeping these people and their families healthy and productive makes straight common sense. But thats only if you factor out the politics. * * * Running in the background of this discussion is the obvious: Donald Trumps administration and the GOP-led Congress are threatening to penalize states that provide health care to undocumented immigrants. California could lose as much as $27 billion in federal funds between 2028 and 2034, according to the Center on Budget and Policy Priorities. And without question, the Medi-Cal expansion has cost more than expected. The Department of Health Care Services estimated that the state is paying $2.7 billion more than budgeted on Medi-Cal for undocumented immigrants, driven by higher than anticipated enrollment and increased pharmacy costs. (There has also been a significant uptick in overall Medi-Cal sign-ups, especially among older adults.) In other words, the expansion worked. California residents, including those who are undocumented, signed up for Medi-Cal. And now that the budget crunch is real, its immigrants whose coverage is deemed the most expendable. We are outraged by the governors proposal to cut critical programs like Mei-Cal, said Masih Fouladi, executive director of the California Immigrant Policy Center. At a time when Trump and House Republicans are pushing to slash health care access and safety net programs while extending tax cuts for the wealthy, California must lead by protecting, not weakening, support for vulnerable communities. Wednesday was a step back in that regard. It certainly wont be the last word. And what does not change is the most profound truth: The need for Californias immigrants to have access to basic health care didnt go away. Itll be there again tomorrow. This piece was originally published by Capital & Main, which reports from California on economic, political, and social issues.
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E-Commerce
The headlines scream it daily: Markets are fluctuating wildly, AI is transforming entire industries overnight, supply chains are fracturing, and the workforce is reshuffling at unprecedented rates. According to the World Economic Forum, 78 million new job opportunities will emerge by 2030, but this comes amid massive workforce transformation, with 77% of employers planning upskilling initiatives while 41% anticipate reductions due to AI automation. All these moving parts are playing out against a global background of financial insecurity, war, climate change, and political disruption. The age of anxiety Welcome to the age of VUCAvolatility, uncertainty, complexity, and ambiguitya concept adopted by the military to describe post-Cold War conditions but now perfectly capturing our business landscape. And here’s the brutal truth. We’re facing this unprecedented VUCA while collectively and perfectly depleted from the trauma of the past five years. A recent American Psychiatric Association survey reveals that 43% of U.S. adults feel more anxious than they did the previous year, with 70% particularly anxious about current events. Research from meQ also finds that depression and anxiety rates are more than four times higher for people who feel least prepared for change. This isn’t another challenging period to weather. Chaotic change isnt a bug in the code we can just rewrite. It’s a fundamental feature of our era, requiring a complete reinvention of our relationship with change itself. Why the U in VUCA Hurts So Much Right Now In a word, trauma. The pandemic threw us into societal trauma at a level few of us had ever known. Unlike normal adversity, where mental health improves once the challenge passes, the pandemic created persistent mental health issues that have worsened even after the acute phases passed. When it comes to mental health, trauma has a long tail. The pandemic delivered a perfect storm of traumatic conditions: Chronic and unrelenting. Rather than a sharp, short crisis, it dragged on with no clear endpoint. Pervasive impact. It transformed every aspect of life simultaneouslywork, relationships, health, finances. Global with no escape. You couldn’t get on a plane to avoid it. Beyond our control. Individual actions had minimal impact on the overall trajectory. Shifting goalposts. Vaccines were promised, then delayed; variants emerged; reopenings were followed by new lockdowns. Aversion to Uncertainty This roller coaster of false hope and disappointment forced us to experience unrelenting uncertainty, and even in good times, our brains hate uncertainty. In a 2016 University College London study, people experienced more stress and anxiety when facing a 50/50 chance of receiving an electric shock than when facing a 98% certainty of receiving that same shock. Uncertainty was more unbearable than guaranteed pain. This preference made evolutionary sense when stability increased the chance of survival. In today’s business environment, it’s a dangerous liability. The fight-flight-freeze responses that helped our ancestors survive short periods of uncertainty now paralyze us in boardrooms, strategy sessions, and daily decision-making. We are not yet equipped to handle the ongoing uncertainty of todays nonstop change. The New Approach to Change I often describe our current relationship to change as abusive. Another disruption shakes us off course, and we think “this time will be different,” but it never is. The resulting uncertainty plagues us as much as before, because we haven’t changed our approach. Transforming our ingrained fear of uncertainty requires a process that rewrites our own relationship with change. We are then empowered to lead our teams and organizations through this era of VUCA without end. Step 1: Reject our old-fashioned beliefs about uncertainty and change We all have deep-seated beliefs about how the world should work. I call these Iceberg Beliefs because theyre enormous and largely lie beneath the surface of our awareness. They often define how we react to change. Classic beliefs about change and uncertainty might sound like: If I keep my head down and work hard, certainty should be my reward. “Uncertainty is unbearable and unfair.” The more control I get, the better my life will be. Steady as she goes wins the race. Change is frightening. It should be resisted or ignored. We have to discard these beliefs. For one, theyre not accurate. While hard work helps achieve our goals, it brings no guarantee of certainty or constancy. Second, they frame VUCA in a way thats not useful. VUCA is happening to us all, and fair has nothing to do with it. These beliefs push us to waste our time and energy fighting for an illusion of certainty that will never come. We must reject these naive Icebergs and replace them with beliefs that reflect reality and point to a path ahead. Step 2: Reinvent and reimagine our beliefs about uncertainty and change Reinventing our relationship with change means rejecting old and tired thinking and constructing new belief systems. We can ease into this by first endorsing beliefs that get us more comfortable with change. Not all uncertainty ends badly. There have been college applications, new jobs, and reorgs that turned out well. Ive been through change before, and most of the terrible stuff I worried about at 3 a.m. every night didnt actually happen. I am powerless to change change, but I alone have the power to change my relationship with it. Next, we can finally turn the tables on this abusive relationship by edging toward embracing change. Well get there with beliefs like there is no growth without change” and every change brings opportunity. We can also recognize that some of life’s most exhilarating momentsfalling in love, becoming a parent, getting a promotion, starting a new ventureinvolve profound uncertainty and change. Part of this work must include recalibrating our sense of what is under our control and mapping our sphere of control daily. Trauma distorts our sense of what we can and cannot influence. For example, during the pandemic, I found myself obsessively worrying about my elderly parents’ health in Australiasomething I had limited control overwhile neglecting my children’s online education happening right in front of me. I was systematically failing to control what Icould because I was exhausted trying to control what I couldn’t. Step 3: Lead your people through change With the threat of uncertainty neutralized and our beliefs about change and control starting to shift, we turn attention outward. How can we react to disruption more productively? And how can we successfully lead the people who count on us through VUCA? Practice a growth mindset These habits of mind help us see opportunities and stay focused through chaotic disruption. As leaders, we shift our teams response to change when we approach challenges with principles such as: Abandoning perfectionism. Accepting inevitable mistakes. Reframing mistakes as progress to value. Encouraging creativity without judgment. We can also educate our managers in this new approach to change, and help them learn to coach their teams to do the same. When this training happens at scale, our entire workforce is much more equipped to navigate and accelerate through organizational changes. Adjust work to the demands of VUCA We cant lead like business as usual when VUCA rules. However, with our greater resilience in the face of change, we can skillfully shift workplace expectations and norms to reduce VUCAs impact, thereby protecting growth and well-being as changes unfold. Reduce Volatile Processes. Slow processes down when possible. External forces put a ceiling on how much volatility you can control, but even small reductions help. The greatest athletes visualize the game in slow motion, while they respond in real time. Deal with one thing at a time rather than everything simultaneously. Reduce Uncertain Outcomes. While you can’t eliminate uncertainty, take actions today that narrow the field of possible outcomes. Thats why we try to exercise and eat healthfully. While never a guarantee that well dodge illness, it renders that uncertainty small enough to set aside for now. Reduce Complex Problems. Break problems into smaller pieces. Think of untangling yarnstart with one strand, simplify it, then move to the next. Organizations like NASA excel at this approach, breaking seemingly impossible challenges into manageable components. Reduce Ambiguous Information with Clarity. The U in VUCA is future-directed, while the Aambiguityis happening now. During change, people will fill information gaps with their Icebergs and fears. In my research, organizations that fare better during VUCA have transparency of process and open information. Its widely held in military circles that in a battle, communication is often the first thing to fail. By the time an organization is in VUCA, its too late to develop lines of communication. Work now, preemptively, to build strategies to keep your people informed. The payoff is clear. Research at meQ shows that most change-ready, resilient, and supported employees are significantly VUCA-proofed, with rates of depression, anxiety, and burnout slashed by around 75% when compared with their less change-ready peers. Taking the Power Back from Change The ultimate reality? Periods of stability will become increasingly rare. The concept that we just need to get through this “liminal time” before returning to normal is outdated. It’s the brief periods of stability that are now liminalunusual spaces between the predominant times of change, turmoil, and flux. Those who can adapt internally rather than demanding external stability will be best positioned to thrive. The pursuit of stability is a fool’s errand, and what we’re chasing is fool’s gold. The only thing at stake is this: Our entire mental health, wellness, happiness, productivity, and performance. It’s time to take back the power in our relationship with change.
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E-Commerce
As summer approaches, millions of Americans begin planning or taking trips to state and national parks, seeking to explore the wide range of outdoor recreational opportunities across the nation. A lot of them will head toward the nations wilderness areas110 million acres, mostly in the West, that are protected by the strictest federal conservation rules. When Congress passed the Wilderness Act in 1964, it described wilderness areas as places that evoked mystery and wonder, where the earth and its community of life are untrammeled by man, where man himself is a visitor who does not remain. These are wild landscapes that present nature in its rawest form. The law requires the federal government to protect these areas for the permanent good of the whole people. Wilderness areas are found in national parks, conservation land overseen by the U.S. Bureau of Land Management, national forests and U.S. Fish and Wildlife refuges. In early May 2025, the U.S. House of Representatives began to consider allowing the sale of federal lands in six counties in Nevada and Utah, five of which contain wilderness areas. Ostensibly, these sales are to promote affordable housing, but the reality is that the proposal, introduced by U.S. Rep. Mark Amodei, a Nevada Republican, is a departure from the standard process of federal land exchanges that accommodate development in some places but protect wilderness in others. Regardless of whether Americans visit their public lands or know when they have crossed a wilderness boundary, as environmental historians we believe that everyone still benefits from the existence and protection of these precious places. This belief is an idea eloquently articulated and popularized 65 years ago by the noted Western writer Wallace Stegner. His eloquence helped launch the modern environmental movement and gave power to the idea that the nations public lands are a fundamental part of the United States national identity and a cornerstone of American freedom. var divElement = document.getElementById('viz1747405934583'); var vizElement = divElement.getElementsByTagName('object')[0]; if ( divElement.offsetWidth > 800 ) { vizElement.style.width='100%';vizElement.style.height=(divElement.offsetWidth*0.75)+'px';} else if ( divElement.offsetWidth > 500 ) { vizElement.style.width='100%';vizElement.style.height=(divElement.offsetWidth*0.75)+'px';} else { vizElement.style.width='100%';vizElement.style.height='777px';} var scriptElement = document.createElement('script'); scriptElement.src = 'https://public.tableau.com/javascripts/api/viz_v1.js'; vizElement.parentNode.insertBefore(scriptElement, vizElement); Humble origins In 1958, Congress established the Outdoor Recreation Resources Review Commission to examine outdoor recreation in the U.S. in order to determine not only what Americans wanted from the outdoors, but to consider how those needs and desires might change decades into the future. One of the commissions members was David E. Pesonen, who worked at the Wildland Research Center at the University of California at Berkeley. He was asked to examine wilderness and its relationship to outdoor recreation. Pesonen later became a notable environmental lawyer and leader of the Sierra Club. But at the time, Pesonen had no idea what to say about wilderness. However, he knew someone who did. Pesonen had been impressed by the wild landscapes of the American West in Stegners 1954 history Beyond the Hundredth Meridian: John Wesley Powell and the Second Opening of the West. So he wrote to Stegner, who at the time was at Stanford University, asking for help in articulating the wilderness idea. Stegners response, which he said later was written in a single afternoon, was an off-the-cuff riff on why he cared about preserving wildlands. This letter became known as the Wilderness Letter and marked a turning point in American political and conservation history. Pesonen shared the letter with the rest of the commission, which also shared it with newly installed Secretary of the Interior Stewart Udall. Udall found its prose to be so profound, he read it at the seventh Wilderness Conference in 1961 in San Francisco, a speech broadcast by KCBS, the local FM radio station. The Sierra Club published the letter in the record of the conferences proceedings later that year. But it was not until its publication in The Washington Post on June 17, 1962, that the letter reached a national audience and captured the imagination of generations of Americans. Wallace Stegner, right, knew the power of American wilderness landscapes. In this photo, probably from the 1950s, he pauses with his son Page and wife, Mary, on a Yosemite National Park hiking trail. [Photo: Multimedia Archives, Special Collections, J. Willard Marriott Library, University of Utah] An eloquent appeal In the letter, Stegner connected the idea of wilderness to a fundamental part of American identity. He called wilderness something that has helped form our character and that has certainly shaped our history as a people . . . the challenge against which our character as a people was formed . . . (and) the thing that has helped to make an American different from and, until we forget it in the roar of our industrial cities, more fortunate than other men. Without wild places, he argued, the U.S. would be just like every other overindustrialized place in the world. In the letter, Stegner expressed little concern with how wilderness might support outdoor recreation on public lands. He didnt care whether wilderness areas had once featured roads, trails, homesteads or even natural resource extraction. What he cared about was Americans freedom to protect and enjoy these places. Stegner recognized that the freedom to protect, to restrain ourselves from consuming, was just as important as the freedom to consume. Perhaps most importantly, he wrote, wilderness was an intangible and spiritual resource, a place that gave the nation our hope and our excitement, landscapes that were good for our spiritual health even if we never once in ten years set foot in it. Without it, Stegner lamented, never again will Americans be free in their own country from the noise, the exhausts, the stinks of human and automotive waste. To him, the nations natural cathedrals and the vaulted ceiling of the pure blue sky are Americans sacred spaces as much as the structures in which they worship on the weekends. Stegner penned the letter during a national debate about the value of preserving wild places in the face of future development. Something will have gone out of us as a people, he wrote, if we ever let the remaining wilderness be destroyed. If not protected, Stegner believed these wildlands that had helped shape American identity would fall to what he viewed as the same exploitative forces of unrestrained capitalism that had industrialized the nation for the past century. Every generation since has an obligation to protect these wild places. Stegners Wilderness Letter became a rallying cry to pass the Wilderness Act. The closing sentences of the letter are Stegners best: We simply need that wild country available to us, even if we never do more than drive to its edge and look in. For it can be a means of reassuring ourselves of our sanity as creatures, a part of the geography of hope. This phrase, the geography of hope, is Stegners most famous line. It has become shorthand for what wilderness means: the wildlands that defined American character on the Western frontier, the wild spaces that Americans have had the freedom to protect, and the natural places that give Americans hope for the future of this planet. Death Valley National Park in California contains one of the largest protected wilderness areas in the United States. [Photo: National Park Service/E. Letterman] Americas best idea Stegner returned to themes outlined in the Wilderness Letter again two decades later in his essay The Best Idea We Ever Had: An Overview, published in Wilderness magazine in spring 1983. Writing in response to the Reagan administrations efforts to reduce protection of the National Park System, Stegner declared that the parks were Absolutely American, absolutely democratic. He said they reflect us as a nation, at our best rather than our worst, and without them, millions of Americans lives, his included, would have been poorer. Public lands are more than just wilderness or national parks. They are places for work and play. They provide natural resources, wildlife habitat, clean air, clean water and recreational opportunities to small towns and sprawling metro areas alike. They are, as Stegner said, cures for cynicism and places of shared hope. Stegners words still resonate as Americans head for their public lands and enjoy the beauty of the wild places protected by wilderness legislation this summer. With visitor numbers increasing annually and agency budgets at historic lows, we believe it is useful to remember how precious these places are for all Americans. And we agree with Stegner that wilderness, public lands writ large, are more valuable to Americans collective identity and expression of freedom than they are as real estate that can be sold or commodities that can be extracted. Leisl Carr Childers is an associate professor of history at Colorado State University. Michael Childers is an associate professor of history at Colorado State University. This article is republished from The Conversation under a Creative Commons license. Read the original article.
Category:
E-Commerce
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