vetoes

California Gov. Gavin Newsom this week signed a suite of privacy protection bills for transgender patients amid continuing threats by the Trump administration.

But there was one glaring omission that LGBTQ+ advocates and political strategists say is part of an increasingly complex dance the Democrat faces as he curates a more centrist profile for a potential presidential bid.

Newsom vetoed a bill that would have required insurers to cover, and pharmacists to dispense, 12 months of hormone therapy at one time to transgender patients and others. The proposal was a top priority for trans rights leaders, who said it was crucial to preserve care as clinics close or limit gender-affirming services under White House pressure.

Political experts say Newsom’s veto highlights how charged trans care has become for Democrats nationally and, in particular, for Newsom, who as San Francisco mayor engaged in civil disobedience by allowing gay couples to marry at City Hall. The veto, along with his lukewarm response to anti-trans rhetoric, they argue, is part of an alarming pattern that could damage his credibility with key voters in his base.

“Even if there were no political motivations whatsoever under Newsom’s decision, there are certainly political ramifications of which he is very aware,” said Dan Schnur, a former GOP political strategist who is now a politics lecturer at the University of California-Berkeley. “He is smart enough to know that this is an issue that’s going to anger his base, but in return, may make him more acceptable to large numbers of swing voters.”

Earlier this year on Newsom’s podcast, the governor told the late conservative activist Charlie Kirk that trans athletes competing in women’s sports was “deeply unfair,” triggering a backlash among his party’s base and LGBTQ+ leaders. And he has described trans issues as a “major problem for the Democratic Party,” saying Donald Trump’s trans-focused campaign ads were “devastating” for his party in 2024.

Still, in a conversation with YouTube streamer ConnorEatsPants this month, Newsom defended himself “as a guy who’s literally put my political life on the line for the community for decades, has been a champion and a leader.”

“He doesn’t want to face the criticism as someone who, I’m sure, is trying to line himself up for the presidency, when the current anti-trans rhetoric is so loud,” said Ariela Cuellar, a spokesperson for the California LGBTQ Health and Human Services Network.

Caroline Menjivar, the state senator who introduced the measure, described her bill as “the most tangible and effective” measure this year to help trans people at a time when they are being singled out for what she described as “targeted discrimination.”

In a legislature in which Democrats hold supermajorities in both houses, lawmakers sent the bill to Newsom on a party-line vote. Earlier this year, Washington became the first to enact a state law extending hormone therapy coverage to a 12-month supply.

In a veto message on the California bill, Newsom cited its potential to drive up health care costs, impacts that an independent analysis found would be negligible.

“At a time when individuals are facing double-digit rate increases in their health care premiums across the nation, we must take great care to not enact policies that further drive up the cost of health care, no matter how well-intended,” Newsom wrote.

Under the Trump administration, federal agencies have been directed to limit access to gender-affirming care for children, which Trump has referred to as “chemical and surgical mutilation,” and demanded documents from or threatened investigations of institutions that provide it.

In recent months, Stanford Medicine, Children’s Hospital Los Angeles, and Kaiser Permanente have reduced or eliminated gender-affirming care for patients under 19, a sign of the chilling effect Trump’s executive orders have had on health care, even in one of the nation’s most progressive states.

California already mandates wide coverage of gender-affirming health care, including hormone therapy, but pharmacists can currently dispense only a 90-day supply. Menjivar’s bill would have allowed 12-month supplies, modeled after a 2016 law that allowed women to receive an annual supply of birth control.

Luke Healy, who told legislators at an April hearing that he was “a 24-year-old detransitioner” and no longer believed he was a woman, criticized the attempt to increase coverage of services he thought were “irreversibly harmful” to him.

“I believe that bills like this are forcing doctors to turn healthy bodies into perpetual medical problems in the name of an ideology,” Healy testified.

The California Association of Health Plans opposed the bill over provisions that would limit the use of certain practices such as prior authorization and step therapy, which require insurer approval before care is provided and force patients and doctors to try other therapies first.

“These safeguards are essential for applying evidence-based prescribing standards and responsibly managing costs — ensuring patients receive appropriate care while keeping premiums in check,” said spokesperson Mary Ellen Grant.

An analysis by the California Health Benefits Review Program, which independently reviews bills relating to health insurance, concluded that annual premium increases resulting from the bill’s implementation would be negligible and that “no long-term impacts on utilization or cost” were expected.

Shannon Minter, legal director for the National Center for LGBTQ Rights, said Newsom’s economic argument was “not plausible.” Although he said he considers Newsom a strong ally of the transgender community, Minter noted he was “deeply disappointed” to see the governor’s veto.

“I understand he’s trying to respond to this political moment, and I wish he would respond to it by modeling language and policies that can genuinely bring people along.”

Newsom’s press office declined to comment further.

Following the podcast interview with Kirk, Cuellar said, advocacy groups backing SB 418 grew concerned about a potential veto and made a point to highlight voices of other patients who would benefit, including menopausal women and cancer patients. It was a starkly different strategy than what they might have done before Trump took office.

“Had we run this bill in 2022-2023, the messaging would have been totally different,” said another proponent who requested anonymity because they were not authorized to speak publicly on the issue.

“We could have been very loud and proud. In 2023, we might have gotten a signing ceremony.”

Advocates for trans rights were so wary of the current political climate that some also felt the need to steer clear of promoting a separate bill that would have expanded coverage of hormone therapy and other treatments for menopause and perimenopause. That bill, authored by Assembly member Rebecca Bauer-Kahan, who has spoken movingly about her struggles with health care for perimenopause, was also vetoed.

In the meantime, said Jovan Wolf, a trans man and military veteran, patients like him will be left to suffer. Wolf, who had taken testosterone for more than 15 years, tried to restart hormone therapy in March, following a two-year hiatus in which he contemplated having children.

Doctors at the Department of Veterans Affairs told him it was too late. Days earlier, the Trump administration had announced it would phase out hormone therapy and other treatments for gender dysphoria.

“Having estrogen pumping through my body, it’s just not a good feeling for me, physically, mentally. And when I’m on testosterone, I feel balanced,” said Wolf, who eventually received care elsewhere. “It should be my decision and my decision only.”

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 — the independent source for health policy research, polling, and journalism.

SACRAMENTO — Gov. Gavin Newsom on Monday vetoed legislation that would have allowed public and private colleges to provide preferential admissions to applicants directly descended from individuals who were enslaved in the United States before 1900.

The governor thanked the bill’s author for his commitment to addressing disparities and urged educational institutions to review and determine “how, when, and if this type of preference can be adopted.”

“This bill clarifies, to the extent permitted by federal law, that California public and private postsecondary educational institutions may consider providing a preference in admissions to an applicant who is a descendant of slavery,” Newsom wrote Monday in his veto. “These institutions already have the authority to determine whether to provide admissions preferences like this one, and accordingly, this bill is unnecessary.”

The legislation would not have required applicants to belong to any particular race or ethnicity — a crucial detail that proponents said distinguished it from affirmative action, which is banned at California colleges. Critics, however, argued the term “slave” was used as a proxy for race.

Legal experts told The Times last month the measure probably would have faced challenges in court if the governor signed it into law.

“The question with this sort of provision is does this count as on the basis of race?” said Ralph Richard Banks, professor at Stanford Law School and the founder and faculty director of the Stanford Center for Racial Justice. “A secondary issue is going to be whether, even if it is not formally about racial classification, was it really adopted to get around the no-racial-classification rule? The law prohibits indirect methods of doing something that would be prohibited if you were to do it directly.”

Race-based college admissions are banned by federal and state law.

Proposition 209, which California voters approved nearly three decades ago, amended the state Constitution to bar colleges from considering race, sex, national origin or ethnicity during admissions. The U.S. Supreme Court in 2023 in effect ended race-conscious college admissions nationwide, ruling in Students for Fair Admissions vs. Harvard that such policies violate the equal protection clause of the 14th Amendment.

California became the first state government in the country to study reparations, efforts to remedy the lingering effects of slavery and systemic racism, after the 2020 killing of George Floyd by a Minneapolis police officer sparked a national conversation on racial justice.

Newsom and state lawmakers passed a law to create a “first in the nation” task force to study and propose effective ways to help atone for the legacy of slavery. That panel spent years working on a 1,080-page report on the effects of slavery and the discriminatory policies sanctioned by the government after slavery was abolished, and the findings became the genesis for a slate of legislation proposed by the California Legislative Black Caucus.

Last week, Newsom signed Senate Bill 518, which will create a new office called the Bureau for Descendants of American Slavery. That bureau will create a process to determine whether someone is the descendant of a slave and to certify someone’s claim to help them access benefits.

Assemblymember Isaac Bryan (D-Los Angeles), who introduced Assembly Bill 7, said his legislation would have allowed colleges to grant preference to the descendants of enslaved people in order to rectify a “legacy of exclusion, of harm.”

Andrew Quinio, an attorney specializing in equality issues for the Pacific Legal Foundation, believes AB 7 was blatantly unconstitutional. The foundation is a conservative public interest law firm that seeks to prevent government overreach.

“This was a bill that was born out of the Reparations Task Force recommendations; it was part of the package of bills of the Road to Repair from the California Legislative Black Caucus so this has a very clear racial intent and racial purpose and it will have a racial effect,” he said. “[Legislation] doesn’t have to benefit the entirety or even the majority of a demographic in order for it to be unlawfully based on race.”

Lisa Holder, a civil rights attorney and president of the Equal Justice Society, a progressive nonprofit that works to protect policies that promote diversity, argued the measure’s framing made it highly likely to satisfy legal challenges.

“This (legislation) is very specifically tailored to correct the harms that we have seen, the harms from the past that continue into the present,” she said. “… Because this bill seeks to erase those harms by focusing specifically on the descendant community, it is strong enough to establish a compelling interest.”

Gary Orfield, a law and education professor and co-founder of the Civil Rights Project/Proyecto Derechos Civiles at UCLA, agreed the legislation was carefully written in a way that could have withstood legal challenges. He pointed out California allows university programs that support Native American students because they were narrowly tailored to focus on tribal affiliation — which is considered a political classification — instead of race or ethnicity.

Orfield said applicants of various races could have potentially benefited from the new admissions policy, as many Native Americans were enslaved and Asiatic coolieism, or Asian indentured servitude, was declared a form of human slavery in the state constitution in 1879.

“All Black people weren’t slaves and all slaves were not Black,” he said. “I think there is a good argument to say that slavery isn’t defined strictly by race and is not just a proxy for race and there certainly is a legitimate concern when you are thinking about remediation for historic violations.”

Orfield, however, said convincing the public was a different matter.

“I don’t think all people will easily understand this,” he said. “Americans tend to think that discrimination doesn’t cross over multiple generations. But I think that it does — I think there has been a long-lasting effect.”

Staff writer Melody Gutierrez contributed to this report.