The safeguard was designed to prevent users from being overwhelmed by harmful content, but TikTok wanted to determine whether it made the app less engaging.

Rebecca Feinglos never expected to get divorced. She’d been with her partner for nine years, and married for six, but finally she had to admit to herself that her relationship had taken an abusive turn.

It was 2021 when she decided to end it. But Feinglos was surprised to discover then that the state she was living in, North Carolina, requires couples to reside in separate homes continuously for a full year before they can even file. 

“In amicable divorces you could lie, but I did not have an amicable divorce,” she told me. “It took 18 months for my divorce to be signed by a judge, and we did not have children.”

When she was finally out of her marriage she felt angry. She knew that many people could not afford to live in separate places, let alone pay for the attorneys needed to navigate all the fraught legal proceedings. Feinglos, a former state government employee with a master’s degree in public policy, started researching divorce laws nationwide. “It was so confusing even for me,” she said. “This was before ChatGPT, and all the Google search results were from family attorneys saying, ‘Oh this is really complicated, you definitely need to hire us to help you.’” She has spent the years since pushing to change those laws.

North Carolina is one of a handful of states, including South Carolina and Arkansas, that require couples to live separately for a set period before they can file for no-fault divorce. Most states make couples wait after they file, a “cooling-off” period meant to give spouses a chance to change their minds. In Wyoming, it’s 20 days. In Missouri, 30. In California, couples need to wait six months, and having children can stretch the timelines further. In some states the clock only starts when one’s spouse is formally served, which means a husband or wife who’s hard to track down can add weeks to the wait before it even begins.

“The system sets people up for conflict, sets people up for war,” said Erin Levine, a former divorce lawyer who founded a company that helps people navigate divorce outside the traditional law firm model. “In some states it’s called a ‘petition,’ in some states it’s called a ‘complaint,’ the forms say ‘spouse v. spouse’ — you are being sued.”

This issue runs, inevitably, into the culture wars. Today some conservatives are trying to make it even harder to get divorced, part of a broader push to strengthen the traditional nuclear family, built on the argument that children fare better when parents stay together. Over the last few years Republican lawmakers in states like Missouri, Tennessee, and Texas have considered new restrictions on no-fault divorce, which lets a person end a marriage without proving their spouse did something wrong. Others have proposed expanding so-called covenant marriages, which require counseling before the wedding and allow divorce only for specific reasons like adultery or abuse. House Speaker Mike Johnson has long endorsed making divorce harder, and Vice President JD Vance has complained that no-fault divorce allows people to “shift spouses like they change their underwear.” (Faced with criticism, a spokesperson later said that Vance does not support changes to divorce law.) 

But as more people come forward with stories of the financial cost, family stress, and even physical danger of extended divorce proceedings, there’s a growing push to address their complaints by making it easier to separate and divorce rather than harder. In 2023, Maryland lawmakers eliminated fault-based divorce entirely, cut Maryland’s separation mandate from a year to six months, and let couples count as separated even while living under the same roof. Washington, DC, has gone further. The same year, the DC Council unanimously scrapped its requirement that couples separate before divorce, and in Virginia, a law that took effect just last month lets people get in front of a judge on the first day they separate, instead of waiting six months or a year to sort out custody, support, and who stays in the house.

The issue has gotten more attention on social media over the last few weeks, as Jen Hamilton and Hadley (Vlahos) Fairley, two bestselling authors with more than 7 million followers across Instagram and TikTok, have started speaking out about how divorce laws in their respective states affect women like them. Hamilton, who is based in North Carolina and separated from her husband in June, has blasted the “asinine, outdated, and paternalistic laws” that keep people trapped in marriages, and has been fundraising on her platforms to help women afford to escape their unsafe relationships. 

Fairley, based in Mississippi, has been recounting the many court filings, legal fees, and emotional pain she endured for nearly three years trying to end her marriage. A no-fault divorce in Mississippi requires both spouses to agree to it, and when they don’t, the only way out is to prove in court that your spouse did something wrong, like adultery or desertion. In May, after eleven days in court, a judge finally granted Fairley a divorce, determining that her ex-husband’s conduct met the state’s legal standard for “habitual cruel and inhuman treatment,” citing a DUI he lied about under oath, more than $200,000 in secret trading losses that were mostly her earnings, a cancer diagnosis he faked to get her sympathy, and months of messages the judge called harassing and manipulative. Custody and the division of their assets are still unresolved, and more trial days are set for September.

“I understand burden of proof for a murder trial, but when it’s your personal life it’s very different,” Fairley told me. “I mean, you’re having our friends and our family go on the stand and testify to what they witnessed and it’s incredibly intrusive…even my therapy notes were subpoenaed.” 

Feinglos has been watching this all, and feeling cautiously hopeful that a reform bill pending in her state’s legislature might finally gain traction. “I do believe we’re at an inflection point,” she said.

The wait itself is the danger

Until the late 1960s, ending a marriage meant proving in court that your spouse had done something the state recognized as wrong, like cheating or abandonment. The burden fell on whoever wanted out, and meeting it often meant airing intimate details that judges weighed differently depending on whether a husband or a wife was asking. Starting in 1969, when California enacted the first no-fault law, states began letting couples divorce without assigning blame. Most followed within a decade, though holdouts like New York lingered. Divorce rates, already rising, peaked around 1980.

The laws mandating divorce waiting periods carry the logic of that earlier system. States tend to justify them by saying couples might reconcile if they’re given time. States also argue that decisions about custody and property shouldn’t be made quickly in the heat of the moment. Underneath both rationales is a theory that married households are valuable to the public, especially where children are involved, and so the state has a responsibility to slow couples down rather than treating marriages like contracts either side can simply cancel. 

Critics have long argued that the first rationale doesn’t hold up, since couples rarely reconcile during the waiting period and few people end a marriage on a whim. The second, they say, ignores what the wait actually does to someone leaving an unhappy or unsafe marriage, which is put them in danger. Separation is one of the most dangerous periods in an abusive relationship, and researchers have found that homicide risk climbs when an abuser senses they are losing control. Some research suggests a court’s intervention can make things worse rather than better if it provokes retaliation without actually getting the victim away from the abuser.

This danger has become a major issue in Virginia, where the push for divorce reform has been closely tied to a horrific murder-suicide by a prominent Democratic politician that made national headlines. 

Cerina Fairfax spent nearly two years in the same house as the husband she was trying to divorce, former Lt. Gov. Justin Fairfax. Up until last month, Virginia required couples with children to be separated a year before they could file, though permitted them to spend that year under one roof, so long as they could show a judge the marriage was genuinely over. When she finally filed for divorce in July 2025, her husband — a lawyer, representing himself — argued she hadn’t specified that she intended their separation to be permanent and in January a judge agreed with the technicality. Cerina Fairfax was told she could amend her complaint and try again. At some point during the proceedings she installed cameras throughout their house.

On March 30 a judge granted her sole physical custody and ordered Justin Fairfax to move out within a month. He was still there when he shot her in the house in the middle of April and then killed himself. Their two teenagers were home, and the cameras were recording.

Virginia’s new divorce law had just been signed days earlier. Tucked into it was an order for a work group to study whether the state should scrap fault-based divorce altogether. Activists pushing officials to take that next step point to the Fairfax episode, arguing it shows the dangers of prolonged divorce proceedings with a spouse who could become unstable or threatening. The report is due to the legislature in December.

Courtenay Schwartz, the legal and policy director for the Virginia Sexual and Domestic Violence Action Alliance, told me that while the change that just took effect in Virginia is a big one, her state’s laws still make it “very onerous” to get divorced, noting that the requirement to be separated still stands. 

“If you have someone interested in dragging out the process which Justin Fairfax was, it can really get drawn out and run in the hundreds of thousands of dollars,” she said. “It’s just prohibitively expensive, especially if you are experiencing domestic violence.” 

Schwartz says Virginia Democrats, who control both chambers of the legislature and the governor’s office, have grown increasingly interested in “access to justice” issues, meaning reforms that make the legal system navigable for people who can’t afford a lawyer. This has been driven partly by a 2022 Legal Services Corporation study that found 92 percent of the civil legal problems experienced by low-income Americans received inadequate or no legal help. 

North Carolina’s governor tells Vox he backs reform

Woodson Bradley, a Democratic state senator in North Carolina, won her first race in 2024 by just 209 votes, in a district the Republican-controlled legislature had redrawn the year before. She holds one of the most competitive seats in the state.

Now Bradley is the lead sponsor of SB 626, which would cut North Carolina’s separation requirement from a year to six months and let survivors of domestic violence file for divorce immediately, with no separation at all. It’s been stalled in committee for nearly a year and a half.

The issue is personal to Bradley, who experienced domestic violence in her 20s while living in another state. “When I left I was tracked down and beaten, and there were no real stalking laws back then in the 1990s,” she told me. She later moved to North Carolina, remarried someone “who I thought was wonderful, had two kids, and then things weren’t wonderful anymore.”

Bradley soon found herself in yet another abusive, coercive relationship, fleeing with her children, an experience she describes as “the most brutal thing I’ve ever been through.” It took her years to finally get a divorce, because her ex-husband continued to contest and extend the proceedings. 

Jen Hamilton, the famous labor and delivery nurse and author of the New York Times bestselling book Birth Vibes, has been raising the issue on her platforms and talking with Bradley about changing North Carolina’s laws.

“Jen speaking out is very much changing things,” Bradley told me, adding that although the issue is very partisan in North Carolina, five Republican lawmakers have reached out to her recently about her bill. Past efforts at reform in North Carolina have failed, including in 2015, 2019, and 2021.

North Carolina’s lame-duck Senate leader Phil Berger, who lost his Republican primary in March, did not return requests for comment but a spokesperson for North Carolina’s Democratic Gov. Josh Stein told me he supports reform. 

“North Carolinians don’t need government making their life harder, especially during some of their darkest times,” they said. “The Governor is willing to work with anyone to ensure our laws are more appropriate for the world we live in today.” Last year Stein signed a bill that made habitual domestic violence a felony.

For Rebecca Feinglos, the proposals moving through Raleigh are still catching up to what she already lived through.

“I remember the line in my divorce decree allowing me to change my last name back to my maiden name, my now late father’s last name,” she said. “Every moment I had to use my married name throughout the proceedings felt like a reminder that I was still stuck in a life I didn’t want.”

Just last month, I marked my 25th year as a professional journalist, which I guess means my journalistic career is old enough to rent a car, no questions asked. Work in the news for that long, and you’ll occasionally find yourself surprised by things you published in the past. Like, I had all but forgotten that I had written this Time magazine cover story in 2008:

A couple things here. One, as the cover demonstrates, journalistic sensitivity was…less than ideal then, to say the least. And two, over a quarter-century occasionally covering obesity (both childhood and adult), that story only seemed to go in one direction: worse.

It wasn’t for lack of trying. We put calorie counts on menus, taxed soda (well, in some places), built workplace wellness programs, and funded a small library of diet research. We deplored food deserts and promoted farmers’ markets. We told people — again and again — to eat less and move more. But the lines just kept going up.

By the CDC’s measured survey, the share of US adults with obesity did not change meaningfully between 2013 and 2023. The age-adjusted obesity rate sat at 40.3 percent, while the age-adjusted severe obesity climbed from 7.7 percent to 9.7 percent over the same stretch.

While the question of weight in America is inextricably tied to body image and moralizing, those numbers had a deadly effect. One demographic model estimated that obesity was associated with roughly 18 percent of deaths among Black and white Americans ages 40 to 85 between 1986 and 2006. From diabetes to kidney failure, heart disease to sleep apnea, obesity is the delivery system for other diseases.

Which is what makes a Gallup report published in July so surprising. In Gallup’s self-reported height-and-weight series, the US adult obesity rate fell to 36.4 percent, down from a peak of 39.9 percent in 2022. Over roughly the same period, the share of adults who said they were currently taking a GLP-1 drug for weight loss rose from 3 percent in 2024 to 11 percent in 2026 — approximately 29 million people. While this only shows correlation, not causation, and Gallup’s self-reported measure should not be compared directly with the CDC’s measured rate, the timing is suggestive to say the least. 

And the weight might be the least interesting thing about these drugs. 

Semaglutide — the molecule sold as Ozempic and Wegovy — was first developed and approved as a treatment for type 2 diabetes, not obesity. It was only after earlier GLP-1 drugs and diabetes trials showed substantial effects on appetite and weight that researchers deliberately tested a higher dose for obesity, resulting in Wegovy in 2021. 

But as it turns out, the list of things that have been noticed happening on the side with GLP-1s has gotten so long it’s begun to eclipse the main event. The coverage of GLP-1s has barely kept up with this news, because weight loss is what made these drugs famous and what we continually obsess over. But it turns out, weight loss may not be what they’re best at.

Side effects may include…

Let’s start with sleep apnea, which, untreated, drives up blood pressure, strains the heart, and raises the risk of stroke. These are people whose breathing stops dozens of times an hour, all night, every night. Two year-long trials put 469 of them on tirzepatide — the drug sold as Mounjaro and Zepbound — and cut those interruptions by more than half. Roughly half the group finished the year with no apnea at all, or with so little left that they stopped being tired all day.

Then there are the kidneys. A major trial followed 3,533 people with type 2 diabetes and chronic kidney disease for a median of 3.4 years. Semaglutide reduced the relative risk of a composite of kidney failure, a sustained loss of at least half of kidney function, or death from kidney-related or cardiovascular causes by 24 percent; all-cause mortality was 20 percent lower.

And the liver: A trial, still underway, biopsied the livers of 800 people whose organs had grown fatty, inflamed and scarred and randomly assigned them to semaglutide or a placebo. After 72 weeks the inflammation had cleared in nearly 63 percent of those on the drug, with no worsening of the scarring, against 34 percent on placebo. 

And the knees: In 407 adults with obesity and moderate knee osteoarthritis, pain scores on the 0-100 WOMAC metric fell 41.7 points against 27.5 on placebo. 

And to top it off, a 17,604-person trial of participants who were overweight or obese but did not have diabetes found a 20 percent drop in major cardiovascular events.

These results may not be as grabby as cultural debates over “Ozempic face,” but they deserve far more attention.

Medicine’s happy accidents  

As GLP-1s — which in part came out of a hormone in Gila monster venom — demonstrate, medicine has long found some of its biggest wins in the margins of drugs ostensibly built to do something else entirely. 

Sildenafil, better known as Viagra, began life at Pfizer as a candidate treatment for the heart disease angina. It failed at that, and its now-famous use turned up in data as a side effect in what must have been a very interesting trial for its subjects. Minoxidil (Rogaine) was a blood pressure pill that turned out to help patients grow hair. Finasteride (Propecia) was approved for enlarged prostates before anyone thought to sell it for baldness — and then a trial of more than 18,000 men found it cut prostate cancer diagnoses by about 25 percent, a benefit that took 20 years of follow-up to fully vindicate. 

Perhaps the most famous example is aspirin, which spent most of a century as a painkiller before a doctor in California named Lawrence Craven noticed that the patients he’d given aspirin gum to after tonsillectomies bled more than they should. He guessed the aspirin thinned the blood, and started handing it out to middle-aged men, who were at higher risk of heart attacks. Craven died in 1957; the trial that ultimately proved that he was onto something — showing that aspirin in heart attack victims cut vascular deaths by a fifth — didn’t run until 1988. 

The strange morality of Ozempic

Viewed this way, GLP-1s can seem like miracle drugs — but even miracle drugs can’t cure everything.

There had been great hope that GLP-1 might reduce dementia rates, but when Ozempic maker Novo Nordisk ran a proper trial, it didn’t show evidence of slowing clinical progression of Alzheimer’s. Much the same happened with cancer. Observational data had hinted that GLP-1 users developed tumors less often, but when a Harvard team pooled 48 placebo-controlled trials covering 94,245 people, they found the drugs have little to no effect on the risk of thyroid, breast or kidney cancer, though evidence for other cancers was less certain, leading to FDA boxed warnings. One plus: In some early animal studies, high doses of GLP-1 drugs caused thyroid tumors in rodents, but further research largely hasn’t validated the fears that it could be more widespread, though uncertainty about some rare thyroid cancers remains.  

For many people, weight loss isn’t the end of what these drugs seem able to do. It’s where the benefits begin.

The bigger concerns largely remain the known ones, starting with muscle loss. Across 22 randomized trials, about 25 percent of the weight lost on these drugs turns out to be lean muscle mass. Some of that is simply unavoidable in any weight loss, but too much can mean a great deal, especially if you’re 75. 

And cost remains a barrier: In a 2025 KFF poll, 56 percent of adults who had ever used a GLP-1 said the drugs were difficult to afford; 27 percent said they had insurance but paid the full cost themselves. In a separate Cleveland Clinic chart review of 288 adults without diabetes who stopped injectable semaglutide or tirzepatide within a year, 47.6 percent stopped because of cost or insurance problems, compared with 14.6 percent because of side effects. (The money, at least, is improving. An oral GLP-1 drug was approved in April, and it starts at $149 a month for people paying cash, while Medicare trial pricing of $50 a month for some GLP-1s went live in July.)

A stickier obstacle is the one that can’t seem to be divorced from questions about weight: judgment. As my colleague Dylan Scott wrote recently, researchers at Rice University found that people rate a GLP-1 user more harshly than someone who never lost weight at all. That makes perfect sense when you consider how contentious weight is in America — and none at all when you think about just how many people have benefited from these drugs in so many different ways.

I sometimes wonder how we would view GLP-1s if they could do everything they’ve been shown to do, but somehow not change a person’s appearance. 

So much of the discourse around these drugs has been shaped by the fact that many of the earliest and most public and apparent users were already thin people, often celebrities, using them to get even thinner. But that framing has become increasingly difficult to square with reality. 

Two things can be true at once: American culture has a toxic relationship to weight, and millions of Americans can and are benefiting from these drugs. For many people, weight loss isn’t the end of what these drugs seem able to do. It’s where the benefits begin.

A version of this story originally appeared in the Good News newsletter. Sign up here!

Over the weekend, Rep. Alexandria Ocasio-Cortez (D-NY) announced on Instagram that she had joined the thousands of American women who freeze their eggs every year, a number that has been steadily growing for the past decade.

“This is a choice that I am making to feel more in control of my life,” Ocasio-Cortez said in her Instagram story sharing her decision. 

As politicians in the public eye often do, Ocasio-Cortez turned her personal choice into a statement:

Usually I keep my private life quite private, but I have made the decision to start freezing my eggs, and I want to share this because I was weighing it for a very long time. I was saving for it for a very long time, and there just isn’t a ton out there, I feel, and sometimes it can feel very daunting. As women in general, we are not taught about our own bodies. We are not prepared for our own lives. … We need to show more depictions of women having full lives.

At the same time, she acknowledged being “in a very privileged position” to be able to take advantage of egg freezing. The process still typically costs $10,000 or more — and most insurance still doesn’t cover it. Not even AOC’s federal health plan. Egg freezing is a luxury afforded only to the people who can pay for it and take on the significant burden of the treatment and all of the uncertainty that comes with it.

Ocasio-Cortez’s announcement underscores the awkward place that egg freezing still occupies in the landscape of fertility access — at a moment when Republicans in power are lamenting falling birth rates and searching for ways to encourage more people to start families. In theory, egg freezing gives women the flexibility to take more control of their decisions about having kids and preserve that possibility for themselves in the future. But in reality, the promises of this important procedure have often been unfulfilled. 

Beyond the intimidating price tag, as AOC alluded to, many young women don’t know some of the basics about age-related fertility decline and how to maximize their chances that egg freezing will lead to an actual pregnancy. There are some “significant gaps in fertility knowledge amongst Gen Z women in particular,” said Danielle Melfi, CEO of Resolve, a fertility treatment advocacy group. 

“That points to why someone like AOC who has such broad awareness and broad reach across her channels,” Melfi told me, “specifically younger people who aren’t tuned into any politician but would be tuned into her. Her sharing her story and journey matters.”

Egg freezing is not a panacea, and it never will be. But it can give individuals options and a sense of empowerment. And right now, as AOC acknowledged in her video, those are privileges reserved for the people who are in the know and have the means to take advantage of it. For everyone else, significant barriers still remain.

Freezing time doesn’t come cheap — or easily

On average, the cost of egg freezing averages between $10,000 and $20,000. And, for most people, including AOC, who makes $174,000 a year on her congressional salary alone, health insurance coverage is not an option. According to a 2024 KFF employer survey, just 12 percent of large employers who offer health insurance provide egg or sperm freezing.

That’s not for lack of trying.

As of now, 21 states have mandates requiring health insurers to provide some level of coverage for “fertility preservation” when it is deemed medically necessary — for a younger cancer patient who is about to undergo chemotherapy, for example, a more and more common scenario these days. But coverage for what is viewed as elective freezing, as AOC is doing, is still generally not included in those requirements.

But even the state-level mandates come with a huge carveout. Under America’s Frankenstein healthcare system, there is a very important type of health insurance plan that is exempt from such state laws: self-funded employer plans, meaning those that fully cover their workers’ medical expenses without relying on an outside insurance company. They are governed only by a federal law known as the Employee Retirement Income Security Act, and that law provides no guarantees for egg freezing or other reproductive care. 

About half of Americans get their insurance through their work, and of those employer plans, more than 60 percent are self-funded. That is a lot of people who have no guarantees for this kind of service, even when a serious medical reason is motivating them to freeze their eggs. The select few who can get egg freezing covered are typically higher-income, too, adding to the disparity between the US healthcare system’s haves and have-nots.

Support for IVF among the American public has been rising, with 70 percent saying in 2024 that access to IVF was a good thing. And fertility coverage is having a political moment, too: the HOPE With Fertility Services Act, which would require insurers to cover some basic fertility treatment when it is deemed medically necessary, was introduced this year with a bipartisan slate of more than 20 sponsors, though it remains stuck at the committee level for now. The Trump administration has fixated on dropping fertility rates, but, beyond a limited IVF executive order, they have not seriously pursued plans to expand access to egg freezing. A national mandate to cover egg freezing, even only when medically necessary, could end up being opposed by both health insurers (which have fought all kinds of benefit requirements in the past) and the religious right (which has specifically challenged mandates for reproductive healthcare, like the Affordable Care Act’s contraceptive mandate).

It will likely take a variety of policy changes to give people more financial support for this important but expensive service. So what now? Unfortunately, I think we are stuck with patchy coverage and can expect only incremental improvements for the foreseeable future. On the plus side, Melfi said, more employers may increasingly offer these benefits as a competitive advantage.

But access isn’t the only problem.

Egg freezing works best when people actually know how to take advantage of it

Even if a person is able to access egg freezing, it doesn’t always pay off. 

A study published in the American Journal of Obstetrics and Gynecology in February found that fewer than 6 percent of people who froze their eggs electively had come back to thaw them within five to seven years. Of those people, 79 percent had a usable embryo after warming and 29 percent had a pregnancy that resulted in a live birth.

Of course, just because some people haven’t warmed their eggs within seven years doesn’t mean they won’t come back in nine: The point of this service is you could freeze your eggs at 30 even if you’re not ready for kids until you are 40. Those numbers will likely grow with time. And some of those people might end up successfully getting pregnant on their own the old-fashioned way, which means they won’t need their frozen eggs at all. 

“Typically, people who are coming in to freeze their eggs haven’t actually tried to conceive yet. When they are ready to start conceiving, a lot of people may not have any issues conceiving,” said Dr. Mabel Lee, a reproductive endocrinologist and infertility specialist at HRC Fertility in Pasadena, California who led the published study. 

What is true is that getting pregnant is difficult no matter how you go about it — even conceiving through intercourse only results in a 20 to 25 percent success rate on a given try, Lee said — and success with frozen eggs depends on how young the person was when their eggs were preserved: The younger they are, the higher the chances of success. That makes it all the more important that people — particularly younger people — know about the realities of egg freezing and how to make the most of it, whether they are spending thousands of dollars of their own money or whether they are using insurance to pay for it. Awareness among young people of the basic relationship between age and fertility remains discouragingly low. Lee said she has patients come in all the time who say they wish they had known more about egg freezing sooner.

The likelihood of a live birth may go up if the eggs were younger, but is that enough to convince someone in their mid-20s to pay out of pocket to freeze their eggs? In the midst of an affordability crisis, is that even an option? It might not be; in the meantime, Lee said women could get a blood test to measure their ovarian reserves, which estimates a person’s egg count, and use that to make an informed decision about egg freezing in consultation with their doctor.

Once you have decided to freeze your eggs, using a high-quality clinic is a must: That’s the other major variable in success, Lee told me. The Society for Assisted Reproductive Technology maintains a national database covering clinics across the country and tracking birth success rates and other metrics. It’s like a report card of sorts, so you can hopefully choose the best provider for you.

There are still no guarantees. Fertility is too fickle. But by improving access and raising awareness, there are clear steps we can take to try to maximize egg freezing’s potential.

Last week, President Donald Trump issued a new executive order that purports to strip citizenship from some Americans. 

This isn’t our first time here: Last year, Trump issued an executive order that attempted to strip citizenship from many Americans born in this country. Months later, in response to a lawsuit brought over Trump’s order, the Supreme Court reaffirmed that everyone born in the United States who is subject to US law is a citizen. The Court’s decision in Trump v. Barbara (2026) was hardly a surprise, as the Court first ruled that everyone born in the US and subject to its laws are citizens in United States v. Wong Kim Ark (1898).

Still, the Barbara decision did invalidate an executive order from Trump. And that made him very angry. The new order appears to be a response to that 2025 Supreme Court decision, though it is much narrower than his original one.

In this sense, Trump appears to be experimenting with where the line is for the justices when it comes to birthright citizenship. When Trump’s first order came before the Court in Barbara, there was more than a century of precedent establishing that the order was unconstitutional. Nevertheless, four justices voted to overrule at least some of that precedent. 

Now, with the new order, Trump is testing whether a smaller bite at the apple is enough to win over one of the justices who voted with the majority in Barbara — two of whom are Republicans. If he manages to hold onto the four dissenters in Barbara and pick up just one more justice’s vote, his new order will stand. It’s a plausible outcome, and one that could potentially foreshadow future efforts to chip away at birthright citizenship.

What does the order actually do?

Trump’s first citizenship order, the one struck down in Barbara, attempted to strip citizenship from many Americans whose mothers were either undocumented or legally-but-temporarily present in the United States when they were born. Had this order been in effect at their birth, it would have stripped citizenship from many prominent Americans, including former Vice President Kamala Harris.

The new order, entitled “Continuing to Protect the Meaning and Value of American Citizenship” is much narrower; indeed, it’s unclear some of the categories of people it hopes to denaturalize actually exist. The new order, for example, purports to strip citizenship from children of two non-citizen parents when either parent belongs to a “designated Foreign Terrorist Organization.”

So, in the unlikely event that, say, a member of Al-Qaeda impregnated a non-US citizen woman who later gave birth on US soil, Trump’s order would mandate that the child’s US citizenship would be taken away. 

Another provision purports to strip citizenship from the children of foreign nationals who work in their nation’s embassies or in similar diplomatic capacities but who do not enjoy diplomatic immunity from US law. Again, it’s unlikely that all that many children fall into this category, given the relatively small number of these jobs.

The largest group of people that Trump targets in his new order is children whose parents “engage in a commercial transaction to ensure that the person’s mother is present in the United States” for their birth, such as by buying a plane ticket to enter the United States while pregnant. But this category is also fairly small. 

In 2024, the Centers for Disease Control and Prevention reported that 9,576 people were born in the United States to residents of foreign countries — out of about 3.6 million annual births — though it is unclear how many of these babies would be affected by Trump’s new executive order, because we don’t know if their mothers entered the United States “to ensure” that their child we be on US soil when born.

So, what does the Constitution actually say about birthright citizenship?

The question of whether people born in the United States are citizens was, until fairly recently, one of the most uncontroversial questions in US law. When Judge John Coughenour, a Reagan appointee, handed down the first court decision blocking Trump’s original attack on birthright citizenship, he commented that he’d “been on the bench for over four decades [and]…can’t remember another case where the question presented is as clear as this one is.”

The relevant provision of the Constitution’s 14th Amendment provides that “all persons born or naturalized in the United States, and subject to the jurisdiction thereof, are citizens of the United States.” So, everyone born in the US, regardless of their parent’s immigration status, past behavior, or membership in a particular organization are citizens — unless they are not “subject to the jurisdiction” of the United States.

As the Court recently reaffirmed in Barbara, moreover, a child is within US jurisdiction if they are “subject to American law.” So, if undocumented immigrants and their children were not subject to US jurisdiction, that would mean that it was illegal to arrest and deport them. And, if members of foreign terrorist organizations were not subject to US law, that would mean that it is illegal for the US government to prosecute them for committing terrorist acts.

That said, Wong Kim Ark did recognize a few narrow categories of individuals who are present in the US but not subject to its laws — two of which are still relevant today. Children of invading foreign armies do not receive birthright citizenship, nor do children of foreign ambassadors and other diplomats who are immune from US law.

As the Court clarified in Barbara, both of these exemptions are derived from an old English rule that provided that the King could not convey citizenship to “those born in lands that he did not control.” Thus, when a foreign military occupied English soil and stripped the King of his ability to rule over those lands, children born to members of that military were not citizens.

The exemption for ambassadors and some other foreign diplomats, meanwhile, flows from what Barbara described as a “fiction of extraterritoriality.” While senior diplomats are present in the United States, they are nonetheless deemed to “remain on foreign soil” and thus are not subject to US law.

But not all employees of foreign governments qualify for this diplomatic immunity. Consider, for example, the tragic facts of Moncada v. Rubio (2025), a recent federal appeals court decision holding that a man who lived as a US citizen for nearly seven decades was not, in fact, a citizen. 

Roberto Moncada is the son of a Nicaraguan diplomat who worked in the United Nations when Moncada was born in 1950. The US government previously concluded that Moncada’s father served as a “consul” when his son was born, and, thus, Moncada was a US citizen, because consuls and their families do not enjoy diplomatic immunity. But, in 2018, the US government discovered that Moncada’s father was actually an “attaché,” a more senior diplomat who does enjoy immunity. And then, the father’s diplomatic immunity cut the son off from US citizenship.

Under these principles, several provisions of Trump’s new executive order are unconstitutional, at least in part. The provisions stripping citizenship from the children of employees of foreign governments are lawful to the extent that they apply to children of people with diplomatic immunity but unconstitutional to the extent they apply to lower-ranking individuals with no immunity. 

The provision dealing with members of foreign terrorist organizations is also unconstitutional, since people who engage in terrorism on US soil are very much subject to US law — as are babies born on US soil to parents connected to terrorism. Although, in the unlikely event that a foreign terrorist group actually seized control of some portions of US soil, then the exemption for children of invading armies would likely apply. 

The provision dealing with so-called “birth tourists” is also unconstitutional, because a pregnant woman who enters the United States to ensure that their child is a US citizen is subject to US law, as is her child.

Indeed, Trump appears to concede this later point in a separate executive order handed down at the same time as his “Continuing to Protect” order. The second order, entitled “Ending Birth Tourism,” instructs two federal cabinet departments to update their rules to discourage alleged birth tourists from entering the country, including by taking “appropriate action to prevent the entry into the United States of, or the granting of any visa or other travel authorization” to such individuals. But, again, if the United States has the power to deny visas or otherwise bar these individuals from entering the country, that means that they are subject to US jurisdiction.

Why Trump keeps trying to restrict birthright citizenship

So, the Constitution’s text, the Court’s venerable decision in Wong Kim Ark, and its brand new decision in Barbara are all clear about who qualifies for birthright citizenship. All of these authorities establish that much of Trump’s new executive order is unconstitutional, because it purports to strip citizenship from people who are subject to US jurisdiction.

But that doesn’t necessarily mean that the order will be struck down. While Barbara did little more than reaffirm the same rule the Court announced nearly 130 years ago in Wong Kim Ark, four justices dissented in Barbara — although, these justices also released four separate opinions with four separate definitions of who does and does not qualify for birthright citizenship. So, on this Supreme Court, the mere fact that a legal question has been settled for more than a century does not prevent many of the justices from voting to unsettle it.

Indeed, this Court does not even reliably follow its own recent precedents. The Court’s decision in Louisiana v. Callais (2026), which repealed a 1982 amendment to the Voting Rights Act and limited Congress’s power to prevent race discrimination in elections, was wholly at odds with the Court’s three-year-old decision in Allen v. Milligan (2023). The Court’s decision in Medina v. Planned Parenthood (2025), which repealed a federal law permitting Medicaid patients to choose their own doctors, cannot be squared with its decision two years earlier in Health and Hospital Corporation v. Talevski (2023). 

So, while two of the Court’s Republicans joined all three of its Democrats in Barbara, it is possible that at least one of those Republicans will vote with the dissenters on a narrower question, like whether Trump can strip citizenship from the children of so-called birth tourists. And even if all of the justices in the Barbara majority hold the line, if one of them leaves the Court while Trump is still in office, he will almost certainly replace them with someone who opposes birthright citizenship.

So, while Trump’s executive orders often defy the Constitution’s explicit text, Trump also understands something important about US law: It doesn’t actually matter what the Constitution says if you have five votes on the Supreme Court who are willing to do what you want them to do.

Los Angeles offers one of the most vivid examples of our nation’s broken housing system: a quintessentially American expanse of traffic-clogged roads and single-family homes, coupled with the highest home-price-to-household-income ratio of any major city in the country.

To moderate prices, LA urgently needs to build more homes by allowing more density in its neighborhoods — but much of the city’s leadership has vigorously opposed it. Nowhere has that been more evident than in the fight over SB 79, a landmark California law that overrides local zoning to permit taller, denser housing near major transit stops. LA’s city council and its incumbent mayor, Karen Bass, have opposed it and sought ways to avoid complying with it. 

Now, as Bass seeks reelection, mayoral candidate Nithya Raman — one of the city’s, and perhaps the country’s, strongest advocates for building more housing — wants to oust her.

Raman has gained unusual traction in a city long resistant to growth and has become a nationally prominent YIMBY. How to accommodate LA’s need for more housing, Raman told Vox in a recent interview, is “a question that the city has actually turned away from.” She believes she can do better.  

Earlier this summer, Raman advanced in LA’s mayoral primary, setting up a November runoff against Bass. The race has resonated far beyond Los Angeles, because Raman is making one of the defining problems in American life — the punishing non-affordability of our most productive cities — the centerpiece of her campaign. Its outcome could shape the future of housing in America’s most populous state and help determine whether LA can become the engine of California’s pro-housing turn, or its most potent obstacle. If she succeeds, she might cut a path forward for better housing policy in high-cost blue cities elsewhere.

Just as core to Raman’s appeal is a commitment that’s often seen as at odds with housing abundance. She is a member of the Democratic Socialists of America (DSA) and a forceful champion of tenant protections, including rent control. (Her relationship with the DSA is complicated, however.) She helped shape a stricter rent stabilization formula that was adopted in LA late last year, though it was strongly opposed by rental property owners. 

Many housing policy experts, as I recently wrote, believe rent control can worsen the housing affordability crisis it aims to solve, because it tends to reduce the supply of rental housing. But in high-cost cities and states, interest in it has been surging nonetheless. A rising cohort of progressive politicians, including Raman and Zohran Mamdani in New York City, believes cities must protect current renters from price shocks and displacement while adding housing supply. In doing so, they hope to mount the kind of political support that has long eluded YIMBYs.   

I spoke with Raman about how she thinks about these competing interests, and how she intends to combine them to make a meaningful dent where her predecessors have failed. I was struck by how cautiously she discussed one of the city’s most politically explosive housing policy questions — densifying single-family neighborhoods. Though she has previously pushed for legislation allowing midsize apartment buildings in some wealthier single-family neighborhoods, she emphasized gentler, more gradual change in our conversation. It reflected the core paradox facing housing reformers in LA and nationwide: the need for sweeping change, and the political pressure to make it feel gradual.

Our conversation, condensed and edited for clarity, is below.

You’ve gotten an enormous amount of traction on housing issues in LA. If you win the election, then what? 

When I’m asking for-profit developers and affordable housing developers alike, “What is your biggest barrier to building in LA?” they say that the city of LA is their biggest barrier to building in LA. Whether it is extraordinarily long permit approval timelines, whether it is the failure of the Department of Water and Power [DWP] to be a good partner and to provide real predictability in the building process, both in timelines and in costs. The city of Los Angeles stands in the way of new housing. 

As mayor, I want to do everything in my power to change that. I want to set deadlines by which departments have to respond to applications. I want to bring DWP to the table early and to ensure that they’re a predictable partner for new development. I want to make sure that departments that need to talk to each other are talking to each other quickly and early on in the process, as opposed to providing conflicting answers and taking months and even years to respond. These are all within the power of the mayor to influence and things that this mayor has ignored.

Sometimes rent control and renters’ rights on one hand and new housing production on the other are treated as rival agendas, yet you have made them both central to your politics. What connects them for you?

I don’t think that you can have lower rental costs in a city like Los Angeles without having more housing being built. This is a city that has resisted the construction of new housing for decades, explicitly restricted new apartments from being built in many, many parts of the city for a very long time. We have among the fewest homes per adult of any major city in America and the highest rent-burdened population of any city in America, and to me those two facts are very deeply connected. We can’t really lower rents unless we have more housing here, and lower rents are a big part of how you protect renters.

LA has a rent control system, and you were a champion of a change that tightened that system last year. Do you worry at all that tighter rent control could do damage to housing supply through some of the well-documented mechanisms, like causing landlords to convert apartments to condos? Is that in tension with the goal of increasing housing supply?

Housing built after 1978 cannot be subject to rent stabilization [in LA]. So, making sure that renters in older buildings are protected and trying to incentivize new housing from being constructed to me are not in conflict with one another.

You talked about landlords potentially exiting the market. We’ve also heard concerns from apartment associations and from neighborhoods that there’s been increasing corporatization of housing, that smaller landlords are selling to larger corporate landlords, that being a mom-and-pop landlord is becoming increasingly unfeasible. What we’d love to see is more data on that. And, if that is actually happening, if we are driving landlords out of the market through these changes, if smaller landlords are selling to large corporate landlords, I want to know, and we should be looking at the impacts of this policy accordingly.

I’m very open to learning more. But, so far, what I see is that we have an extremely unaffordable city where all the data has shown us that rents have risen higher than incomes for a very long time. The regulations that we put in place are really trying to ensure that struggling renters are still able to stay in LA.

Is there one specific, concrete housing policy mistake made by Mayor Bass that you would point to? How would you have handled it differently?

There has been an overall lack of urgency in addressing housing supply in [Bass’s] administration, exemplified by the fact that we have not had a deputy mayor of housing for years.

The city has actually opposed and written letters to state officials pushing back against new mandates to build more housing. Instead of telling Sacramento, “How do you want to build that housing?” and trying to shape state laws to suit us — the largest housing market in the entire state — those laws should be written with our input, not written with our opposition. 

I think the most stark example [of Bass’s failures on housing] is this: We’ve had 100 percent affordable housing projects like Venice Dell that are fully funded, that the city has sued and opposed and stalled for years.

“I think there is a growing consensus that supply is part of the problem and is driving the cost of housing.”

To what degree do you think that LA voters see the housing affordability crisis as a problem caused by a lack of supply — a housing shortage? 

I think there is a growing consensus that supply is part of the problem and is driving the cost of housing. It’s not universally necessarily agreed upon, but I think if you were to ask people, “Is there a housing shortage? Is there a shortage of housing you can afford?” everybody would say yes.

Why should renters trust private developers?

I think that renters should trust the city to regulate private development such that we actually are building what we need here in LA and such that new building is actually enhancing what people love about their neighborhoods. I don’t think it’s the job of renters to trust developers. They need to trust that their city is going to make sure that we’re working hard to build neighborhoods that are beautiful, and welcoming, and beneficial, and can help families thrive. 

That’s part of why I talk about production and protection always in the same breath. If you see that new construction is going to displace you, I think you’re less inclined to support it or to accept it. But if you feel secure in your current housing, and you know that you’ll be able to stay there, then new housing is less of a threat and can actually be a boon for a neighborhood.

That relates to an argument I’ve heard a lot: that tenants who feel protected from displacement by rent control and eviction protections will be less afraid of new development and more willing to support it. Have you seen evidence of that happening in LA?

There is a very broad coalition of people who are fighting for more housing now, a much broader coalition than I’ve seen in many other places. And it includes renters’ rights organizations that have historically been some of the strongest advocates for tenant protections. They’re actually in council chambers testifying around the need for more density across the entire city, particularly around transit hubs. 

Do you see rent control as a temporary bandaid on a broken housing market, or is it something that should have a permanent place in housing policy?

I think protections against rent gouging are really important, and I think regulation in the housing market is really important. As a city, we have to be very careful about how we regulate these markets so that we are eliciting the best results and outcomes for our residents. I’m going to follow the research, and I’ll always engage with these issues closely. 

The Democratic Socialists of America, of which you are a part, has talked about wanting to “de-commodify” housing and take it out of the private market. The DSA’s Housing Justice Commission says, “the housing market is not necessary.” Do you think that’s a good idea? 

My approach to these issues is driven by how I can help Angelenos who are dealing with spiraling costs that’s driving working families out of the city. The city saw, I believe, a 16 percent drop in people under 18 over the past few years, because families cannot afford to live here anymore. That is a travesty for the city of Los Angeles. 

My question as I approach this is about what I can do to ensure that we can keep people here. We can build new housing through publicly funded housing. I want to be able to make sure that people who will never be served by the private real estate market have support from the city to rely on that can help them stay, whether that’s in the form of housing vouchers, whether that’s in the form of social housing, whether that’s in the form of permanent supportive housing or new public housing.

I’m supportive of measures that are bringing public dollars to the table to build. However, the money that we have available to us will never be able to satisfy the extraordinary demand that there is for new housing in Los Angeles. So now, we have to rely on the private real estate market to make housing available and affordable to a much larger number of Angelenos. 

Rent control primarily protects tenants who already occupy apartments that are covered by rent control. But building more housing is partly about people who don’t yet have a foothold in LA and who would move there if they could afford it. Is it possible to build a housing politics that gives those future residents real weight, even though they don’t vote in city elections?

I think that’s the question of this election in many ways. That’s been the question of my politics. But it’s not just about the future; it is also about our present. It’s also about parents whose children can’t live near them anymore, because it’s too unaffordable here. It’s about rising homelessness, which is inextricably connected to the cost of housing. All the impacts of not having housing are already felt by Angelenos. 

So much of LA is single-family homes, and there’s been research finding that the city’s housing shortage can’t be filled without densifying single-family neighborhoods. Is that politically possible?

Some of the largest numbers of new units being built are actually ADUs, which are densifying single-family neighborhoods. And duplexes and triplexes and other kinds of interventions are in many places already legal to build. That’s been happening and, largely, been non-controversial in neighborhoods. 

Around certain transit hubs, I think potentially greater density will be allowed in single-family neighborhoods through SB 79. So I think some single-family neighborhoods will have to change. But what I’m seeing in LA is a gradual process of adding more density that I think, in many ways, can be even beneficial for homeowners, because they’re able to make additional income or accommodate more people on their lots.

Editor’s note, August 9, 8 am ET: We’re bringing you some of our best-loved Your Mileage May Vary columns while Sigal Samuel is on parental leave. The one below was originally published in April.

This unconventional advice column offers you a unique framework for thinking through moral dilemmas. It’s based on value pluralism: the idea that each of us has multiple values that are equally valid but that often conflict with each other. Submit your own question here.

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I’m trying to decide whether to keep my elementary school-age kid in the neighborhood public school or move him to a more exclusive private school. Our public school is okay, but my partner and I feel that he might be more challenged and ultimately better off moving to a private school.

But I’m very aware of the increasing flow of students around the US out of public schools, and the effect that is having on the children who remain there. For one thing, since public schools get more funding the more students they have, every family that leaves effectively takes money with them. I worry that by taking my child out of public school, I’m contributing to that problem, but I also don’t want my child to bear the personal burden of my politics.

Dear Public School Parent,

The way you’ve framed the question makes it sound like keeping your kid in public school means imposing a burden on him. And if that were the case — if we really were talking about sacrificing your child’s well-being — I know exactly what I’d tell you.

I’d tell you not to be bullied by utilitarian philosophers. They argue we have to consider everyone’s well-being equally, with no special treatment for our own kids, so they’d probably say it’s wrong to give your child a fancy education while consigning other children to a school with fewer resources. But the 20th-century British philosopher and critic of utilitarianism Bernard Williams argues that this sort of total impartiality is an absurd demand — and I agree.

Williams points out that moral agency — the capacity to act on values and commitments — always comes from a specific person. And as specific people, we have our own specific, individual, core commitments. These “ground projects,” as Williams calls them, are the commitments that give a life its meaning and continuity. A parent has a commitment to ensuring their kid’s well-being, over and above their general wish for all kids everywhere to be well. Williams would say any moral theory that requires you to ignore such personal commitments severs you from the very things that make your life recognizably yours.

So if keeping your kid in public school really meant hurting him, I wouldn’t say you have to do it.

But you said your neighborhood school is okay. It sounds like it’s not bad and not unsafe. So I don’t have reason to think that it is actually hurting him. In fact, it might be helping him in ways you’re not fully accounting for. 

Education is complicated. If I were to get into all the details about school choice and vouchers and charter schools and magnet schools, I’d have to write a whole book. So let me just stick to the main points relevant to your dilemma, starting with this: There’s a popular narrative that says private schools are better than public schools, but the evidence does not support that — especially if we take a broad look at what we mean by “better.”

Although studies do show private school students outperforming their public school counterparts on tests, the studies also show that private school advantages disappear mostly or entirely once you control for family background. 

Longitudinal research led by Robert Pianta and Arya Ansari at the University of Virginia tracked more than 1,000 children from birth to age 15 in 10 locations nationwide. After controlling for family income, parental education, neighborhood socioeconomic makeup, and other background variables, the private school advantage…vanished.

“If you want to predict children’s outcomes — achievement test scores, the things we care about socially — in high school, the best thing you can use to predict that is going to be family income — regardless of what high school you go to,” Pianta said.

Pianta’s was a modest-sized study with some methodological limitations. But another analysis of two large, nationally representative datasets also found that public school kids did just as well in math as private school kids — or even outpaced them — after accounting for demographic differences. (Math is considered a particularly robust indicator of school quality writ large because, unlike reading, it’s a subject learned mostly at school and not at home.) The researchers suggested that might be because public school teachers have to do stricter certification and can be required to do more frequent professional development, so they may be more reliably up-to-date on the latest pedagogical approaches, like those developed by the National Council of Teachers of Mathematics.  

Admittedly, the very fanciest of private schools do offer some special advantages. Network effects are real. Maybe you want your kid rubbing elbows with a future senator. And maybe if you send your kid to ultra-elite Andover or Exeter, he’ll have a leg up if he applies to a fancy private college. 

But that is not the same as ensuring your child actually thrives. I’m sure you also care about your child’s psychological well-being. And here, some of the evidence about exclusive, high-achieving schools is worrying. 

The most important educational institution in your kid’s life is you.

The unrelenting pressure to compete and achieve can be brutal in those schools. When students constantly compare themselves to others and peg their self-worth to achievement, the results are alarming. Studies conducted over decades by psychologist Suniya Luthar and colleagues found that students attending high-achieving schools are at significantly higher risk for anxiety, depression, and substance use. (These are often private schools, though hyper-competitive public schools can also fall into this trap.) In fact, the National Academies of Sciences now names these students an “at-risk” group for mental health problems, alongside kids who live in poverty or in foster care or who have incarcerated parents.

In addition to potentially providing a less stressful environment, public schools can confer other important advantages. For one thing, your local public school can help you and your child be part of the neighborhood community, which is incredibly valuable for social development and countering loneliness. And being in an environment that’s more diverse in terms of race, ethnicity, or class can teach your kid to empathize and get along with a wide variety of people. 

As the American philosopher John Dewey pointed out, these are essential skills and capacities for a flourishing adult life and for a flourishing democracy. Democracy is a way of being in community with people unlike yourself; that’s a mode of life that has to be cultivated, and public schools are great grounds for learning to navigate a shared world.

Plus, public education is free! (Well, “free” — you’ve already paid for it with your taxes, whether or not your kid uses it.) So you could save all the money you’d spend on private school and instead use it on enriching opportunities to expand your child’s horizons. Personally, I’d take my kid to Italy and teach them about Ancient Roman gladiators and Renaissance art and the many flavors of gelato! Or you could collaborate with your child to decide where to donate some of that money to fund education resources for kids elsewhere. 

On balance, since the evidence suggests that a child at a decent public school, with involved parents, probably won’t gain meaningful advantages from switching to an exclusive private school — and may face real psychological risks in a hyper-competitive environment — I don’t see a compelling reason to make the move. If you’ve got the resources to even consider private school, then your home life will probably play the biggest role in your kid’s academic trajectory, regardless of which building he sits in during the day. The most important educational institution in your kid’s life is you.

That said, I’m not arguing that parents should never pick private school. To some extent, this depends on the unique needs of your kid and your family. Maybe your kid is absolutely in love with music and the private school nearby has an amazing music program. Maybe your kid is being bullied at his current school but has a couple great friends who attend the private school. Or maybe a religious education is very important to you, so a private parochial school makes sense. 

If you do make the choice to send your kid to private school, you’ll have to grapple with the collective action problem you hinted at: Any single family’s departure from a public school barely registers, but when every family with options reasons the same way, the cumulative effect on the school’s funding — and on the kids who remain — can be devastating.

Here, the American political philosopher Iris Marion Young can help you. She points out that our usual model of responsibility — the “liability model,” which says that when something bad happens we should assign blame to a particular individual — is inadequate when we’re dealing with situations of structural injustice. In these situations, it’s a whole system that’s producing predictable patterns of disadvantage. 

Just look at the complex web that breeds educational inequality: Historical housing segregation has concentrated poverty in certain neighborhoods. Poorer neighborhoods generate less property tax revenue, which means less money for local schools. States can try to offset that, but schools in poorer areas still tend to end up with fewer resources. Families with options leave for better-resourced schools, enrollment drops at the local public school, and the school loses even more funding. The kids who remain get less of the materials — from textbooks to counselors — that would have set them on the path to success. There’s a clear downward spiral, but no one person or decision is the villain.

So instead of blaming any one individual for their personal lifestyle choices, Young says that in cases of structural injustice, we should adopt the “social connection model” of responsibility. Under this model, you don’t bear blame if you send your kid to private school, because systemic problems shouldn’t rest on one family’s shoulders. Young doesn’t think you need to discharge your obligations through personal lifestyle choices. 

But that doesn’t mean you owe nothing. 

You do still have a political obligation: to work toward changing the structure that produces injustice. As a participant in the political system that shapes education in this country, you have some power to act on it. You can vote and organize and advocate. You can pressure decision-makers and support reform movements. The more power you’ve got, and the more privileged you are by the current system, the greater your obligation to take action.  

Make the effort to act on that obligation. Let your child watch as you do. Better yet, involve them in the process. Kids learn from seeing what their parents do: Show them that you’re bent on enacting your values, and you’ll be giving them an education for life.

Bonus: What I’m reading

• This is a fun piece in Asterisk about how high-school science fairs have become so ridiculously competitive that they no longer give students a chance to do real independent research.
  
• This week’s question prompted me to listen to the podcast series “Nice White Parents.” It’s a fascinating look at what happens when parents think that choosing public school would mean sacrificing their child’s prospects on the altar of their own political ideals. Spoiler: Practically no parent is willing to sacrifice their own child. But they often don’t realize they’ve constructed a false trade-off.
  
• Living life requires making choices. It’s unavoidable that we’ll feel regret about some of the paths not traveled. But this Aeon essay explains how “living in closer alignment with our values and authentic preferences may help us avoid the worst pain of regret.”

This story was originally published in The Highlight, Vox’s member-exclusive magazine. To get access to member-exclusive stories every month, become a Vox Member today.

As homeownership slips further out of reach in America, more people are spending more of their lives as renters. Millennials and Gen Zs are less likely to own homes than older generations did at the same age, and the median age of a first-time homebuyer recently reached an all-time high of 40, up from 28 in 1991. 

That need not be a bad thing. Renting offers many benefits — flexibility, far lower upfront costs, never having to figure out what a “sacrificial anode rod” is — and homeownership is overrated as a savings vehicle. 

But being a renter in America (as roughly one in three people here are) can also be a very undignified experience. In most states, your landlord can kick you out when your lease ends for no reason at all, even if you haven’t done anything wrong. Many tenants live in fear of receiving their next lease renewal, not knowing if they’ll be displaced by the next rent hike. 

Some progressive policymakers, buoyed by the growing influence of democratic socialism and a resurgent tenant movement, are reviving an old, highly controversial answer to renters’ lack of security: simply ban steep rent increases through rent control. 

In June, New York City, under Mayor Zohran Mamdani, froze rents on rent-stabilized apartments, which make up about 40 percent of the city’s rental housing stock. Rent control laws have been passed or tightened in recent years in places from Washington state to Los Angeles to Montgomery County, Maryland, and tenant advocates this year have pushed similar measures in Massachusetts, Washington, DC, Providence, Rhode Island, and Redwood City, California. 

Rent control’s advocates argue that the policy not only moderates prices, but also offers tenants stability and a firmer claim to their homes. It helps put “the landlord-tenant dynamic on different and more equal footing,” as Siraj Sindhu, executive director of Reclaim Rhode Island, which backed a Providence rent-stabilization ordinance that passed the city council before being vetoed by the mayor, told me. 

Those are really important goals. I’m a lifelong renter, having literally never lived in an owner-occupied home, and I hate that I can’t predict what my housing costs will be less than a year from now. But is rent control the best way to achieve stability? 

Housing economists have long hated rent control; the Swedish economist Assar Lindbeck famously called it “the most efficient technique presently known to destroy a city — except for bombing.” Decades of research have found that it can have many unintended negative consequences, including depressing housing construction by making it financially impractical to build new rentals. And as we know from today’s crippling housing shortage, nothing is worse for long-term affordability than a scarcity of homes. More recent research, however, suggests that better-designed rent control laws can protect some tenants without having catastrophic consequences for housing supply. 

That rent control keeps coming back as a centerpiece of our housing politics reflects just how impoverished our policy ideas are for providing renters what they lack most: predictable costs and secure tenure. The US has an elaborate policy infrastructure to privilege and subsidize homeownership, while treating renting as an afterthought, like a condition of poverty or at best a waystation on the path to buying a house. That makes ever less sense in a country where millions of people will rent for life, whether by choice or necessity.  

The truth about rent control is somewhere between both extremes. It can, in some cases, certainly be worthwhile. But it remains a highly limited tool, and others can furnish some of the same benefits without fueling the very affordability crisis that they’re meant to address.   

Why economists (mostly) oppose rent control

Rent control polls favorably, and it’s not hard to imagine why — voters despise high prices. Capping rents might intuitively seem fair and costless: The tenant is protected from ridiculously high prices, the landlord profits a bit less, and society as a whole is no worse off. Who could object to that? 

In fact, though, many economists vehemently oppose rent control precisely because it isn’t cost-free — it merely moves costs onto others and makes them less visible.

In uber-expensive cities like New York and Boston, rents are so high because demand to live there far outstrips the supply of homes. In a healthy housing market, high prices signal to developers to build more homes, which then brings prices down and, just as importantly, grows the city’s population and economy by providing homes to people who want to move there. We’ve recently seen this happen in Austin, Texas: The city experienced a rapid run-up in rents during Covid, and builders responded (after the city eased some of its building restrictions) with a flood of new apartments. Rents have since fallen well below pre-Covid levels in real dollars. By contrast, policies that cap rents would diminish the incentive to build rental homes at a time when the US needs many more of them. 

Meanwhile, if rent caps fail to keep pace with landlords’ rising costs, owners may neglect maintenance or even pull apartments from the rental market if they no longer pencil out. One widely cited economics paper documented this dynamic in San Francisco, where the majority of rental housing is rent-controlled and annual rent increases are capped well below inflation. The city’s 1994 expansion of its rent control law, the researchers found, shrank the supply of rental housing among newly covered properties by 15 percent, largely because landlords converted rentals into owner-occupied units. The expansion made tenants 10 to 20 percent more likely to remain in their homes, but at the cost of making San Francisco’s rental housing scarcer and raising the rents of non-rent-controlled apartments. 

Rent control programs are generally not means-tested, meaning that tenants in eligible apartments receive it regardless of their incomes. So a higher-income tenant who happened to secure a regulated apartment can remain indefinitely at a steep discount, while a lower-income newcomer is left to compete for market-rate units, which are exorbitantly priced in part because of rent control.

As a result, rent control laws bear part of the blame for why San Francisco and New York City are so unaffordable, Arpit Gupta, a housing economist at New York University, told me. Trying to suppress rents in cities like these is like trying to hold the lid down on a boiling pot — the pressure inevitably spills over somewhere else. Gupta, who sits on the New York City Rent Guidelines Board, which sets maximum increases for the city’s rent-stabilized apartments, cast the lone “no” vote on the rent-freeze measure this summer. 

The freeze creates “a severe risk of financial distress” for many buildings, he told me. It could prompt landlords to leave apartments vacant after a tenant moves out if the cost to rehabilitate it cannot be recouped through the legally permitted rent. The number of vacant rent-stabilized apartments in the city has already been rising, and Gupta has argued that New York state’s 2019 overhaul of its rent-regulation laws, which further constrained landlords’ revenues, may be partly to blame.

Many leftists don’t like arguments like these because they’re uncomfortable with the idea that housing must be kept financially worthwhile for private owners. I sympathize with that instinct — housing is a human need, and it feels wrong for its availability to depend on profitability. But it doesn’t do us much good to ignore the structure of the economy we actually live in, where housing is overwhelmingly provided by the private market. 

Housing markets can be very good at providing for people’s needs, if we allow them to work better by legalizing more housing construction and pair it with targeted rental subsidies to people with low incomes. 

How rent control got smarter 

One of the clearest ways to understand rent control comes from Shane Phillips, a housing researcher at UCLA. It should be viewed not as a long-term affordability strategy, he has argued, but as a targeted stability tactic. For affordability, there’s no substitute for building enough homes. But in already broken, unaffordable markets, like many of America’s superstar cities, rent control can be a stopgap that lets some residents remain in their homes. It’s reasonable to expect that people’s homes shouldn’t be treated as crude commodities that they can be priced out of at any moment. The question is how to balance security for existing residents against the structural harms rent control can cause to the overall market.

Not all rent control policies are created equal. Old forms of it appeared in places from ancient Rome to imperial China to the Jewish ghettoes of Early Modern Europe. When describing modern rent control, however, researchers distinguish among a few different types. “First-generation” rent controls arose largely as emergency measures across Europe during World War I, becoming very widespread in the US during World War II. These typically froze each unit’s rent at a fixed dollar amount, with few avenues for adjustment as costs rose; over time, they tended to push homes out of the rental market and discourage maintenance, reducing both the quantity and quality of rental housing.

By the 1970s-80s, a “second generation” of rent control laws, often called “rent stabilization,” was adopted in New York, Boston, Washington, DC, municipalities across New Jersey, and numerous California cities. These introduced some important innovations: They allow modest annual rent increases, set by a formula or regulatory board and often pegged to the rate of inflation. They exempt new-construction buildings from price controls, which reduces the disincentive for developers to build new apartments. 

They also often include “vacancy decontrol,” which allows landlords to reset an apartment’s rent to its current market rate after a tenant moves out (after that, the unit remains subject to the annual rent increase caps). Vacancy decontrol is especially important for preserving rental housing supply, experts told me. But it also creates an incentive for owners to try to push tenants out so they can raise the rent. To combat this, most rent-control programs include “just-cause” eviction protections, meaning that landlords cannot arbitrarily evict tenants or refuse to renew their leases; they must cite a serious lease violation (or another legally recognized reason, such as removing the unit from the rental market). 

Second-generation systems remain in place in major US cities, including New York, San Francisco, and Los Angeles. They tend not to distort housing markets as severely as first-generation laws, but they can still, as seen in the evidence from San Francisco, meaningfully damage housing supply. And Gupta has warned that New York City’s system has been regressing back toward first-generation rent control, with the recent rent freeze and the removal of vacancy decontrol under New York state’s 2019 Housing Stability and Tenant Protection Act.

Meanwhile, the recent revival of interest in rent control has produced some laws whose design may magnify the policy’s worst impacts. Montgomery County, Maryland, which includes some of Washington, DC’s most expensive suburbs, implemented a rent-control law in 2024 that lacks vacancy decontrol, while St. Paul, Minnesota, voters approved a 2021 ballot measure that initially lacked both vacancy decontrol and an exemption for new construction. Both places subsequently saw sharp declines in apartment construction, though the timing alone does not prove rent control was the sole cause. (St. Paul has since added partial vacancy decontrol and a permanent new-construction exemption.)

In a recent working paper, a pair of UCLA economists identified a “third generation” of rent control that is less restrictive than second-generation laws. California passed a statewide rent stabilization law in 2019, for example, that set a high ceiling on allowable annual rent increases: 5 percent plus inflation, or 10 percent, whichever is lower. It exempts new buildings for their first 15 years, and includes vacancy decontrol and just-cause eviction. Oregon passed a similar law the same year, as did Washington state in 2025. Using data from San Diego, the new paper found no discernible loss in housing supply there under California’s law. The implication is pretty intuitive: “The laxer the policy, the fewer the negative consequences,” as Phillips put it. 

The flipside, of course, is that the least restrictive laws also do the least to protect tenants — a 10 percent cap mostly just amounts to an anti-gouging measure, and landlords rarely raise rents by that much anyway. Still, double-digit rent increases do happen. And even a loose cap can offer renters peace of mind and insurance against a life-upending rent hike. 

We need a broader renter stability agenda 

Some current proposals may soon play out the tradeoffs of rent control. This November, residents of Redwood City, located between San Francisco and San Jose, will vote on a ballot measure that would cap rent increases at 60 percent of inflation, with a maximum increase of 5 percent.

Clara Jaeckel, a renter in the city and an organizer with the campaign, told me that the proposed law would allow landlords to petition for higher increases if it’s necessary to cover operating costs. It’s “designed to strike a fair balance between letting landlords have a fair return on their investment and keeping things affordable for renters,” she said. Under California law, the city would still be required to include vacancy decontrol and exempt housing built after 1995. “We believe building new housing goes hand-in-hand with rent control — so we want both of those things,” Jaeckel said.

Limiting rent increases so far below inflation, which is similar to San Francisco’s rent cap, has the potential to meaningfully reduce the quantity and quality of rental housing. But it’s also possible that its negative impacts remain muted. Gupta and Phillips both told me that vacancy decontrol substantially limits the harms of rent control, regardless of the exact percentage rent increase permitted, and the proposed Redwood City rent cap would apply to a smaller share of its rental housing than San Francisco’s law does. 

Voters and policymakers might decide that this tradeoff with housing supply is worth it if it can allow longtime residents to stay in their homes. The Bay Area has become so unaffordable that such laws right now represent one of the few ways that communities in the region can maintain some measure of class diversity. 

But it’s worth considering how to deliver the same stability and affordability without rent control, which for too long has been the fallback that expensive cities and towns reach for after allowing their housing markets to become dysfunctional. It can ultimately only offer tenants a cramped kind of security, trapping them in homes that may no longer suit their needs because leaving would mean surrendering their only affordable option. 

A better stability agenda for renters would give them genuine choices in where to live, and how long to stay. In places with broken housing markets, that means, first and most importantly, repealing exclusionary zoning laws and other barriers to building enough homes. That’s the foundation of affordability for everyone, but especially for renters, whose housing costs rise unpredictably with the market rather than remaining relatively fixed by a long-term mortgage. Renters with low incomes, meanwhile, need help affording housing even in a balanced market, and that ought to be provided far more consistently (Section 8 vouchers and other federal rental-assistance programs currently only reach a fraction of people who qualify).

Other policies can offer the long-term stability that rent control provides, too. “The ultimate issue that a lot of [rent control] interventions are trying to target is the challenge of being a renter and being faced with these cost shocks year after year,” Gupta said. Most American residential leases are one year long, but policy could encourage longer terms, which are common in some peer countries like Germany and Japan, and, Gupta noted, widespread in US commercial leases. 

Another step is to give tenants a presumptive right to remain in their homes — in the vast majority of states, landlords can refuse to renew a lease without any cause because the law simply defers to their private property rights. That is a bigger deal than it might sound like: If you’re a renter in one of the 40-odd states that don’t have a right to renewal, and you have, say, loud young children who irritate one of your neighbors, you can be forced out when your lease ends without any recourse. I’ve seen this happen firsthand as a renter in Wisconsin, and it’s one of many ways that cities can be hostile to families. Protection from arbitrary eviction would benefit renters regardless of whether their units are rent-controlled.

These sorts of policies also need to be balanced with reliable processes for removing tenants who seriously damage property, endanger their neighbors, or repeatedly violate their leases. “Sometimes landlords are taken advantage of. Sometimes they are lied to,” Phillips said. It’s rare to find a jurisdiction in the US that’s both “very concerned about tenants and very concerned about landlords,” he said. Instead, US housing policy tends to oscillate between either extreme, but protecting the rights and interests of both need not be mutually exclusive. 

America will remain stuck with a housing shortage for the foreseeable future, which not only makes housing unaffordable in our highest-demand cities and suburbs, but also gives landlords a structural advantage over renters because they’re shielded from competition. Until that changes, a limited form of rent control can redistribute some of that power back to renters. That may be a bargain worth making, but, Phillips said, cities should make it knowingly: with a clear idea of which renters they intend to protect, and who will bear the cost.

Editor’s note, Aug. 5, 6:20 am ET: Kansas voters rejected a proposed amendment to change how state supreme court justices are selected. This piece below was originally published on August 4.

Four years after the Dobbs decision, abortion battles have largely taken a backseat in national news to other policy fights this cycle. Leaders in the anti-abortion movement say they’re disillusioned with President Donald Trump’s unwillingness to push for further restrictions. The federal battle over access to abortion medication seems to be settled — for now. Public awareness of that fight is limited, and even at the state level, a couple years have passed since the high-pitched but successful state-level efforts to protect abortion access in red states.

Yet a little-known battle has been playing out in Kansas, where a ballot measure to change the way state supreme court justices are selected serves as a reminder that these fights over abortion are still active, even if they take the form of creative procedural and administrative efforts. 

If it succeeds, opponents say, it would open the floodgates for similar efforts in other states to politicize the remaining independent state courts (13 other states use a method similar to Kansas) and provide a road map to undoing abortion protections in other states that have safeguarded them.

On Tuesday, Kansans are deciding whether to change the way judges on the state’s highest court are selected. Up until now, judges were selected through a nonpartisan merit-based system: When a spot opens on the bench, a nine-member commission submits a list to the governor, who then selects a replacement.

The referendum would replace this system with direct, partisan elections of judges, like any other politician. Proponents say it’s a democratic move, a way to better express the will of voters over “unelected” bureaucrats. Yet critics say it’s first and foremost about restricting abortion rights — which both the court and voters have rejected.

How Kansas became an abortion rights flashpoint

In 2019, the state supreme court recognized the right to abortion in the state constitution; three years later, after Dobbs, voters rejected a Republican-championed proposal to overturn that ruling, choosing to preserve abortion rights by a 59-41 margin in a deeply red state.

It was after that failed vote in 2022 that then-state attorney general Republican candidate Kris Kobach outlined a new strategy for undoing these protections: changing the way the supreme court is selected, electing anti-abortion candidates, and “slowly and quietly” overturning the 2019 decision and 2022 vote.

“If you look at the various proposals, one of the proposals that is crystal clear is allowing people to popularly elect justices to the supreme court, which is the most common system among all of the states in the country,” Kobach said in 2022.

He’s a bit more careful talking about this in 2026: “There is a real desire to bring back some accountability to the judiciary,” he told the New York Times this week. “It’s not just about abortion.”

Tuesday’s results would have huge ramifications, critics said, given that nonelected state courts have been a final bulwark against Republican supermajorities and governors in red states. Kansas has been an island for abortion access for women in the South and central US since the Dobbs decision.

The victory in 2022 also inspired abortion rights advocates to try to use ballot measures to enshrine these protections in about a dozen other states, which successfully overturned abortion bans in Missouri and Ohio. State courts in Utah and Wyoming, meanwhile, blocked bans.

The next frontier in the abortion wars

These independent checks on power have been under attack for years, Michael Milov-Cordoba, a court expert and counsel in the Brennan Center for Justice’s judiciary program, told me. 

“State legislators across the country are increasingly trying to undermine those courts. … That retaliation takes a few different forms, but changing how judges are selected is top of the list,” Milov-Cordoba said. “And what we’ve seen is that in many states where courts stand up for abortion rights and strike down abortion restrictions, efforts to change state judiciaries have followed.”

He noted the complete reworking of the Utah supreme court in the last year, including by expanding and packing it. Similar retooling of the state supreme court happened in Iowa in 2022. Montana is likely the next battleground, where Republican legislators are exploring various avenues to strip or limit the state supreme court’s powers. That in turn has led the ACLU to get involved to boost a constitutional amendment this year that would preserve the nonpartisan status of judicial elections.

And in recent years, state supreme court elections have been inundated with spending and attention from both in- and out-of-state backers. Last year’s Wisconsin judicial election, for example, became the most expensive race of its kind in US history, with more than $100 million spent — just two years after a contest for a different seat on the state supreme court had set its own record at more than $50 million spent.

“If these courts become partisan, then they will be just like any other election fight — subject to being bought and sold by billionaire political funders,” Deirdre Schifeling, the chief political and advocacy officer at the ACLU, told me. “They become a race to the bottom … and [Republicans] are finding backdoor ways to seize power to push their ideological agenda.”

Already, Kansas has seen heavy spending: More than $12 million have been spent from both sides, including about $5 million from the ACLU, Schifeling told me.

”Everyone’s focused on the Michigan Senate race, other kind of big-ticket, sexy elections,” Schifeling said. “Well, this is just as important and much more under the radar. Without a balanced court, we are going to lose rights and liberties across the board in a state like Kansas.”

Let me start with the most local of local stories: the intersection down the street from my apartment in Brooklyn, New York, where Columbia Street meets Summit Street.

Since my family moved into the neighborhood in 2023, I’ve hated this intersection. It has no stop signs, no crosswalks, no signal. Crossing on foot with my son has meant grabbing his hand and hoping any oncoming cars would slow down, which, given that this is New York City, is maybe a 50/50 proposition at best. Everyone knew a stop sign or signal was needed, but the city did nothing.

That finally began to change late last year, after a 10-year-old girl was struck and injured by a car just two blocks north of the intersection. The neighborhood organized, packed a public meeting, and eventually walked a city official down the block so he could stand in the intersection and see what they saw every day. Which is how I woke up on July 17 to see four stop signs and freshly painted crosswalks at the intersection I hated so much.

My very local story is part of a much bigger one. Cars kill about 1.16 million people a year worldwide — more than the population of San Jose, California erased every year. Road injuries remain the leading cause of death for everyone between the ages of 5 and 29 — ahead of malaria, ahead of war and homicide, ahead of every disease we spend more time worrying about.

For most of the 20th century, that was simply the price of moving around faster. Being in a car was the most dangerous thing most of us did on any given day, and we seemed to have no choice but to accept the consequences.

But, it turns out, we don’t. According to new data released last month, between 2011 and 2025, the rate at which the world’s roads killed people, measured against population, fell 21 percent, even as more than a billion motor vehicles were added to the world’s roads. It’s still far too high, and the death rate actually increased in Africa, as more vehicles are added to often substandard roads. But in epidemiological terms: Globally, exposure went up while deaths went down. What ultimately changed was an argument about whose fault it really is when a car crashes.

The doctor who decided crashes were not accidents

It’s not too much of an exaggeration to say that American cars were once all but literal death traps. In 1966, they killed 50,894 Americans and injured 1.9 million more, in vehicles with rigid steering columns aimed at the driver’s chest and metal dashboards studded with knobs that lacerated and impaled human bodies. The toll was horrific; as President Lyndon B. Johnson put it in 1966, the million and a half Americans who had died on the roads so far that century were “nearly three times as many Americans as we have lost in all our wars.”

Detroit’s answer to all this was that Americans were bad drivers. A doctor named William Haddon Jr. thought the industry was looking at the wrong thing. Haddon trained as a physician and came to car crashes as an epidemiologist. He saw them as systems failures and understood that cars had to be designed to protect drivers against themselves.

Haddon wasn’t working alone. In April 1959, a Labor Department official named Daniel Patrick Moynihan published “Epidemic on the Highways,” making a version of the same argument: The problem was how cars were built, not who was driving them. In 1965, the consumer advocate Ralph Nader — whom Moynihan had hired the year before to help write the government’s highway safety report — published Unsafe at Any Speed, a catalog of everything automakers already knew they should fix and had decided not to.

Nader’s book became a national bestseller, and, in September 1966, Johnson signed the National Traffic and Motor Vehicle Safety Act, which finally gave the federal government power to mandate how cars could be built. Johnson appointed Haddon to lead the new federal traffic- and highway-safety agencies that later became National Highway Traffic Safety Administration (NHTSA).

A safer system

NHTSA estimated that federal vehicle-safety standards prevented more than 860,000 deaths and 49 million nonfatal injuries from 1968 through 2019. Preliminary data released this week showed that the US motor vehicle death rate for the first quarter of 2026 was 0.99 per 100 million vehicle miles traveled: the second lowest first quarter figure on record and down 82 percent from the 1966 death rate, when Congress passed the vehicle safety act.

But while America has largely aimed to make crashes survivable, other countries decided that wasn’t ambitious enough. In October 1997, the Swedish parliament adopted a national policy called Vision Zero, built on the premise that nobody should be killed or seriously injured on the roads — and that, when someone is, ultimate responsibility belongs to the people who designed the system, rather than solely to the person who made the mistake. Sweden began adding median barriers to rural highways in 1998, and a national revision of speed limits rolled out in 2008-’09. Since Vision Zero’s adoption, Swedish road deaths have fallen about 61 percent, from 541 in 1997 to 213 in 2024 — about two deaths per 100,000 people, the lowest rate in the EU.

New York adopted the same framework in February 2014, explicitly modeled on the Swedish work, and cut its default speed limit from 30 to 25 miles per hour that November. By the end of 2025, the city’s traffic deaths were down 31 percent from 2014. The year closed with 205 road deaths, the fewest since New York began keeping records in 1910. In the first half of 2026, pedestrian deaths were more than 42 percent below the comparable period in 2014.

Four stop signs on a Brooklyn corner are what that idea looks like at its smallest possible scale.

The people we left outside the car

But, in our effort to make our cars safer, we neglected to do the same for everyone else on the street. Between 2009 and 2023, US pedestrian deaths rose 80 percent, even as other categories of traffic deaths increased just 13 percent. By 2022, pedestrian deaths had climbed to a 40-year high — back to 1981 levels.

One major contributor is as simple as geometry. The Insurance Institute for Highway Safety (IIHS) found that vehicles with hoods above 40 inches are about 45 percent more likely to kill the pedestrian they hit than vehicles with hoods of 30 inches or less and a sloped profile. A low, sloped hood catches an adult at the legs and rolls the body up onto it. A tall flat one catches the torso and drives the body down and under. Light trucks — which have gone from under a fifth of new vehicle sales in 1975 to more than four-fifths today — accounted for 54 percent of US pedestrian deaths with a known vehicle type in 2023.

It’s only recently that this second curve has begun to bend. Preliminary state data indicated that US pedestrian deaths fell about 7 percent in 2025 to an estimated 6,732, a third consecutive annual decline. Part of it is that a pandemic-era spike in reckless driving is receding. Part is states spending on infrastructure and enforcement. And part is that cars now come with automatic emergency braking with pedestrian detection spreading, which IIHS found cuts pedestrian crash risk by about a quarter.

Pedestrian-detecting automatic emergency braking is spreading, as well. IIHS found that it was associated with a 27 percent reduction in pedestrian crashes, though detection spreading, which IIHS found cuts pedestrian crash risk by about a quarter. (But there is work to do, as those systems don’t reduce risk on unlit roads at night, and more than three-quarters of pedestrian deaths happen after dark.)

Driver Zero

I’m glad there are stop signs at Summit and Columbia now, but it was a good outcome produced by a bad process — one that required a child being hit by a car to get started. There are more dangerous intersections in this country than there are communities with the voice and the stamina to demand fixes. A real Vision Zero wouldn’t wait for the crash; it would identify which intersections could kill someone and fix those first.

For now, though, I’m simply happy that, in my local corner of the world, the streets got just a little bit safer.

New York is also an outlier. As my colleague Marina Bolotnikova wrote earlier this year, Vision Zero hasn’t worked nearly as well elsewhere in the country, largely because the American public is less accepting of road designs that inconvenience drivers.

That’s why the US, for all its long-term improvement, lags behind its peers. Over the decade to 2021, road deaths fell 36 percent in WHO’s European region and did not move at all in the Americas. The US sees about 12 road deaths per 100,000 people, more than twice the rate in Australia, Israel, or South Korea — a gap so large that the International Transport Forum publishes OECD road safety averages both with the US included and without it, presumably to keep us from skewing the results.

Since the US probably won’t adopt Sweden’s approach, a more realistic hope might be autonomous vehicles. This month, the Insurance Institute compared about 50 million driverless Waymo miles across four cities with human driving in the same places and found that, per mile, the robotaxis were involved in 68 percent fewer crashes of the kind a human driver would typically report to police. Waymo’s own tally across more than 220 million driverless miles claimed 93 percent fewer injury-causing crashes involving pedestrians — which is to say the technology is best at precisely the thing American road design has been worst at.

If Haddon fundamental insight was that systems have to be built to counter the inevitable errors when a human drives a two-ton hunk of metal and glass at 60 mph, then maybe it makes sense that the ultimate system response is to remove the human altogether. For now, though, I’m simply happy that, in my local corner of the world, the streets got just a little bit safer.

A version of this story originally appeared in the Good News newsletter. Sign up here!

For a brief moment late last week, it looked like acting Attorney General Todd Blanche’s bid to get the word “acting” removed from his job title was in serious trouble. But that moment appears to have passed, as two key Republican senators just signaled that they will vote to move his nomination forward.

Sens. John Cornyn (R-TX) and Thom Tillis (R-NC) halted Blanche’s nomination because of concerns about a $1.8 billion slush fund that Blanche helped create as the Justice Department’s acting leader, as well as some objections to a collusive deal between President Donald Trump and the IRS that could have shut down tax investigations into Trump, his family, and his businesses. Both senators announced on Monday that they will no longer block the nomination.

Though these two senators, both of whom are retiring in January, did extract some minor concessions from the Department of Justice in return for their votes, they objected to only a small fraction of Blanche’s efforts to transform the DOJ’s lawyers into Trump’s personal advocates and enforcers. The fact that Blanche is likely to be confirmed, despite his sycophancy toward Trump, suggests that any meaningful guardrails on a weaponized Justice Department have ceased to exist.

Cornyn and Tillis both currently serve on the Senate Judiciary Committee. That committee, where Republicans currently have a two-vote majority, was originally scheduled to vote on Blanche’s nomination Thursday — but that vote would have failed if Cornyn and Tillis rejected the nominee. And, now, it’s likely to go ahead.

Cornyn and Tillis’s objections to Blanche were quite narrow in scope. They demanded a written order from Blanche “terminating the anti-weaponization fund,” a reference to the $1.8 billion slush fund that could be paid out to Trump’s allies, including participants in the January 6 attack on the US Capitol. Blanche originally established this fund in a May 18 order. On Sunday night, he tweeted out a new document terminating his May 18 order. 

Cornyn also objected to the breadth of settlement between Trump and the IRS — which could be read to permanently cut off that agency’s power to audit Trump, his companies, or many members of his family — but only sought to narrow this settlement’s scope.

For the most part, however, the two senators did not object to Blanche’s broader efforts to weaponize the Justice Department against people who’ve displeased Trump, including the use of law enforcement to cow Trump’s critics. As both deputy attorney general and as acting attorney general, Blanche oversaw several highly dubious prosecutions brought against Trump’s perceived enemies and prominent Democrats.  

A video introduced in federal court, for example, indicated that Blanche personally instructed law enforcement officers to arrest Newark’s Democratic Mayor Ras Baraka — an arrest that led a federal magistrate judge to scold the DOJ for “using the immense power of the government to pursue weak cases or to make examples without sufficient cause.” Under Blanche’s oversight, the DOJ’s also brought flimsy charges against individuals like former FBI Director James Comey and New York state Attorney General Letitia James, who investigated Trump for potential wrongdoing. (One minor exception: Tillis did previously pressure Blanche to drop an investigation into former Federal Reserve chair Jerome Powell.)

So, while Cornyn and Tillis successfully pushed Blanche to make some small concessions in order to secure their votes in the Judiciary Committee, neither senator appeared interested in a confrontation over Trump and Blanche’s broader efforts to transform the DOJ into a revenge-seeking agency. And now, it appears likely that Blanche will be confirmed — and that those efforts will continue. 

What did Blanche actually agree to do in order to get Cornyn and Tillis’s votes?

Earlier this year, Trump, the Trump Organization, and Trump’s two oldest sons sued the IRS, claiming that it failed to prevent a contractor from leaking some of Trump’s tax documents. The president originally demanded a $10 billion payout from the federal government, and the lawsuit triggered widespread concerns about a conflict of interest, because Trump was both the plaintiff and the chief executive of the government he sued.

On May 18, a little over a month after Blanche became the federal government’s top lawyer, Trump (and the other plaintiffs) entered into a “settlement agreement” that did not include a $10 billion payday for Trump but that did include several provisions favorable to Trump, his family, and his companies. 

Among other things, the settlement announced the creation of the “anti-weaponization fund,” which would distribute money to an unknown group of people who claim they were unfairly targeted by previous administrations based on decisions by five individuals appointed by Blanche. It also included a provision claiming that the IRS (and potentially other federal agencies) is “FOREVER BARRED” from pursuing any claims that “have been or could have been asserted by Plaintiffs” — open-ended language which sparked fears that a wide range of potential investigations into Trump, his family, or his companies could be shut down forever.

In response to Cornyn and Tillis’s objections to this settlement, Blanche tweeted out a brief order on Monday, stating that his own May 18 order establishing the anti-weaponization fund “is rescinded and shall have no force or effect.” According to Tillis, the DOJ also “acknowledged in a binding written order that the audit settlement is limited to the plaintiffs and the scope does not extend beyond the defendants in the lawsuit.”

So, Blanche walked back the specific order that he signed to establish the $1.8 billion slush fund, but he did not repudiate the part of the settlement that immunizes Trump, his two oldest sons, and the Trump Organization from many tax investigations. According to Tillis, the DOJ merely said that this part of the settlement does not apply to parties (including federal agencies) that were not parties to Trump’s original lawsuit.

Though this deal appeared to have been enough to secure Cornyn and Tillis’s votes, and most likely to ensure Blanche’s confirmation in a Republican Senate, it is unlikely to placate Democrats. As Sen. Adam Schiff (D-CA) tweeted Tuesday morning, Blanche’s new order “doesn’t prevent payouts to violent insurrectionists in the future,” and it “leaves in place a tax-immunity deal that could help Trump skip taxes on the $2.3 billion he made last year.”

And the question of whether the DOJ may bring politically motivated charges against figures like Baraka, Comey, or James appeared to not even be part of the deal struck between Blanche, Cornyn, and Tillis.

One reason why the two senators exacted such meager concessions may be because they didn’t have a very strong hand to play against Trump. Because Blanche is currently the Senate-confirmed deputy attorney general, he can remain head of the Justice Department, in an acting role, for as long as Trump is president. Indeed, when negotiations between Blanche and the two senators appeared to hit an impasse late last week, Trump threatened to “keep Todd as Acting A.G., and push hard to get the Anti-Weaponization Bill” if Cornyn and Tillis wouldn’t support Blanche.

But that doesn’t change the fact that Blanche’s concessions are thin gruel. His statement on the slush fund merely confirms that “there is no Fund” right now. And, under the terms of the apparent deal reached with Cornyn and Tillis, Trump, his sons, and his primary business still gain broad immunity from a wide range of tax investigations. 

So, while Cornyn and Tillis may have given Trump and Blanche a brief scare, they never put up much real resistance to Trump’s nominee.

New Yorkers will soon enjoy a 30 percent discount on their meat, seafood, milk, and bread — so long as they shop at a city-owned store.

Mayor Zohran Mamdani touted such bargains this week at a press conference detailing his plans to launch five public grocery stores, in a bid to lower New Yorkers’ food costs. Under the proposal, the city would own each supermarket and dictate its pricing and labor practices, while private grocery companies would handle the day-to-day operations.

Mamdani’s proposal has been getting people worked up from the moment he unveiled it on the campaign trail for his 2025 mayoral run. For many progressives, state-owned supermarkets embody one of their movement’s highest ideals — the prioritization of public needs over private profits. For conservatives, meanwhile, “Mamdani Marts” represent an attack on free enterprise (if not, the first step on the road to Soviet breadlines).

While stimulating, these grand philosophical arguments have often overshadowed more banal but pressing questions: Would public grocery stores do more to advance Mamdani’s stated goals than other things the city could do with the same money? Has New York’s mayor discovered a way to sell groceries more efficiently than Costco does — or an approach to nutritional relief more effective than simply giving poor people more cash and food?

The answer to both of these questions appears to be “no.” And that should concern more than just New Yorkers. Mamdani’s vision is already inspiring imitators, with San Francisco and Boston both exploring their own public grocery store proposals. And in national discourse, the mayor’s policy is widely understood as an experiment — one testing a bold new theory of how governments can make food more affordable.

Unfortunately, although public grocers have merit in some circumstances, the theory underlying Mamdani’s specific plan is not merely unproven but incoherent.

Grocery socialism makes more sense for small-town Republicans

Public grocery stores have historically aimed to solve a problem that New York City does not have — a total absence of private supermarkets.

In 2018, the small town of Baldwin, Florida lost its only grocer. With only 1,600 residents — and a median income of $44,271 — the community no longer generated enough business to be worth the local IGA’s while. And no other national chain rushed in to fill the gap. 

So, the municipality opened its own grocery store, the Baldwin Market.

This attracted national media attention. And not without reason. A deeply conservative small-town trying its hand at socialism was a fun story. And it turned out that Baldwin wasn’t an aberration: Other aging rural communities in red America had turned to government grocers once private supermarkets had left them in the lurch.

Progressive policy thinkers took inspiration from these examples. In the ensuing years, proposals for using public grocery stores to combat urban food deserts — impoverished neighborhoods without convenient and affordable supermarkets — began to circulate. The merits of such plans can be debated. But their logic was straightforward: Where the market fails to provide residents with healthy food options, the government should step in. 

When post-COVID inflation sowed outrage over food prices, however, some on the left reconceived the purpose of public supermarkets: In their telling, such stores weren’t merely a means of eliminating food deserts, but also a way to make groceries more affordable.

Mamdani’s plan is principally animated by the latter goal. With more than 1,100 grocery stores and 10,000 bodegas, most of New York City is well-provisioned by private food vendors. And although parts of the municipality are under-served, the mayor is not actually concentrating his stores in such areas; his planned East Harlem location lies just blocks from an Aldi, Costco, and many other grocers. 

In a report detailing its policy, the mayor’s office makes clear that its primary aim is to drive down New Yorkers’ food bills. Yet there’s little reason to think that public grocery stores are a cost-effective way to do that.

New York City probably won’t provide groceries more efficiently than Costco

Without question, a government store can make groceries more affordable for its own customers: All it has to do is charge below-market prices.

And yet, if that store manages this feat by operating at a loss, then its shoppers’ savings will come at the broader city’s expense.

That might not be too troubling, if one pictures rich taxpayers footing the bill. But for a city like New York — which faces a structural budget deficit — revenue is a scarce resource. A tax dollar spent on public grocery stores is one that can’t be spent on nutritional assistance for low-income people. And all else equal, the latter will do more to enhance affordability: If you have a limited pool of food subsidies — and want to minimize the number of New Yorkers who can’t afford groceries — then you should spend your funds on the poor, not on whoever happens to show up at your city-owned store. 

Thus, for Mamdani’s supermarkets to be cost-effective, they can’t just subsidize low prices with taxpayer money. Rather, they need to deliver groceries more efficiently than private retailers do.

Public ownership can unlock efficiencies in certain contexts. For example, America’s private health insurance system generates massive administrative redundancies. By one estimate, if the US replaced its sprawling insurance industry with a single government payer, it could cut our health system’s annual administrative costs by $500 billion. In other words, a Medicare For All program could theoretically provide more healthcare-per-dollar than the current system does, by eliminating excess bureaucracy.

But there are no comparable inefficiencies in the grocery sector. True, a government retailer could generate some savings by declining to take a profit. But margins in the industry are slim; the average profit rate among food retailers was just 2.1 percent in 2025. Therefore, Mamdani’s stores can’t finance 30 percent discounts merely by dispensing with shareholder returns. 

Meanwhile, the city actually wants its stores to be less cost-efficient than private grocers in some respects. According to its policy brief, the government grocers will pay their workers higher wages than most retailers and may also favor “local and regional suppliers,” rather than automatically contracting with whichever food producers offer the best rate. 

The city suggests that its stores will have some cost advantages: Unlike private competitors, they will pay no rent or property taxes on their facilities. But these are merely additional subsidies, not actual efficiencies: By providing free real estate to its grocers, the city is forgoing revenue that it could otherwise collect and spend on nutritional assistance or other public goods. 

It is not yet clear how much money the city is prepared to lose each year on these stores. If Mamdani’s celebrity — and heavily advertised bargains — lure large masses of people to his markets, their steeply discounted goods will quickly sell out. In that circumstance, to avoid long stretches with empty shelves, or some complex rationing system, the city would need to rapidly restock money-losing items, compounding the stores’ operating losses.  

In theory, there is one way that government stores could benefit consumers throughout a city without being especially efficient enterprises in themselves: They could force other retailers to cut prices by accepting lower profits or discovering new efficiencies. But with grocery margins already thin, squeezing private markets further could lead to closures, thereby reducing shoppers’ options. Further, Mamdani himself insists that his stores will go out of their way to avoid harming private competitors (which, in New York, consist primarily of the sorts of small businesses that Mamdani has promised to help). 

In any case, five stores won’t substantially impact pricing citywide. And so long as each government grocer operates at a loss, scaling up the program will only deepen its costs — and thus, the tradeoff between funding public supermarkets and anti-hunger programs.

Aldi for all

At present, Mamdani’s grocery store experiment looks fairly cheap. The city estimates the stores will require $70 million in capital costs. As already noted, it’s unclear precisely how large each store’s annual operating budget will be. But even if each supermarket loses many millions each year, it still won’t make that big a difference, in the context of the city’s $125 billion budget.

Still, the opportunity costs of Mamdani’s policy are real. New York City currently plans to spend $3.1 million next year on a program called Get The Good Stuff (GTGS), which essentially gives SNAP recipients up to $10 off each time they purchase fruits and vegetables from 25 participating grocery stores. With the money slated for its public supermarkets, New York could dramatically expand the program, while also investing more money into its food banks. Alternatively, the city could modestly increase cash transfers to its lowest-income residents. 

To be sure, none of that would offer much benefit to middle-class shoppers. And the mayor is quite reasonably concerned with increasing grocery affordability for the typical New Yorker. But the city can advance that aim — while actually increasing its revenue — by easing zoning and permitting rules that currently make it difficult for large, low-cost retailers like Costco and Walmart to operate in many parts of the city. Happily, to Mamdani’s great credit, his administration’s paper on public grocery stores does briefly mention the need for permitting reforms.

Maybe public grocery stores are an end in themselves

All this said, there may still be a reasonable case for Mamdani’s stores or others like them. For example, a city’s residents might come to see such retailers as a kind of attraction, public amenity, or community space, akin to a park or library.

Further, public grocers could theoretically increase the public’s faith in the government. While the grocers are unlikely to be efficient in reality, they may appear to be. After all, their low prices will be far more visible to consumers than their operating costs. If Americans come to associate the public sector with cheap, ostensibly well-run supermarkets — rather than dreary DMV lines — that could aid the left’s broader efforts to expand the government’s remit. (Although, if the public grocers end up being characterized by overcrowding and empty shelves, the policy could further erode Americans’ confidence in the public sector.)

As a means of maximizing affordability, however, Mamdani’s program makes little sense. It will mostly just transfer income from the city’s broad population to the small subset of New Yorkers who happen to live near — or work at — one of its five stores.

Where private markets fail to provide any grocery options, public stores may be the best way for municipalities to meet their residents’ nutritional needs. But in other contexts, governments can make a bigger difference by simply putting more money in poor people’s pockets.

Maybe it was never a great idea to build so many golf courses in the desert. But in the 1990s, when Tiger Woods mania was at its peak, Las Vegas went on a fairway construction spree, dotting the city with dozens of pristine, water-gobbling green oases, most woven around upscale master-planned suburbs. 

One of those new fairways was the privately owned Badlands Golf Club, whose name now evokes huffs of frustration and wistful what-ifs from Las Vegans in the know. Opened in 1995 about 15 miles west of the Strip, the luxury course once wound its way around some of the city’s most opulent mansions and gated communities. 

By the time Woods crashed his car into a fire hydrant in 2009, the golf industry was in a crisis of its own. Many Americans had lost their appetite for the sport, which began hemorrhaging millions of players during the Great Recession and Woods’s fall from grace. Thousands of golf courses built during boom times shut down as a result — Badlands Golf Club among them. 

Meanwhile, Las Vegas, like many American cities, needed more homes to help alleviate its brutally high housing costs. These days, Nevada needs 120,000 additional affordable homes, but it is running out of places to build them, in part because about 85 percent of the state is federally owned, meaning there’s little room left for its cities to grow or sprawl. Shuttered golf courses — which often had the advantage of being tied into existing urban infrastructure, unlike more undeveloped land — presented ideal spots for relatively low-cost development.

Not everyone was happy about the idea. To the ire of its affluent neighbors, the precious real estate of the Badlands Golf Club was slated for a new housing development in 2015. What came next was one of the worst land disputes in Nevada history, a decade-long legal tussle waged by the city of Las Vegas at the behest of wealthy locals. Las Vegas was forced to fork over $286 million to a developer last year — one of the largest such settlements in history, and more than the city’s entire annual municipal culture and recreation budget — for illegally denying applications and permits to build atop the Badlands, which by then sat empty, an abandoned eyesore. Eleven years after the fiasco started, a new developer finally began clearing the site for a new luxury housing complex earlier this year, while Las Vegas has had to enact hiring freezes and delay municipal projects to pay off its hefty bill.         

In cities where space is tight, underused golf courses are, in theory, ideal canvases for new housing. These huge, repurposed tracts of land can fit thousands of new units — ideally, affordable ones — alongside other amenities like parks or basketball courts smack in the middle of some of the country’s most desirable and well-connected neighborhoods. This makes such developments much cheaper to build than creating a new suburb with all new roads and power lines from scratch.

Not every attempt to turn golf courses into housing lands is destined for financial calamity. Just last year, the city of Las Vegas approved a plan to convert a separate golf course, the city-owned Desert Pines Golf Club, into a 1,500-unit housing complex, the largest affordable housing project in Nevada history and a public-private partnership between the city, the Nevada State Infrastructure Bank, a private developer, and nonprofit partners. The project is a rare win for these kinds of developments, and may offer a blueprint for how they can be accomplished in the future. But even there, the challenges are still real. 

“Everyone wants more housing at a regional level. Everyone acknowledges that we need more housing,” said Nicholas Irwin, research director at the Lied Center for Real Estate at the University of Nevada, Las Vegas. “But no one wants it near them, and that’s the tricky part.” 

How to turn a golf course into housing

Desert Pines Golf Club opened in the heart of East Las Vegas in 1996, a lush, manicured 18-hole course, peppered with over 4,000 imported pine trees. Like nearly one in five fairways nationwide, Desert Pines was municipally owned, its pricey water needs subsidized by Vegas taxpayers. 

With its rolling green hills, Desert Pines was, by far, the largest contiguous green space in the mostly working-class neighborhood that surrounds it. But while golfers flocked to the course, many local residents barely even knew it was there or likely assumed it was out of their price range, said Ángeles Ramos, a local organizer with the immigrant advocacy group Make the Road Nevada. “Only the wealthy wanted it for their own purposes,” she told me in Spanish, but “what we want, what we urgently need, is more affordable housing.” 

There was a time when “we could just build anywhere and everywhere because the valley was underdeveloped,” Irwin said, but “now, we’re buttoned up against it. We are incredibly dense, because we’ve basically filled up the land we have.” Much of Nevada is undevelopable because the federal government has set it aside for other purposes like recreation, which explains the state’s bevy of tourist attractions like Lake Tahoe or Red Rock Canyon. But it also leaves the city with little space to build.  

If all 16,000 golf courses in America turned all of their land — about 2.3 million acres — into housing with the same density as Desert Pines, it would be enough space to build 22 million homes. If you applied that approach to only those courses that are, like Desert Pines was, municipally owned, then you could still build 4.3 million affordable homes, which would make an enormous dent in the nation’s current shortage of about 7.2 million affordable homes. 

That’s not to say that every golf course in every land-constrained city ought to be bulldozed to make way for new apartment buildings. Golfing, for the record, has made a bit of a comeback lately, much like its most famous star. And even if fairways were still closing at the rate they were a few years ago, there’s no way that they could solve Nevada’s housing gap alone, much less overcome the shortage nationwide. But they can still help close the gap. 

Ramos, who is among the local leaders organizing community meetings around the Desert Pines redevelopment, believes it could be transformative for the community over time. She says that in her neighborhood it’s become a luxury for many families just to live alone with their spouse and kids, rather than doubling up in cramped apartments, pooling together money each month to keep up with rising costs. 

 When the Desert Pines redevelopment opens about a decade from now, it will include not just 1,500 housing units, but also a soccer pitch, walking trails, and a job training center. In East Las Vegas, the temperature often feels more than five degrees hotter than it does in the Badlands’ affluent suburbs, where residents enjoy over nine times as much parkland per person. 

“This project brings a lot of hope,” said Ramos, who’s especially excited about the prospect of more accessible, kid-friendly green spaces. “We’re all human. We need equity, respect, and to live with dignity, and that’s why we urgently need trees too.”

As it turns out, you can do a lot with an old fairway. Even with all of those bells and whistles, the new development will still likely use less water than the golf course did. And, because the plot of land is already enmeshed within the community of East Las Vegas — close to existing sewer, water, and electricity lines — it will be much cheaper to build there than it would be to try doing so on the outskirts of the city, said Antonio Bermúdez, vice president of McCormack Baron Salazar, the developer working with the city and state government on the proposal.

“What I’ve seen so far in the state of Nevada is that the political will is there,” he said, though the question is, “how do we make this happen not just in Nevada and the city of Las Vegas, but everywhere else where affordable housing is needed.”

Not in my golfyard!

If the Badlands has become a brutal fable of bad governance and highly charged NIMBYism, then Desert Pines may prove to be the model of a golf course-to-housing project gone right.

It also enjoyed the privilege of being located in a welcoming neighborhood, filled with renters who could personally benefit from the project. By contrast, many other golf courses were instead built as a luxury perk embedded in master-planned communities, meaning they’re surrounded by homeowners who fear that losing a recreational amenity — especially if it’s replaced by less upscale housing — could affect their property value.

“Everyone wants more housing at a regional level. Everyone acknowledges that we need more housing. But no one wants it near them, and that’s the tricky part.” 

Nicholas Irwin, research director, Lied Center for Real Estate

Just across the street from the Badlands is another golf course, Angel Park Golf Club, built on federal land granted to the city of Las Vegas. If the city ever tried to build an affordable housing complex like the one it’s planning in Desert Pines, it would almost certainly fail given the outrage with which the surrounding community reacted to a proposal for other high-end housing in their backyard. 

Victoria Seaman, a former Las Vegas City council member, was elected in 2019 to represent the district that includes the Badlands, mid-lawsuit. Even the “big, beautiful two-acre lots” the developer originally envisioned for the site, she said, were not good enough for Queensbridge, an ultra-luxury gated community abutting the course that acted as a powerful lobbying bloc during the decade-long process, influencing the city’s illegal decision to block the original property owner from breaking ground. 

The city of Las Vegas is still paying off the total $286 million settlement it made over its obstruction of the Badlands project, in part through funding cuts to projects like the Desert Pines redevelopment in East Las Vegas.

“These were expensive homes with beautiful planning,” Seaman said of the project planned for the former golf course, and yet somehow, “these very big donors in Queensbridge convinced the entire [homeowners association] that the developer would ruin the neighborhood.”

The fight over fairways is really a fight over who gets to live where

The Badlands example is particularly dramatic, but it also gets at the challenges faced by similar projects across the country. Even a decade after many fairways fell into decline, there are few other examples quite like Desert Pines, and certainly none as large. While dozens of cities — including  Denver, New York, and Virginia Beach — have made overtures to turn golf courses into housing in recent years, almost all such projects have been met with upheaval and fierce resistance from locals. 

To some extent, that’s understandable. In Sparks, Nevada, hundreds of local residents have flooded community meetings in recent months to oppose a proposal to raze the Red Hawk Golf and Resort and build over 700 new homes in its place. “Promises were made to this community,” Tom Ciesynski, one of those homeowners, told me, “these lots, these very nice homes, were sold with premiums added for those that were sitting on the golf course.” Now, he says, the fairway’s owner is trying to build “tract homes that just don’t fit the character” of a neighborhood that has come to see the Red Hawk as its centerpiece, where Ciesynski regularly goes to golf, and where his wife takes her yoga and pilates classes. 

He understands that Sparks, like most of Nevada, faces a housing crunch. “Most people aren’t opposed to all new development, but there’s a right way to do it and a wrong way to do it,” he said, and there are other places within a “stone’s throw of where we live” where he thinks the developers ought to go and build instead.

He arguably has a point. Recreation spaces are important for livable cities, too, and it’s not fair that homeowners who were promised one thing when they bought their properties are now facing a new reality. 

And yet, the most troubling trade-off is not the one that leaves a homeowner golf course-less but the one that leaves families in East Las Vegas unable to afford homes at all. It may be tempting to only build affordable housing in places that won’t put up a fight, which in practice, means avoiding most golf courses, especially those in wealthy neighborhoods that want to preserve the kind of exclusivity that many fairways were built to project in the first place. But cities can no longer afford that indulgence — and in any case, they shouldn’t be digging in their heels to protect it.

When people talk about a new development not fitting the character of a neighborhood, “what they’re describing is an amorphous feeling,” said Irwin of the University of Las Vegas, “and if you make policies based on feelings and vibes, you get bad policy.”

The International Criminal Court is in the trenches right now.

Last week, its chief prosecutor, Karim Khan, was voted out of his position. In a first-of-its-kind vote, 82 member states decided that he engaged in misconduct and a serious breach of duty. The vote comes after he was accused of sexual misconduct by a female colleague at the ICC, which Khan has denied.

It’s a mess, and it’s hitting the ICC at an inopportune time. On top of this internal turmoil, US Secretary of State Marco Rubio recently launched an all-out attack on the court.

In a Wall Street Journal op-ed earlier this month, Rubio wrote that the Trump administration’s goal is to “dismantle the ICC—brick by brick, if necessary,” citing the possibility that the court could “target” American citizens, such as Border Patrol agents or US soldiers.

The US is not a member of the ICC, and has a history of wariness about the organization.

Beth Van Schaack previously served as the US ambassador-at-large for global criminal justice, a role that led her to work directly with the International Criminal Court. She spoke with Today, Explained co-host Noel King about the decades-long tumultuous relationship between the US and the ICC. And they discuss whether, if the ICC is now weaker than ever, the Trump administration can actually break it for good.

Below is an excerpt of their conversation, edited for length and clarity. There’s much more in the full podcast, so listen to Today, Explained wherever you get podcasts, including Apple Podcasts, Pandora, and Spotify.

If the International Criminal Court is charged with dealing with people who have allegedly done very bad things and then trying them, why is the United States not a member?

The United States signed the treaty in the waning days of the Clinton administration, but never submitted it for ratification to the Senate. And one of the concerns is that the final treaty allows for jurisdiction over individuals who may commit crimes on the territory of state parties. And the United States has always been concerned about that principle because we have troop commitments.

Supporters of the court have always said the United States and its personnel are vulnerable regardless of whether you join. If US personnel are committing crimes on the territory of state parties, which we saw in Afghanistan, the response is to do those cases domestically and there’ll be no occasion for the International Criminal Court to consider those matters.

There’ve been peaks and valleys in the relationship between the ICC and the United States. So we’re in a frankly pretty deep valley right now with this new campaign that Secretary Rubio announced.

But back in the Bush administration, there was also very acute concern and it stemmed from this Afghanistan investigation. The Bush administration and Congress both put in place measures that they thought would be protective of US servicemembers. So that was one valley.

Now what’s interesting is in the second term of the Bush administration, many of these measures were dismantled because the Bush administration realized that the court was doing important work in some areas where it also cared about justice — in particular, Darfur.

Then, the Obama administration announced a reset in its relationship with the court, and that’s where I entered the picture. The Obama administration directed various executive agencies to look for ways to support the court where the work that it was doing was consistent with US policy.

Then, we had the first Trump administration, which reversed course almost immediately and eventually imposed sanctions on senior figures, including the prosecutor herself and one of her key aides.

Then, we get to the Biden-Harris administration. They pulled down those sanctions and again launched a reset of the relationship. At that point, there were a number of situations where the court was working, including following the brutal war of aggression by Russia against Ukraine.

Here we saw a remarkable rise of bipartisan support for the work of the court. You had senior Republican figures in Congress supporting the court. The late Sen. Lindsey Graham (R-SC) led a resolution that was supporting justice in Ukraine. Secretary Rubio, then Sen. Rubio, joined that resolution. There was new legislation passed that made it easier for the United States to support the work of the court.

Of course, with the second Trump administration, we have reversed course again, and in particular with Rubio’s announcement.

Well, let’s talk about the reversal. Secretary of State Marco Rubio is at one point on board with the ICC, and then recently he vows to dismantle it. What happened here?

It’s not clear what the precipitating event is, to be honest. There is no existential threat at present. Obviously, there’s always the concern that this is some kind of a distraction because matters are not going well in Iran and with respect to the economy — that this is something to pull eyeballs away from those matters onto something that he can look tough in. Is this just kind of red meat for anti-multilateralism or is there something that is not made public that is happening?

Is there anything actually that Marco Rubio or anyone else in the United States at the highest level could do to the International Criminal Court to put an end to it?

The International Criminal Court is part of a larger system of the rules-based order that we’ve been trying to build since World War II. Almost all of our friends and allies are members of this court and they care deeply about its success. They are committed to seeing a system of international criminal justice. So, no is the answer. The United States alone cannot dismantle this court.

Now, it can injure the court and it has already done so. There are already eight ICC judges, including judges who hail from some of our closest allies — France, for example — who have been subjected to brutal sanctions. They can’t use credit cards that pass through New York. They can’t make reservations online because of financial sanctions. They can’t travel to the United States because of travel bans, et cetera. The chief prosecutor and two of his two deputies have been sanctioned. Non-governmental organizations that are involved in human rights in Palestine have been sanctioned and a UN figure has been sanctioned. Those measures are already in place.

What his most recent campaign seems to announce is some diplomatic move to try and convince states to leave the court or to cease their cooperation with the court. And we have seen in recent days a couple of states announcing that they were withdrawing. These are mostly states within Africa, but also Venezuela, subject to investigation by the prosecutor’s office. The United States can certainly injure the court, but there’s no way that we could dismantle the court.

Most Americans don’t spend a lot of time thinking about the International Criminal Court, but they may know it because lately, it has gotten a lot of attention that the court has issued an arrest warrant for [Israeli Prime Minister] Benjamin Netanyahu. New York City Mayor Zohran Mamdani has said he would like to see Netanyahu arrested if he comes to New York.

Mamdani has said he does not have that power. He cannot order the NYPD to do it, but he would like for it to happen. What are the chances that Benjamin Netanyahu comes to the United States and is arrested?

Pretty close to zero, if not actually zero. This is a matter of federal law and international law. And the Headquarters Agreement between the United States and the United Nations, which placed the headquarters of the UN in New York, basically gives certain privileges and immunities to individuals who are coming to New York to attend official functions.

New Yorkers are a feisty bunch. So when word is out that Benjamin Netanyahu is in New York, can you imagine the protests that would happen? Can you imagine the embarrassment that he might experience when he’s supposed to be giving his remarks at the General Assembly High-level Week where all the heads of states convene to deal with transnational issues and his motorcade is ensnarled in protests protected by the First Amendment, calling for his arrest for various international crimes? If I were his lawyer, I would say, “There’s no chance you’re going to get arrested.” But honestly, it could be a miserable visit, given all of the strong support for accountability in this matter in the United States.

This is a lot of drama for a body that for a long time seems to have avoided a ton of very public drama. So who gets hurt in all of this? Is it the court? Is it the US and its reputation? Where do you think this leads?

Unfortunately, I think everyone comes out not looking great here. The court needs to put in place measures to be able to receive those complaints by witnesses, whistleblowers, victims themselves, process them quickly, but also fairly to all parties involved. The United States looks terrible as well, launching a campaign like this against an international organization whose mandate it is to deliver justice for the worst crimes known to humankind.

AI is the hottest thing in medical care right now — but many of us feel trepidation about it. Just one illustrative public survey sample: An October 2025 KFF poll found just 8 percent of Americans reported feeling a “great deal” of trust in AI managing their appointments or analyzing their health records, and only 32 percent said they would trust an online health tool that uses AI to access their medical records to provide personalized health information.

But many clinicians and healthcare administrators see AI as a powerful new tool that offers myriad opportunities to streamline and improve treatment. A 2026 survey found that more than 80 percent of US doctors use AI professionally — doubling the share from 2023. Physicians are excited by AI’s potential to keep more accurate notes of interactions with patients, to act as a second pair of eyes for human doctors, and to monitor people at risk of deteriorating and ending up in a dangerous situation.

The disconnect between what people and their providers want from AI could create more distrust, at a time when faith in the healthcare system and the medical profession have slid. Patients today want to feel empowered and in control. How can that be possible when these seemingly godlike machines are becoming more and more entrenched in our hospitals and doctors offices?

The answer comes in four words: “human in the loop.” It’s the principle upon which the ethical integration of AI depends and it could help to bridge the gap between lay people and the professionals on AI in medicine. In surveys, people are much more comfortable with the idea of their doctor using AI as an assistant than with AI acting on its own. And most clinicians want to use AI in that way, as a second opinion or passive monitor, not as a replacement for their judgment. There are real fears among the healthcare workforce about that possibility: A group of NYC nurses who were recently laid off claim it’s because their labor was going to be replaced by AI. “Human in the loop” appears to be a point of agreement between doctors and patients at this pivotal moment.

“Doctors…and nurses and staff always have been interested in primarily making the best decision for the people under their care — and these tools can help with that,” Alison Callahan, a research scientist at Stanford University who works on AI programs used in the university’s health system, told me. “The interest in making sure those tools are accurate is high.”

But what does “human in the loop” really mean in practice? How can you know when and how your doctor is using AI? And what is the best way to talk to your provider about the sudden influx of artificial intelligence in healthcare before a robot starts taking appointment notes or analyzing your MRI? I called some leading experts to find out. 

How AI is currently being used in medicine

Patients and providers alike are incorporating AI into healthcare. Individuals are using commercial AI chatbots to ask about their symptoms or the health metrics tracked by their Apple Watch, while large academic medical centers are developing sophisticated programs and protocols to try to improve medical care at the population level.

It starts with ChatGPT, Claude, etc. — the large language models that are available to the public. People are increasingly turning to them to try to understand what’s going on with their own bodies. Individual physicians are also consulting with large language models to answer questions or get up-to-date on the latest research as they figure out how to best care for their patients. 

Then there are ways in which hospitals and doctors offices are adopting AI at the institutional level. Many facilities are using AI as a way to take, collate, and summarize notes on a patient; in theory, it’s a more organized way to keep track of the informal interactions and observations that doctors have when checking on their own patients. Hospitals are also using AI to handle some administrative tasks, like scheduling follow-up appointments; some health systems have even started to use AI to help patients get ready for appointments — to send reminders about colonoscopy prep, for example.

And finally, you have maybe the most ambitious use of AI by health systems right now: as a diagnostic and risk prediction tool. In these cases, AI might offer a second opinion when, for example, a doctor is triaging a patient in the emergency room. It might help the ER staff figure out how to prioritize patients. Or these programs could monitor people either during a hospital stay or out in the real world (by drawing data from the person’s wearable) and make predictions about who may be at higher risk of complications and require further care. AI could recommend that somebody would benefit from seeing certain specialists or receiving a specific medicine or lab test, and generally offer proactive advice about the patient’s medical care.

But at this point, AI adoption is still “highly localized,” said Jennifer Goldsack, CEO of the Digital Medicine Society, a nonprofit that works with healthcare providers, drug makers, and government agencies on how to incorporate new tech (including AI) into clinical care. It depends on the individual doctor or health system. A lot of them are setting up their own programs and their own protocols for how to use these tools.

That is a big reason why it is so important for patients to be proactive about understanding how AI is being used for their health care. You can’t make assumptions; the only way you’re going to know for sure is to ask.

The questions you should ask your doctor about AI

By and large, experts say, patients should feel confident: Doctors and nurses want to keep a human in the loop, even as they integrate AI into their workflows.

“It will be a doctor who is going to be reading that summary or a nurse who is going to be reading that summary and then taking an action to order a lab or put a recommendation in for a follow-up appointment,” Callahan said. “There is high interest in making sure that that is the right decision for that person. That hasn’t changed.” 

Still, many patients say they’d be more comfortable with AI use if their doctor fully explained it in advance. And health systems may have their own priorities that push their facilities toward more rapid AI adoption and delegating more tasks to these AI tools, as seen in the recent NYC nurse layoffs.

So if you want to be informed on exactly where this technology is present and have the ability to consent to its use, you have every right to ask your doctor, experts say. 

“AI is new, but the trust that serves as the foundation of the physician-patient relationship is not,” Timothy Keyes, a machine learning scientist at Stanford Health Care, told me over email. “To that end, I think that conversations about medical AI use should be open, honest, and transparent — just like any other conversations about shared decision-making in the clinical environment should be.”

For some things, your doctor should be asking you proactively if you consent to AI use — note-taking, for example. At my most recent primary care appointment, my doctor asked me if it’d be okay for him to use AI to take and summarize notes from our conversation; Goldstack told me she’d experienced the same at recent physician visits. (This is probably the most common AI use that you will encounter, and Keyes said it’s worth considering giving your consent: “There is growing evidence that they reduce physician burnout and save them at least a bit of time each day writing notes.”)

There are also a number of direct questions that you can ask:

• Will AI be used in my care and how?
• How is my data being protected?
• Can I opt out of any AI services that I do not feel comfortable with? (Keyes noted that patients should be allowed to opt out of any care, AI-related or not; if opting out is not an option, ask how a human provider will be involved.)
• How is the health system or clinic making sure that any AI system they use is working as intended?

And the transparency goes both ways. If you’re asking a question because you consulted ChatGPT before your appointment, tell your doctor. If you’ve talked with a chatbot because of mental health struggles, tell your doctor. And at the same time, feel free to ask your physician how you yourself could actually use AI in a responsible and productive way to improve your health.

“This opens up the opportunity for both the physician and the patient to be humans-in-the-loop,” Keyes said, “in different parts of the loop, with different perspectives, using an AI system to better understand the bigger picture.”

In a way, the novelty of AI and its rapid adoption is an opportunity for all of us to be nosier and more inquisitive patients. What all of these questions really come down to, Callahan said, is how your doctor is making decisions about your health care. That is relevant to all of us, no matter how AI is involved or even if there is no AI being used at all. 

Callahan said she always has a list of questions for her doctor when they recommend a course of treatment: “What are the factors in my health that are informing this recommendation that you have? Would you be making this recommendation for other patients who are similar to me? What can you tell me about the outcomes that I might expect to experience if I say yes to this?”

“I actually think if they can point to the part of your health that is connected to the decision, whether or not an AI tool helped to make that connection is secondary to their ability to communicate effectively to me about it, and help me to feel engaged in making a decision about my own care,” she said.

AI is changing medicine quickly, for both patients and their doctors. The best way to stay ahead is to talk about it.

This story was originally published in The Highlight. To get access to member-exclusive stories like this every month, become a Vox Member today.

America’s housing supply was built for a world we no longer live in. But what will replace it? 

As the nation turns 250, that is one of the most important questions we face in the coming decades. Building enough homes, of the right kind, and in the right places is a prerequisite for economic opportunity and growth. Our crippling housing shortage is upstream of many of the problems that ail the US, from our cost of living and increasingly zero-sum politics to our seemingly intractable national bad mood. 

The root of the problem is that the United States governs housing under a nearly century-old paradigm that’s been cracking under growing strain. Since the end of the Great Depression and World War II, when the baby boom massively increased the country’s population and millions of Americans sought relief from derelict urban housing, suburbia has been the country’s default blueprint for development. Big single-family homes, two-car garages, and giant strip malls were not merely consumer preferences. They were also written into law by rigid zoning codes — the rules that dictate what kinds of things can be built where — incentivized by midcentury lending standards, and absorbed into the professional common sense of planners and builders. 

The system shaped not just the suburbs, but also many cities, and has kept homes scarce, expensive, and sprawling, resulting in a housing affordability crisis that has come to dominate politics. And in the decades ahead, this pattern will become even more misaligned with the reality of American life. Households are getting smaller, and Americans are getting older. If today’s low immigration rates continue, the US Census Bureau projects the country in 2076 will have fewer families with children and working-age adults, and far more seniors — the inverse of the demographic transition that drove the great suburbanization. Climate change and new technology, such as driverless cars, will also force cities and suburbs and populations to adapt.

US history offers reasons for optimism, showing repeatedly that we can reorganize ourselves with extraordinary dynamism when the occasion calls for it. Our cities have already lived many lives, growing from tiny outposts into world-leading metropolises, before receding again in the wake of suburbanization and de-industrialization, and then more recently gaining new life with influxes of younger generations.

The transformations ahead may not be as physically dramatic as those of the American past, but they call for equally monumental cultural and political shifts in our approach to housing. We’re already making progress: The ascendant “yes in my backyard” (YIMBY) movement has persuaded states and localities to roll back restrictive policies that make it essentially impossible to build enough homes. The effects of those reforms are slowly making themselves felt in more affordable neighborhoods. 

But there is still far more to do. Housing reformers will need to turn their attention not just to removing bad regulations like single-family zoning and minimum lot sizes, but also toward reviving a role for government in shaping our communities through real, big-picture planning. Doing so would supply a missing piece in America’s housing agenda — making US cities and suburbs not just more affordable, but more vibrant and livable and helping us better use our existing infrastructure. That will matter even more as a shrinking working-age population makes endless outward sprawl harder to sustain.

A more abundant, more varied, and even more fun housing future is not inevitable, but it is decisively within reach. Here is what the future could look like by America’s 300th birthday, if we commit to making ourselves anew. 

Suburban retrofit abundance

Arthur Nelson, a professor emeritus of urban planning and real estate development at the University of Arizona, has a few words of warning for anyone trying to report on what cities might look like in a half-century: “You’re not going to be right.” 

Urban planners tend not to project many decades into the future because what that future will look like invariably hinges on factors we couldn’t possibly imagine today. The most important unknown for our future population and housing needs will be whether the US opens its doors to many more immigrants, as it has done at times in the past. Assuming immigration rates remain low, however, US population is projected to peak somewhere around the mid-21st century and fall thereafter; by 2076, it will have dropped back to today’s size, on the way to declining further. 

Despite that uncertainty, many of the housing abundance advocates, policy experts, and urban planners I spoke to for this piece expressed striking optimism that the future of housing will be better than the present, and enthused about how much can be transformed in 50 years. Start with the suburb, where the majority of Americans live today, and where the future of American housing will be decided. 

Imagine that, in 2076, you’re walking through a residential neighborhood in La Mirada, California, a midcentury, southeastern suburb of Los Angeles, one of the regions at the epicenter of today’s housing crisis. The bones look much like the suburbs we know today — gently curving streets, sun-baked yards, low-slung buildings set back from the sidewalk — but the old single-family monoculture in many neighborhoods has loosened: Houses built during the region’s mid-20th-century building boom now have small cottages, also known as accessory dwelling units (ADUs), tucked beside them. Some bigger houses have been subdivided into two homes. Other lots now hold triplexes, fourplexes, and small apartment buildings that sit comfortably among single-family homes. A few houses have become shared homes for seniors who want support and companionship without being cordoned off into a retirement community. (In 50 years, that will include people born in the 1980s, 1990s, and ’00s — me, and perhaps you, too.)

Even as the overall US population has plateaued, this late-21st century Greater Los Angeles might be home to millions more people than today, but it has not had to push all of them farther into the arid desert or the fire-prone hills. Because as many as two to three times more people are living on each acre of land, housing costs have eased. Many people rely on shared driverless cars, freeing up the space that would be needed for car storage, so land that had been parking can be put to better uses.

Perhaps most strikingly different from today’s suburbia, the hard wall between home and commerce — which is near-universally mandated by local zoning codes today — has softened. Near the neighborhood’s edge, where local streets meet a larger main road, a neighborhood grocery and clinic have opened on what used to be strictly residential lots. And, yes: That is a donut shop running out of a neighbor’s garage. A few doors down, an old three-bedroom has become a small co-working space, and a converted garage houses a bicycle repair shop. Housing has not only become more affordable, but with more of the rituals of daily life mixed in, the suburb has gained a richer, more connected public sphere. There are simply more people around — walking, talking, and lingering. 

Could we get there? Some experts I consulted predicted that simply easing regulations on what can be built in these neighborhoods will unlock a long-suppressed capacity for creative adaptation, allowing suburban areas to evolve in precisely this way. In the suburbs of superstar cities like LA, San Francisco, and Boston, land values are so high that property owners have strong incentives to redevelop single-family lots into more economically valuable uses, like multiple housing units. They just need to be legally allowed to do so. 

The YIMBY movement’s recent legislative successes have already put much of the country on that path. More than a dozen states, including California, have passed laws to allow building ADUs on residential home lots, and many others have new laws allowing denser housing, like townhomes and small apartment buildings in these areas too.

“I suspect it’s just a matter [of time] before the rest do the same,” M. Nolan Gray, senior director of legislation and research for the advocacy group California YIMBY, told me in an email. The upshot for the far future of housing is that “detached single-family zoning is dead,” predicts Gray, who is also an urban planner by trade. “I think the typical lot in a (non-HOA) suburb of a typical US city in 2076 will have at least a second unit; perhaps a manufactured ADU plopped in the back, perhaps a McMansion that has been converted into a duplex.” 

Such reforms also offer important tools for a graying population. As Nelson has argued, the number of senior households in the US is already growing faster than younger ones, and without zoning flexibility to redevelop single-family homes into smaller units or adapt them to the changing market in some other way, older homeowners would face the prospect of being stuck with large, hard-to-maintain houses. 

Even more dramatic suburban retrofits might come in commercial districts — think aging, abandoned malls, strip malls, and “power centers” built around big box stores and even bigger parking lots. As Vox’s Rachel Cohen Booth has written, there is a growing movement to turn those sites into housing. 

An increasing number of states have started allowing apartments in commercial districts, where building multifamily housing is an easier sell politically than allowing it in residential areas where neighbors might resist. 

Meanwhile, Gray added, communities across the country have been very rapidly repealing parking minimums — the fixed number of parking spots required at every residence and business. As minimums are phased out, parking lots can be redeveloped  into housing and other uses better than acres of underused, heat-trapping asphalt.

“I expect most of today’s strip malls and shopping malls will gradually be converted into mixed-use pocket neighborhoods,” Gray predicts — a distinctly American version of a much older human pattern of development, where homes, shops, services, and public life are allowed to coexist. 

Maybe we need an urban planning revival

Despite early signs these reforms are nudging American housing toward a better future, the national rate of new home construction has barely moved, and forecasters expect little change in 2026. That owes less to the reforms than to the broader economy: mortgage rates largely stuck above 6 percent since 2022, which raise borrowing costs for builders and freeze existing owners in place; rising material and labor costs; and a thinning construction workforce worsened by President Trump’s immigration policies. Where YIMBYs have passed new laws, many local governments prove adept at finding ways to flout them. Housing advocates will have to commit themselves to a long fight, until change exists not only on paper, but also in the real world.

Even then, unleashing the free market alone won’t solve every problem with how American cities and suburbs are built and organized, or how they feel to live in.

Those failures are visible everywhere: Have you ever wondered why so many residential streets wind around in aimless, circuitous patterns, disconnected from the town around them? Or why you are forced to endure a nightmare commute to drive just 10 miles? These are all failures not just of too much regulation in the form of rigid zoning, but also of an absence of coherent urban planning. 

Robert Goodspeed, an associate professor of urban planning at the University of Michigan, points to good planning as an essential missing element in today’s housing reform movement. “I think that the YIMBY movement has completely missed the importance of planning,” he told me. “Even if we repealed all zoning, it still doesn’t realize a well-designed, well-planned community that has high quality of life.”

The zoning approach works so poorly because it micromanages what can or cannot be built on any given parcel of land. It’s a set of prohibitions on what the private market is allowed to do (made without regard for how people actually want to live): No apartments can be built on this street, even if there’s an enormous amount of demand to live there; no coffee shop may be opened on that corner, even if it would fill up with neighbors delighted to make it part of their daily routine.

Urban planning, on the other hand, at its best is concerned with the public realm. It oversees the larger body of a city or area and provides the connective tissue of its infrastructure — roads, transit, parks, sewers, and other utilities — that links up the space, something the private sector can’t provide. It allows cities to function as a cohesive whole and has the potential to give the public access to what a community has to offer. 

In the late 19th and early 20th centuries, American planners were animated by real civic ambition, laying out future-minded street grids that could continue to grow and connect the residential and the commercial. One reason more recent development has been so poorly designed, Gray argues, is that planners have become so bogged down enforcing the tedious minutiae of zoning codes. “Zoning has utterly consumed planning, to the point that many city planning departments now do little that would resemble what a normal person might think of as planning,” he writes in his book Arbitrary Lines. Gray calls for abolishing zoning altogether, and freeing up municipal planning offices for more useful work that can accommodate the changes we know we need to make to our housing stock. 

Easier said than done, of course. The US comprises thousands of individual cities and suburbs, each with its own zoning code, and they will not surrender that authority willingly. 

But it’s not crazy to imagine that, in 50 years, planning in the US looks very different from today. Local governments derive their authority to zone from states, Gray points out. And just over the last few years, states from Montana to Maine to Oregon have been wresting certain zoning powers away from cities and suburbs. That shift could provide the seeds for a future where planning is run on a more unified, regional level, much like it is in peer countries like France and Japan. Local planners might then be empowered to focus on what matters — facilitating humane growth in places that people want to move to, and creatively solving the challenges that will arise from retrofitting a built environment that was not designed to accommodate that sort of evolution. 

Could we just…start over with all-new cities? 

One of the country’s most audacious attempts to revive American urban planning is unfolding in Solano County, California, roughly an hour north of San Francisco. There, a controversial, billionaire-backed company is advocating an iconoclastic solution to the Bay Area’s housing affordability crisis. 

Instead of fighting through red tape to get permission to add a few homes in Palo Alto or Marin County, the startup California Forever wants to build a new city from scratch. Forty years after construction begins, the company hopes, it would be more populous than the St. Louis, Orlando, or New Orleans of today, providing homes to around 400,000 people and jobs in advanced manufacturing, shipbuilding, and other industries. 

The project has not yet broken ground, and, ironically enough, likely won’t be able to for several more years, as it moves through environmental review and other required regulatory steps. But it eventually hopes to prove that it’s still possible to build physical things in the world’s tech capital, the place that has transformed everyday life at extraordinary speed but still struggles with the elemental task of making room for people to live. The project has won support from many prominent housing reform advocates, who welcome it as a bracing challenge to an untenable status quo that has meaningfully damaged the US economy. (According to one widely cited study, restrictive housing policies in superstar metro areas, including San Francisco and San Jose, lowered overall American GDP growth by around 36 percent between 1964 and 2009 because they prevented more people from moving to those highly productive cities.)

Despite its Silicon Valley provenance, California Forever’s most interesting ambition is less futuristic than throwback. It hopes not merely to add a mass of badly needed housing stock to the Bay Area, but to deliver it in the form of a pedestrian-centered city of the kind that hasn’t been built in the US in a hundred years. Its architectural renderings show handsome mid-rise townhomes, apartments, and single-family homes along shaded, walkable streets with a bus rapid transit system, all organized around a traditional grid network of streets. Gabriel Metcalf, the head of planning for California Forever, told me he predicts the city will eventually have the lowest per capita rate of car travel anywhere in the US other than New York City.

Of course, the project in its full form might not get past regulatory hurdles. Even if it does, it could end up being too expensive for the people who work in its schools, grocery stores, and coffee shops to live in, especially with California’s high labor costs, environmental review, and other expenses baked in. It’s also very difficult to build a successful city from the top-down. 

But whatever becomes of this movement to build entirely new cities, it is tapping into a real gap that already exists in the US housing market: Despite our reputation for being car-loving suburbanites, many Americans want something different. A 2026 Pew Research Center survey, for example, found that 44 percent of respondents say they prefer to live in a walkable area — even if the homes are smaller (other estimates actually put the number higher). The surest prospect for making that a reality might not be new cities, but repairing existing ones. 

Alicia Pederson, a Chicago-based writer, researcher, and founder of the organization Courtyard Urbanist, predicts that, with good urban planning, we could in 50 years see a “golden age of American city-building.” With a graying and eventually shrinking national population, many cities will have to work harder to attract and retain residents by offering a better quality of life, she told me in an email. That might mean providing better housing options that make vibrant, walkable life accessible to more Americans without sacrificing the benefits of suburban single-family homes: spacious, sunny housing units and abundant green space. The kind of courtyard blocks common in some European cities offer one elegant solution: They occupy an entire city block, with a perimeter of mid-rise buildings and an interior yard. And they can accommodate homes in a range of sizes, which are more flexible and easier for aging people to maintain than detached houses. 

The future is still up for grabs

It’s entirely possible that sheer inertia keeps the US on its current sprawling trajectory as it approaches its 300th birthday, with reforms producing only a scattering of ADUs and boxy apartment buildings often derided as “gentrification buildings,” rather than any deeper transformation of the American built environment. 

Arpit Gupta, an associate professor of finance at New York University who I consulted because of his talent for poking holes in urbanist orthodoxies, predicted that the US by 2076 will actually see “a dramatic increase in sprawl” thanks to the future adoption of autonomous vehicles. That’s because he and many other transportation researchers believe many people would be willing to tolerate longer commutes in self-driving cars than they do in cars they have to drive themselves, providing one more reason to push housing ever outward. Minus the self-driving cars, that’s what’s happening in the hyper-sprawling and still growing Sunbelt, where new housing continues to be built farther and farther from city centers. 

But there are many other paths we might take. Domestic migration may begin shifting northward in the coming decades, amid a warming climate and water scarcity in the Southwest. Many Midwestern cities are showing signs of renewed growth (may I recommend moving to Madison, Wisconsin?), offering a chance to build more and better housing on the region’s extensive pre-war urban bones. And it’s much too early to assume that AVs will massively increase the amount we drive, Michael Manville, a professor of urban planning at UCLA, cautioned me. Different policy choices could lead to shared self-driving systems that encourage less car ownership and more density.

The future won’t vindicate every utopian blueprint — nor should it. Our housing system ought to be open and capacious enough to accommodate the country’s diverse and evolving preferences. The way we’ve organized housing for much of the last century has given us not only pervasive unaffordability, but also too few choices, too few versions of the American dream. That very scarcity is part of why Americans today are so angry at one another: It feeds the sense that we’re fighting over scraps. 

But if we make room for more ways of living together and think big about how to get there, we may find ourselves less trapped by the failures of the present than we think. Cities often surprise us: Fifty years ago, who could have predicted that places like New York City and Boston, then battered by population loss and disorder, would recover so dramatically? 

The trajectory we take in another 50 years will surely confound our predictions, too. And that’s reason enough to build something less brittle than what we inherited — a housing approach with enough room, variety, and imagination to enable American life to change again.

This story appeared in The Logoff, a daily newsletter that helps you stay informed about the Trump administration without letting political news take over your life. Subscribe here.

Welcome to The Logoff: The Trump administration is further limiting due process for asylum-seekers in the US.

What’s happening? On Tuesday, the administration issued a rule changing how some asylum requests are handled. Under the new policy, immigrants in more than 444,000 asylum cases could be denied the chance to speak with an asylum officer and claim asylum, which requires them to have experienced persecution, or the threat of persecution, in their home country because of their race, religion, nationality, political opinions, or another characteristic. 

Instead, those immigrants would be redirected to immigration judges — who could order their deportation without any additional process. 

The change, according to the administration, is intended to help clear a substantial backlog in the US asylum system, which has 1.4 million cases currently pending. But it fits a pattern by the Trump administration of dramatically curtailing access to asylum in the US. 

What’s the context? Under the second Trump administration, many previous immigration judges have been forced out or fired from their roles. Their replacements, as Bloomberg reported earlier this year, are minimally trained and instructed to deny most asylum claims outright. 

What’s the big picture? The Trump administration also has a long record of sending immigrants back into dangerous situations in their home countries, or even to countries to which they have no connection. 

Last year, as my colleague Ian Millhiser reported, the Supreme Court effectively allowed the administration to nullify the Convention Against Torture and send immigrants to war-torn countries like South Sudan. 

And those deportations are poised to get worse: In June, the Court also cleared the way for Trump to end temporary protected status for immigrants from Haiti and Syria, without consideration of procedural rules. Now, Immigration and Customs Enforcement is reportedly preparing to target hundreds of thousands of Haitians living in the US for deportation, even though the island nation is dealing with serious and widespread gang violence. 

With less than 100 days until the 2026 midterm elections, don’t miss my colleague Astead Herndon’s new newsletter, The Midterms, Actually. Every week, Astead breaks down the big ideas and key people behind the political shifts shaping the 2026 elections. You can subscribe here.

And with that, it’s time to log off…

Want to spend less time on social media? Here’s some excellent advice from my colleague Constance Grady, available here with a gift link. 

Thanks for reading, have a great evening, and we’ll see you back here tomorrow!

This story was originally published on June 29 in The Highlight. To get access to member-exclusive stories like this every month, become a Vox Member today.

America in the summer of 1976 was not in a good place. 

The president who presided over the country’s bicentennial, President Gerald Ford, only had the job because the previous president and vice president had resigned in disgrace, making him the sole US president who was never actually elected. The Vietnam War had ended in defeat and disgrace when Saigon fell the year before, after the deaths of nearly 60,000 American servicemembers. Inflation hit double digits in 1974 and stayed ugly, unemployment sat near 8 percent, and economists had to invent a word — stagflation — for an economy that seemed to encompass the worst of both worlds.

Given all that, you might assume the national mood leading up to the 200th anniversary was grim. And, yet, on July 4, 1976, something strange happened: Americans threw themselves a hell of a party. 

In New York Harbor, more than 200 tall ships sailed up the Hudson for Operation Sail, drawing an estimated six million spectators — the largest crowd in the city’s history. Ford reviewed the fleet from the deck of the aircraft carrier USS Forrestal. It was the same scene up and down the country that day: parades in small towns, fireworks over the National Mall, church bells ringing in unison at 2 o’clock. It was one cathartic day of celebration after a decade that had offered little reason for it.

And when pollsters asked people how they felt about the country’s future that year, the mood was, improbably, sunny. A Roper survey found more Americans were optimistic than pessimistic about the future by a nearly three to one ratio. More than three-quarters told Gallup the nation had already achieved at least a fair amount of its founding ideals. Somehow, a nation that was in the middle of a genuinely miserable decade looked in the mirror and liked what it saw.

Jump forward 50 years, to this year’s 250th anniversary, and you’ll find the vibes flipped. Roughly 60 percent of Americans tell pollsters the nation is on the wrong track. A majority say its best years are behind it. About three-quarters think today’s children will end up worse off than their parents. Asked a version of that same founding-ideals question from 1976, 77 percent now say the founders would be disappointed in what we’ve become.

But just as they were in 1976, the vibes don’t match reality. Set the mood aside and look only at the numbers, and the country that felt so good in 1976 was, by the most important measures, a worse place to be alive than the country that now feels so terrible on its 250th birthday.

Start with whether you’re alive

Let’s start with the most basic test of how a society is doing: how long its people live.

Life expectancy at birth in the US was 72.6 years in 1976. In 2024, it reached a record high of 79 years — an extra six and a half years of life. At the start of life, a baby born now is far more likely to survive its first year than one born during the Bicentennial, while cancer, once nearly a synonym for a death sentence, now kills a much smaller share of the people it strikes. 

The US made those gains by stopping some of its worst habits, things that were commonplace in 1976 . You might have seen the Bicentennial celebrations through a cloud of smoke, as cigarettes were woven into ordinary life — on airplanes, in offices, in hospital wards — and roughly 37 percent of adults smoked. Today, it is closer to one in 10, and it keeps falling. 

The heart disease and lung cancer that were connected to all that tobacco have receded with it. Add seatbelts and airbags, better trauma care, and cheap drugs that lower cholesterol and blood pressure, and the result is a country where the things that were most likely to kill an American in 1976 are less deadly now.

The America of 1976 sat at the leading edge of a brutal crime wave; the murder rate would peak in 1980 and stay high for more than a decade. By the early 2020s, however, violent crime had fallen back to roughly a 50-year low, and homicide rates this year may end up at a record low. And the single most dangerous thing most Americans do — get behind the wheel of a car — is far less likely to kill them, with the death rate per mile driven now a fraction of what it was at the Bicentennial.

The country got cleaner, and richer, and fairer

In 1976, the air in American cities carried lead, an honest-to-God neurotoxin that was pumped out of every tailpipe of the more than 90 percent of American vehicles that used leaded gasoline. 

Rivers literally caught fire: The Cuyahoga in Cleveland had burned so many times it became a national joke, and Lake Erie was widely written off as dead. And things were bad outside Ohio, too. In Los Angeles, the smog got thick enough to keep kids inside at recess and erase the nearby mountains from view.

Since 1970, however, the combined emissions of the six main air pollutants the EPA tracks have fallen 78 percent — even as the economy nearly quadrupled in real terms, the population grew by tens of millions, and Americans drove far more miles. That split, with growth going one way and pollution the other, is one of the least celebrated but most consequential triumphs of the past half-century, the product of legislative efforts and technological response. And lead? It’s essentially disappeared from the air. 

And it’s not just economic or environmental statistics that have improved; society advanced, as well. Women now earn the majority of college degrees. The Black poverty rate sits near a record low. Support for same-sex marriage is now the norm — maybe the single biggest social change from 1976, when homosexuality was criminalized in most states. Pick a metric more or less at random, and the line usually runs the right way.

This is not a matter of cherry-picking a few flattering numbers. It is the overwhelming direction of the evidence, across health, wealth, safety, rights, even the basic cleanliness of the physical world an American walks through every day. Measured against its own recent past, the US is in some of the best shape it has ever been.

So what’s with the bad vibes?

A more perfect union doesn’t mean perfect

Well, some things genuinely got worse, and they are not insignificant. 

Americans’ faith in their government has collapsed; fewer than one in five now trust Washington to do the right thing, down from solid majorities in the 1960s — and the country is more polarized than it was in 1976. Democratic decline and even collapse is a live threat. Those economic gains I highlighted above have flowed disproportionately upward. The top 1 percent’s share of income, near a historic low in 1976, has since roughly doubled.

Climate change barely registered in 1976. The carbon dioxide in the atmosphere has since climbed from around 330 parts per million to about 427, and warming will only get worse in the future. And buying a home increasingly feels out of reach for many. By 2024, a record share of households spent more than a third of their income on housing. (Notably, though, the percentage of Americans who own a home is slightly higher than it was in 1976, and those homes are much larger on average.) 

These are real problems, but they remain exceptions to a broader half-century trend of improvement. And a country that scrubbed the lead from its air and put out smoking can overcome new challenges, as well. 

Which brings us back to a tale of two birthdays. In 1976, Americans had less of nearly everything you can count, and, yet, they reported feeling good about the future anyway. In 2026, we have more, and we don’t. 

Just as it can be for a person, a country’s mood is a poor instrument; it measures the story we are telling ourselves more than the lives we are actually living. For all our pessimism about the state of the nation, more than three-quarters of Americans say they are satisfied with their own lives.

The Americans crowding New York Harbor in 1976 were cheering a country that was sicker, dirtier, more dangerous, and less free than the one we live in now. But they were right to cheer; the line was already bending the right way, and it kept bending. It turns out a nation can travel a long way, even while it is convinced it is going nowhere.

A version of this story originally appeared in the Good News newsletter. Sign up here!

Last week, the Food and Drug Administration (FDA) approved a small pill called enlicitide. It is a tablet you swallow once a day on an empty stomach with a sip of black coffee, water, or tea. But it does something that until now took a needle and a specialist’s prescription: It lowers the most dangerous kind of cholesterol by nearly 60 percent, about as much as the strongest injectable drugs on the market.

If that sounds less innovative than some of the medical advances I sometimes cover here — there’s no AI or gene editing involved — you’re missing the story. Enlicitide is just the latest example of how medicine has been quietly making progress against the deadliest thing in the modern world.

That thing is heart disease. It has been the leading cause of death in the United States for essentially a century, and in 2025 it killed 694,708 Americans — about one in five deaths — more than every form of cancer combined. Around the world, cardiovascular disease kills roughly 20 million people a year, the biggest cause of death on the planet.

But today, our enemy is on the retreat. In the US, the age-adjusted death rate from cardiovascular disease has fallen about three-quarters since 1950. In plain terms: A 60-year-old today is roughly four times less likely to die of heart disease this year than a 60-year-old was when Harry Truman was president. As I wrote last year, deaths specifically from heart attacks are down 89 percent since 1970.

That progress comes down to a single number. Low-density lipoprotein, or LDL, aka the “bad” cholesterol your doctor always wants you to lower. Until recently, a high LDL score was all but inescapable, something you could nudge lower with a better diet and willpower but struggle to really fix. What has changed is that we can now lower LDL for nearly anyone who needs it — further, more easily, and earlier in life than before.

A lifesaving genetic mutation

It’s a story that goes back 20 years. In the early 2000s, two geneticists at University of Texas Southwestern, Helen Hobbs and Jonathan Cohen, wanted to solve a medical mystery: Why did some individuals have striking low cholesterol levels? They combed the Dallas Heart Study for an answer. They found a handful — many of them Black Americans — carrying a broken copy of a gene called PCSK9. Their bodies cleared LDL from the blood with unusual efficiency, and the payoff was staggering: carriers of the strongest variant had about 28 percent lower LDL and roughly 88 percent lower risk of heart disease than people who did not carry the mutation.

That finding proved lowering LDL prevents heart attacks, and it handed drugmakers a target: copy that gene. Every PCSK9 drug since — including the new enlicitide — imitates a mutation a few people in Dallas were simply born with.

Millions of Americans still take the old cholesterol-lowering workhorses, statins, and they’ve proven highly effective at reducing heart disease for most people. But not everyone: Some people can’t tolerate the muscle aches; others take them faithfully and still don’t get their LDL low enough. Enlicitide is built for exactly those people: a pill as cholesterol-lowering as an injection but without the needle, and a drug that spares them the statin muscle aches.

Closing the loop

If the pill is today, gene editing is tomorrow — and it may be the answer to a problem no pill can reliably solve: getting people to keep taking their medicine.

About half of patients on statins quit them within a year, and a daily pill, however potent, only helps the people who actually take it. So that demands a fix you can’t forget. A company called Verve Therapeutics, now owned by Eli Lilly, has been testing a treatment that makes a single-letter edit to the PCSK9 gene in the liver — one infusion, in theory for life. In its first human trial, published over the spring in the New England Journal of Medicine, a single dose cut LDL by as much as 62 percent, and held it there for more than a year. Instead of a pill mimicking the effects of the genetic mutation that protected those people in Dallas, gene editing just switches off the gene.

As important as it is, cholesterol isn’t the whole story when it comes to heart disease. There’s smoking, which declined from about 40 percent of US adults in the 1960s to under 15 percent today, sparing countless arteries. High blood pressure — the silent condition that killed President Franklin D. Roosevelt at 63 in 1945, when doctors had few effective ways to treat it — can now be caught early and treated with cheap generic pills.

And then there are the GLP-1s. More than one in 10 US adults say they are currently on an anti-obesity drug, and whatever else you may think of them, they’ll make a significant dent in heart disease. In one major trial semaglutide cut cardiovascular events by 20 percent.

The war continues

Still, the war on heart disease won’t be easy to win.

Just because a pill like enlicitide has been proven to lower a lab value does not mean it’s yet proven to lower deaths. They should — the injectable versions of these drugs cut heart attacks and strokes by about 20 percent in long trials. But enlicitide’s own outcomes study won’t conclude for years.

Precisely because the condition itself so widespread, treatments for heart disease will only be effective if they are equally widespread.

Heart disease is shifting, too. The same research showing heart-attack deaths down 89 percent found deaths from other heart conditions — heart failure, arrhythmias, hypertensive disease — up 81 percent since 1970, though because heart attacks were killing several times as many people, overall heart-disease deaths have still dropped by about two-thirds since 1970.  Some of that shift is perversely the result of success: people who might have died of an initial heart attack now live long enough for the heart to wear out in other ways. And some of this is the reverse of progress: As smoking and cholesterol fell, obesity climbed to about 40 percent of US adults, pulling diabetes and high blood pressure with it.

And then there’s perhaps the biggest problem in medicine: access. A 60 percent drop in cholesterol helps only the people who can actually get the drug. Half of patients abandon cheap statins within a year. Enlicitide arrives at about $300 a month with uncertain insurance coverage. The gene edit, whenever it becomes available, will certainly cost far more, and at first will reach only the sickest.

More than 60 percent of US adults are projected to have some form of heart disease over the course of their life. Precisely because the condition itself so widespread, treatments for heart disease will only be effective if they are equally widespread.

Which brings us back to that unassuming little pill. It’s just a tablet, doing what a generation of scientists spent their careers trying to do: turning one of the deadliest numbers in medicine into one you can change. It’s the kind of progress that’s too easy to miss — until it saves your life.

A version of this story originally appeared in the Good News newsletter. Sign up here!

Abdul El-Sayed is among America’s most prominent proponents of Medicare-for-all. 

The frontrunner in Michigan’s Democratic Senate primary literally wrote the book on that policy (or at least, a book on it). In El-Sayed’s view, Medicare should cover “all necessary healthcare” for every American — without co-pays, premiums, or deductibles — and be “accepted everywhere.”

Alas, despite his many years of advocacy, El-Sayed has seemingly failed to persuade his wife of that last point: According to a recent report from the Washington Free Beacon, El-Sayed’s partner, the psychiatrist Sarah Jukaku, does not accept Medicare as a form of payment at her private practice.

This bit of gossip is of little importance, in and of itself. The Free Beacon’s story does nothing to refute the case for El-Sayed’s candidacy or his healthcare plan (his wife’s business is, well, her business). As hit pieces go, it’s weak tea.

Nevertheless, the tension between El-Sayed’s healthcare proposals and his wife’s business practices is real. And it is illustrative of a major challenge facing anyone who wishes to reform our nation’s misbegotten healthcare system: To meet the medical needs of all Americans, reformers will need to defy the interests of most doctors — and in many cases reduce their compensation. 

And that won’t be easy. Few people feel a deep fondness for insurance companies. But El-Sayed is far from the only American who loves a physician.

The biggest obstacle to Medicare-for-all

To understand why Medicare-for-all would be bad news for many doctors — and how the Free Beacon’s story illustrates that point — we must first dwell on one fundamental fact about America’s healthcare system: It’s a rip-off. 

The US spends about twice as much per person on medical goods and services as other wealthy countries. And yet, all that money does not actually buy us much more care. Compared to our peers abroad, Americans are less likely to see a doctor, secure a long hospital stay, or access a timely appointment for medical treatment. On the other hand, we do have the privilege of paying radically higher healthcare prices.

To take just one telling example: In the United States, a coronary bypass surgery will typically cost more than $89,000; in Australia, it costs just $17,741.

Such exorbitant prices are the chief obstacle to any version of universal healthcare. Even with one-third of working-age Americans uninsured or underinsured — and thus, consuming too little medical care — the bill for America’s health sector ran to $5.7 trillion in 2025. 

In El-Sayed’s vision, Americans would consume vastly more medical services than they do today: The uninsured would suddenly have access to every doctor in the country, while everyone else would see their co-pays and deductibles drop to zero, encouraging them to schedule far more doctors’ visits.

This would be a costly proposition in any country. At America’s current healthcare prices, it would be prohibitively expensive. There is simply no way to realize anything approaching the left’s healthcare ambitions without slashing the amount of money that Americans pay per medical service. 

Doctors will pay a price for universal healthcare

Medicare-for-all advocates are aware of this fact. And they’re typically eager to talk about one source of America’s high healthcare prices: The inefficiencies of our private health insurance model. 

In America’s byzantine system, each insurer needs its own teams of auditors, claims reviewers, and myriad other specialists, while every major healthcare provider needs a horde of administrators to navigate the idiosyncratic rules of all these different insurance companies. Americans pay dearly for this bureaucratic bloat. By one estimate, our system’s administrative costs are $500 billion higher than they would be if the insurance industry was consolidated into a single public insurer. 

And yet, as large as that figure may seem, it still represents a fraction of America’s excess healthcare costs. The primary cause of our nation’s exorbitant medical prices is simpler than administrative redundancies: our healthcare providers charge exceptionally high rates.

Hospitals are the biggest culprits on this front. But physicians are also part of the problem.

According to a 2026 study from economists at the University of Chicago, Stanford, and the US Census Bureau, American physicians earn about twice as much as Canadian ones — and four times as much as Swedish doctors. 

Critically, this does not merely reflect America’s greater wealth or wage inequality. It is true that educated professionals of all kinds — financial analysts, lawyers, software engineers, etc. — earn more in the US than they do in other rich countries. But American doctors don’t just earn unusually high absolute incomes — they also occupy an atypically rarified place within their own country’s class hierarchy. About 42 percent of American specialty physicians are in the top 1 percent of their nation’s income earners. Among Canadian specialists, that figure is just 27 percent; for Swedish ones, it is 7 percent.

The main driver of these disparities is straightforward: America imposes fewer price controls on its healthcare sector than other nations do. 

And this is where Jukaku’s practice reenters the picture. 

The public parts of America’s insurance system — Medicare and Medicaid — pay rates that are only modestly above international norms. It is when American doctors bill private insurers — or the rich consumers of boutique medicine — that they really make bank.

As a result, top clinicians like Jukaku often decline to take Medicare. If you’ve got affluent patients beating down your door, accepting Uncle Sam’s rates just doesn’t pay.

Unless the government forces doctors and hospitals to swallow steep pay cuts, however, Medicare-for-all won’t pencil out. According to a widely cited 2018 analysis by the economist Charles Blahous, if a single-payer system kept provider payments constant, national health spending would rise by $3.25 trillion over a decade, even with administrative savings taken into account. By contrast, if all providers were forced to accept Medicare’s rates, health spending would actually fall by $2.05 trillion over the same period.

Soaking physicians is tough politics

Thus, there is a clear conflict between progressives’ healthcare ambitions and medical providers’ material interests. 

Yet the left is often reluctant to acknowledge this reality. El-Sayed tends to portray insurers as the sole economic beneficiaries — and political defenders — of America’s inequitable healthcare system. The fact that hospitals and doctors also profit off the status quo’s dysfunctions does not feature prominently in his rhetoric. To the contrary, El-Sayed suggested in 2020 that doctors like his wife are actually underpaid, even though American psychiatrists earn far higher salaries than their counterparts abroad. 

To be fair, progressives aren’t alone in eliding providers’ culpability. Virtually all Democratic politicians do the same. And not without reason. Politically speaking, it is one thing to denounce the greed of private insurers — the faceless bureaucracies standing between Americans and their desired treatments. It’s quite another to call for reducing the wages of doctors, men and women who perform laudatory work and enjoy widespread admiration. 

Precisely for this reason, however, reformers must grapple with healthcare providers’ investment in the current system. The American Medical Association (AMA), the lobby representing our nation’s physicians, was instrumental in killing past attempts to move toward single-payer. And at least some segments of the medical profession would surely mobilize against any contemporary Medicare-for-all bill that imposed substantial cost controls on the healthcare sector. What’s more, in doing so, they would be able to draw on a resource the private insurance industry lacks — the public’s trust.

How to make healthcare less expensive right now

There is no easy answer to the problems all this presents. But part of the solution is to chip away at providers’ payment rates where progressives already have the power to do so. This would not only help drive down costs for existing healthcare in the short term, an urgent priority all its own, but also would smooth the path to universal coverage in the long run.

That project can take many forms. One would be state-level payment regulations. In Maryland, hospitals receive the same rates, no matter whether their patients pay with Medicare, private insurance, or cash. And their budgets are also fixed, so that they aren’t able to milk fees out of unnecessary care. Rhode Island, meanwhile, caps the growth of its hospital reimbursement rates at the pace of overall inflation. Other states could follow their lead. 

But policymakers should also address the supply constraints that undergird American doctors’ high salaries. US physicians’ ability to command high pay doesn’t just reflect America’s weak cost controls but also a persistent shortage of working doctors. The US has roughly 2.7 physicians for every 1,000 of its residents; the average among comparable countries is 3.9, according to a Kaiser Family Foundation analysis.

In this context, forcing down doctors’ pay might seem perilous. After all, doing so would reduce young people’s incentive to pursue a medical career, potentially deepening the shortage. 

In reality, however, there is no dearth of qualified people who want to practice medicine in the US. We just don’t let many of them do so.

This is partly because American policymakers consciously sought to restrict the number of doctors in the country, beginning in the 1980s. As Robert Orr of the Niskanen Center explains, the US government issued a report in 1981 warning of an imminent “physician surplus” and recommending “immediate action to curtail both the domestic training of physicians as well as the admittance of those trained outside of the country.”

The report’s argument rested on false premises; it failed to anticipate that Americans’ demand for healthcare would rise sharply as they grew wealthier. Nonetheless, its recommendations were largely implemented: Federal support for medical-school scholarships was pared back while funding for residencies has been capped since 1997. 

At the same time, policymakers maintained high barriers to the immigration of fully-trained foreign doctors: Even physicians with years of experience, and credentials in nations with high medical standards, are typically required to complete a multi-year residency before being able to practice in the US.

Ending the federal freeze on residency funding will require congressional action. But states can immediately make it easier for foreign doctors to practice within their borders. In fact, Tennessee established a pathway for such physicians to ply their trade in the state, without having to repeat a residency, in 2023. And many states subsequently enacted similar reforms.

Removing the bottlenecks on America’s doctor supply won’t eliminate the political hurdles to Medicare-for-all. But it would put downward pressure on doctors’ salaries, reduce the risks of capping physician pay, and make the left’s vision of healthcare abundance more feasible. After all, you can’t actually eliminate the care rationing that so many Americans resent by extending insurance coverage or enacting price controls alone. No matter how we pay for our medical services, we can only deliver as much care as our health sector’s resources allow. 

Don’t hate the doctor, love the sick

In saying all this, I don’t mean to convey disdain for the medical profession. Like El-Sayed, some of my best friends are doctors! In fact, my mother, father, brother, and sister-in-law are all physicians. And they all have contributed far more to American society than I ever will. My brother spends his workdays providing lifesaving treatments to cancer patients; I often spend mine sitting at a desk in my pajamas, arguing about politics on the internet. 

Physicians deserve to be well-paid for their strenuous labor. But if we want healthcare in America to be universally affordable and widely accessible, we will need to pay many of them a bit less.