Amy Lindgren

Quiz: What’s more difficult than leaving a job you don’t love? Staying in that job, of course.

At a time when online job boards have made it seem simple to change employers, it can take Herculean effort not to browse the postings whenever your boss makes an unreasonable demand. Even more difficult is resisting the temptation to switch employment when promotions aren’t forthcoming: Job hopping is a well-known strategy for climbing the ladder faster.

So why should anyone keep a job they don’t love? Besides the fear that there isn’t another job out there, I count three reasons: To gain more experience in one’s field; to avoid the hassle of a job search; to leverage specific benefits such as tuition reimbursement.

And of course, the classic reason, which is to ride things out until you can retire. Since anyone trying to last until retirement doesn’t need encouragement to keep a job, I’ll focus on folks who are still building their careers.

For perspective, remember that we’ve just come through a period when employers were conducting bidding wars for some workers. For a brief window after COVID, offers were generous and seemingly abundant, making it feel like a no-brainer to keep switching jobs. Why wouldn’t you promote yourself, so to speak, by taking better and better positions?

The answer to that question was never really obvious, at least to me. In some cases, I watched while hard workers finally got the recognition they deserved as they sprang up three rungs on the career ladder. But in other cases I feared the worst as workers landed in jobs they barely understood, and not always with the support needed to succeed.

In all cases, I was running the checklist: Was the new job really better, or was the worker making the leap before knowing what could be possible if they stayed? Would they be vulnerable in the new workplace, having been last-hired? And if this was the second or third switch in a short time, were they developing a “bad brand,” so to speak?

If you’re in a stay-or-go quandary right now, these questions are relevant to your decision. But if you’re in a can’t-go situation because you perceive the job market won’t accommodate a switch, you might be feeling trapped.

What to do?

I’m going to argue for staying if you’re on the fence, and for making lemonade if you’re feeling trapped. In both cases, you’ll wake up to the same job next week as this week, so let’s look at the advantages that might bring.

First, and not insignificantly, deciding against job search removes a time-consuming task from your to-do list. Until you’ve done it, it’s hard to appreciate how much lighter you feel not facing online job boards and a pile of obligatory emails every day while you search for new work.

Next, knowing that you are staying lets you develop yourself in the job you have. Instead of splitting your attention with a job search, now you can focus on the resources around you. Can you cross-train for a new set of skills? Is there a committee you can join for contact with other departments? Perhaps you’ve been thinking about finishing your degree — is there tuition assistance available?

Intentionally staying put also frees you to set work goals. For example, have you considered becoming a manager? That could be as simple as waiting for other managers to quit, but in most cases it will require some planning.

This is a discussion best suited for your own manager or perhaps a mentor, but becoming a manager yourself might require leadership training or specific skills such as project management or scheduling, or an improvement in your understanding of budgets or human resources. You can make some educated guesses on what you’d need, but a better plan is to gather information and put yourself on a timeline.

Here’s how that could look. Goal: To be a manager in three years. Requirements: Leadership classes, project management training, supervision experience. Steps: Assign each of these to a specific year for completion. For example, take leadership classes in year one, supervise someone (even an intern) starting in year two, schedule project management cross-training in year three.

This is just an example, of course. You may have no interest in becoming a manager, but that doesn’t mean you can’t find something to shoot for over the next three or five years. Once you’ve identified the goal, your success will depend on staying in the job long enough to make it happen.

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Amy Lindgren owns a career consulting firm in St. Paul. She can be reached at alindgren@prototypecareerservice.com.

By JESSICA DAMIANO

If you’d love to grow fruit trees but think you don’t have the space, think again. You don’t need an orchard or even a large backyard to enjoy garden-picked fruit.

Instead, use a method perfected by Louis XIV’s gardeners back in the 1600s at Versailles, when cold, windy winters, not a lack of space, inspired them to train trees to grow flat against walls. Their goal was to use the masonry as a windbreak and insulator, but the method they called “espalier” also made excellent use of a tiny footprint.

The trees’ form maximized their exposure to sunlight, and also enabled the trees to withstand chilly temperatures better than their untrained cousins. Surprisingly, perhaps, they also produced more fruit.

Which trees are good for espalier?

Most trees with long, flexible branches, such as apple, cherry, fig, peach, pear, plum and quince lend themselves nicely to the espalier method. Even ornamental trees like magnolia, firethorn and witch hazel are good candidates.

The name “espalier” comes from French, indicating something to lean a shoulder against, as the trees lean on their supports.

This undated image provided by Missouri Botanical Garden shows a mature espaliered dwarf Moonglow pear tree in the Kemper Center for Home Gardening at the Missouri Botanical Garden in St. Louis. (Tom Incrocci/Missouri Botanical Garden via AP)

But the 17th century French didn’t invent espalier; it is believed to have been practiced in the Middle Ages and even as far back as ancient Egypt. The Versailles gardeners, however, gave the method a name — and fame.

How it works

Training an espalier tree requires equal parts pruning and patience. You remove undesired branches and coax the remainder to grow sideways by affixing them to walls or fencing with wires or frames until they submit to the process and adapt to the pattern.

Trees will send up shape-spoiling shoots that will continually need to be clipped, but the desired branches will take longer to establish.

To accelerate growth, apply a dose of high-nitrogen fertilizer (look for a ratio of 12-4-8 or 16-4-8 on the package label) three times per season — in mid spring, early summer and late summer.

This 2025 image provided by Planting Fields Foundation shows a free-standing espaliered pear tree at Planting Fields Arboretum State Historic Park in Oyster Bay, N.Y. (Planting Fields Foundation via AP)

Don’t expect flowers or fruit during this stage, which can take several years. The point of the fertilizer is to force the trees to direct most of their energy on growth, not production.

When the tree has achieved the shape and size you desire, switch to a fertilizer specifically formulated for fruit trees and cut down the frequency to just one application per year, in spring, following the dosage recommended on the package. (If growing a non-fruiting tree, seek out a product intended for the species).

The method, however, can lead to increased pest and disease problems, as growing a tree pressed against a wall will restrict air flow around it. So be sure to monitor trees closely, and address issues quickly if they arise.

All that TLC will pay off with a beautiful, living garden sculpture –- and a great story to tell as you await your juicy harvest.

Jessica Damiano writes weekly gardening columns for the AP and publishes the award-winning Weekly Dirt Newsletter. You can sign up here for weekly gardening tips and advice.

For more AP gardening stories, go to https://apnews.com/hub/gardening.

By Julie Appleby, KFF Health News

People thinking about starting a business or retiring early — before they’re old enough for Medicare — may want to wait until November, when they can see just how much their Affordable Care Act health insurance will cost next year. Sharp increases are expected.

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Premiums for ACA health plans, also known as Obamacare, which many early retirees and small-business owners rely on for coverage, are going up, partly due to policy changes advanced by the Trump administration and Congress. At the same time, more generous tax subsidies that have helped most policyholders pay for coverage are set to expire at the end of December.

After that, subsidies would return to what they were before the covid-19 pandemic. Also being reinstated would be an income cap barring people who earn more than four times the federal poverty level from getting any tax credits to help them purchase coverage. Although Congress potentially could act to extend the credits, people weighing optional life changes should factor in the potential cost if lawmakers fail to do so.

“I would hate for people to make a big decision now and then, in a few months, realize, ‘I’m not even going to qualify for a tax credit next year,’” said Lauren Jenkins, an insurance agent whose brokerage helps people sign up for coverage in Oklahoma. “Coupled with the rate increases, that could be significant, especially for someone at or near retirement, when it could easily cost over $1,000 a month.”

Still, how things play out in the real world will vary.

The key factor is income, as the subsidy amount people receive is primarily based on household income and local insurance costs.

People experiencing the biggest dollar increase in out-of-pocket premiums next year will be those who lose subsidies altogether because they earn more than 400% of the federal poverty level. This year, that’s $62,600 for a single person and $84,600 for a couple.

This “subsidy cliff” was removed in the legislation first enacted during the covid pandemic to create enhanced subsidies, but it will be back next year if they expire. About 1.6 million people who earn more than 400% of the poverty threshold bought ACA plans this year, many of them getting some tax credits to help with the premiums, according to KFF data. KFF is a health information nonprofit that includes KFF Health News.

“A lot of small-biz owners fall around that level of income,” said David Chase, vice president of policy and advocacy for the Small Business Majority, a Washington, D.C.-based advocacy group, which is urging Congress to extend the credits.

And a good chunk of ACA enrollment consists of small-business owners or their employees because, unlike larger firms, most small businesses don’t offer group health plans.

In the Washington metropolitan area, “seven out of 10 people who qualify for lower premiums [because of the tax credits] are small-business owners,” said Mila Kofman, executive director of the DC Health Benefit Exchange Authority.

Congress must decide by the end of December whether to extend the subsidies a second time. Permanently doing so could cost taxpayers $335 billion over the next decade, but not acting could cause financial pain for policyholders and pose political repercussions for lawmakers.

Because new premiums and smaller subsidies would take effect in January, the potential fallout has some Republican lawmakers worried about the midterm elections, according to news reports.

Republican pollsters Tony Fabrizio and Bob Ward warned the GOP in a memo that extending the enhanced credits could mean the difference between success and failure in some midterm races, because support for the premium help “comes from more than two-thirds of Trump voters and three-quarters of Swing voters.”

While supporters credit the enhanced subsidies for a record 24 million sign-ups for this year’s ACA plans, critics have blamed them for instances in which sales brokers or consumers engaged in improper enrollment.

“The expanded subsidies were a temporary covid pandemic policy enacted by congressional Democrats on a party-line vote and scheduled to end after 2025,” said Brian Blase, president of the Paragon Health Institute, a conservative think tank. “They have led to tremendous fraud and waste, they reduce employer coverage, and they should be permitted to expire.”

Ed Haislmaier, a senior research fellow at the conservative Heritage Foundation, acknowledged that people earning more than 400% of the poverty level would not be happy with losing access to subsidies, but he expects most to stay enrolled because they want to avoid huge medical bills that could threaten their businesses or savings.

“They are middle-class or upper-income people who are self-employed, or early retirees with significant income, which means they have a lot of assets behind that income,” he said. “These are people who view insurance as financial protection.”

He thinks lawmakers would win political support from voters in this category by addressing two of their other major ACA concerns: that annual deductibles are too high and insurers’ networks of doctors and hospitals are too small.

“If you just give these people money by extending subsidies, it’s only addressing one of their problems, and it’s the one they are least upset about,” Haislmaier said. “That is the political dynamics of this.”

Here’s how the expiration of subsidies could play out for some hypothetical consumers.

People in households earning less than four times the poverty rate would still get subsidies — just not as generous as the current ones.

For example, those whose earnings are at the lower end of the income scale — say, just over 150% of the poverty threshold, or about $23,000 — will go from paying a national average of about $2 a month, or $24 toward coverage for the year, to $72 a month, or $864 a year, according to a KFF online calculator.

On the other end of the income spectrum, a 55-year-old Portland, Oregon, couple with a household income of $85,000 would also take a big hit on the cost of their benchmark plan. They currently pay about $600 a month in premiums — about 8.5% of their household income — with subsidies kicking in about $1,000 to cover the remainder.

Next year, if the tax credits expire, the same couple would not get any federal help because they earn over four times the poverty limit. They would pay the full monthly premium, with no subsidies, which would be about $1,800, based on initial 2026 premium rates filed with state regulators, said Jared Ortaliza, a policy analyst at KFF.

People should begin to see insurance rates late this fall, and certainly by Nov. 1, when the ACA’s open enrollment season begins, said Jenkins, the Oklahoma insurance agent. That gives them time to mull over whether they want to make changes in their plan — or in their lives, such as quitting a job that has health insurance or retiring early. This year, open enrollment extends to Jan. 15. Under new legislation, that open period will shorten by about a month, starting with the 2027 sign-up period.

Those who do enroll for 2026, especially the self-employed and people retiring early, should closely track their incomes during the year, she said.

It would be easy to bust through that income cap, she said.

If they do, they’ll have to pay back any tax credits they initially qualified for. Their income might rise unexpectedly during the year, for example, pushing them over the limit. An income bump could come from drawing down more money from retirement accounts than planned, landing a new customer account, or even from winning big at the casino.

“Maybe they win $5,000 at the casino, but that puts them $500 over the limit for the year,” Jenkins said. “They might have to pay back $12,000 in tax credits for winning a few thousand at the casino.”

©2025 KFF Health News. Distributed by Tribune Content Agency, LLC.

By Christine Mai-Duc, KFF Health News

Jacob Sweidan has seen his patients through the federal immigration raids of the 1990s, a sitting governor’s call to abolish birthright citizenship, and the highly publicized workplace crackdowns and family separation policies of President Donald Trump’s first term.

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But in his 40 years as a pediatrician in Southern California serving those too poor to afford care, including many immigrant families, Sweidan said he’s never seen a drop-off in patient visits like this.

“They are scared to come to the offices. They’re getting sicker and sicker,” said Sweidan, who specializes in neonatology and runs five clinics in Los Angeles and Orange counties. “And when they are near collapsing, they go to the ER because they have no choice.”

In the last two months, he has sent young children to the emergency room because their parents worked up the courage to call his office only after several days of high fever. He said he attended to a 14-year-old boy in the ER who was on the verge of a diabetic coma because he’d run out of insulin, his parents too frightened to venture out for a refill.

Sweidan had stopped offering telehealth visits after the COVID-19 pandemic, but he and other health care providers have brought them back as ramped-up immigration enforcement drives patients without legal status — and even their U.S. citizen children — deeper into the shadows.

Patients in need of care are increasingly scared to seek it after Trump rescinded a Biden-era policy that barred immigration officials from conducting operations in “sensitive” areas such as schools, hospitals, and churches. Clinics and health plans have taken a page out of their COVID playbooks, revamping tested strategies to care for patients scared to leave the house.

Sara Rosenbaum, professor emerita of health law and policy at George Washington University, said she’s heard from clinic administrators and industry colleagues who have experienced a substantial drop in in-person visits among immigrant patients.

“I don’t think there’s a community health center in the country that is not feeling this,” Rosenbaum said.

At St. John’s Community Health clinics in the Los Angeles area, which serve an estimated 30,000 patients without legal status annually, virtual visits have skyrocketed from roughly 8% of appointments to about 25%, said Jim Mangia, president and chief executive officer. The organization is also registering some patients for in-home health visits, a service funded by private donors, and has trained employees how to read a warrant.

“People are not picking up their medicine,” Mangia said. “They’re not seeing the doctor.”

Mangia said that, in the past eight weeks, federal agents have attempted to gain access to patients at a St. John’s mobile clinic in Downey and pointed a gun at an employee during a raid at MacArthur Park. Last month, Immigration and Customs Enforcement contractors sat in a Southern California hospital waiting for a patient and federal prosecutors charged two health center workers they say interfered with immigration officers’ attempts to arrest someone at an Ontario facility.

C.S., an immigrant from Huntington Park without legal status, said she signed up for St. John’s home visit services in July because she fears going outside. The 71-year-old woman, who asked to be identified only by her initials for fear of deportation, said she has missed blood work and other lab tests this year. Too afraid to take the bus, she skipped a recent appointment with a specialist for her arthritic hands. She is also prediabetic and struggles with leg pain after a car hit her a few years ago.

“I feel so worried because if I don’t get the care I need, it can get much worse,” she said in Spanish, speaking about her health issues through an interpreter. A doctor at the clinic gave her a number to call in case she wants to schedule an appointment by phone.

Officials at the federal Department of Health and Human Services did not respond to questions from KFF Health News seeking comment about the impact of the raids on patients.

There’s no indication the Trump administration intends to shift its strategy. Federal officials have sought to pause a judge’s order temporarily restricting how they conduct raids in Southern California after immigrant advocates filed a lawsuit accusing ICE of deploying unconstitutional tactics. The 9th U.S. Circuit Court of Appeals on Aug. 1 denied the request, leaving the restraining order in place.

In July, Los Angeles County supervisors directed county agencies to explore expanding virtual appointment options after the county’s director of health services noted a “huge increase” in phone and video visits. Meanwhile, state lawmakers in California are considering legislation that would restrict immigration agents’ access to places such as schools and health care facilities — Colorado’s governor, Democrat Jared Polis, signed a similar bill into law in May.

Immigrants and their families will likely end up using more costly care in emergency rooms as a last resort. And recently passed cuts to Medicaid are expected to further stress ERs and hospitals, said Nicole Lamoureux, president of the National Association of Free & Charitable Clinics.

“Not only are clinics trying to reach people who are retreating from care before they end up with more severe conditions, but the health care safety net is going to be strained due to an influx in patient demand,” Lamoureux said.

Mitesh Popat, CEO of Venice Family Clinic, nearly 90% of whose patients are at or below the federal poverty line, said staff call patients before appointments to ask if they plan to come in person and to offer telehealth as an option if they are nervous. They also call if a patient doesn’t show five minutes into their appointment and offer immediate telehealth service as an alternative. The clinic has seen a roughly 5% rise in telehealth visits over the past month, Popat said.

In the Salinas Valley, an area with a large concentration of Spanish-speaking farmworkers, Clinica de Salud del Valle de Salinas began promoting telehealth services with Spanish radio ads in January. The clinics also trained people how to use Zoom and other digital platforms at health fairs and community meetings.

CalOptima Health, which covers nearly 1 in 3 residents of Orange County and is the biggest Medi-Cal benefits administrator in the area, sent more than a quarter-million text messages to patients in July encouraging them to use telehealth rather than forgo care, said Chief Executive Officer Michael Hunn. The insurer has also set up a webpage of resources for patients seeking care by phone or home delivery of medication.

“The Latino community is facing a fear pandemic. They’re quarantining just the way we all had to during the COVID-19 pandemic,” said Seciah Aquino, executive director of the Latino Coalition for a Healthy California, an advocacy group that promotes health access for immigrants and Latinos.

But substituting telehealth isn’t a long-term solution, said Isabel Becerra, chief executive officer of the Coalition of Orange County Community Health Centers, whose members reported increases in telehealth visits as high as 40% in the past month.

“As a stopgap, it’s very effective,” said Becerra, whose group represents 20 clinics in Southern California. “Telehealth can only take you so far. What about when you need lab work? You can’t look at a cavity through a screen.”

Telehealth also brings a host of other challenges, including technical hiccups with translation services and limited computer proficiency or internet access among patients, she said.

And it’s not just immigrants living in the country unlawfully who are scared to seek out care. In southeast Los Angeles County, V.M., a 59-year-old naturalized citizen, relies on her roommate to pick up her groceries and prescriptions. She asked that only her initials be used to share her story and those of her family and friends out of fear they could be targeted.

When she does venture out — to church or for her monthly appointment at a rheumatology clinic — she carries her passport and looks askance at any cars with tinted windows.

“I feel paranoid,” said V.M., who came to the U.S. more than 40 years ago and is a patient of Venice Family Clinic. “Sometimes I feel scared. Sometimes I feel angry. Sometimes I feel sad.”

She now sees her therapist virtually for her depression, which began 10 years ago when rheumatoid arthritis forced her to stop working. She worries about her older brother, who has high blood pressure and has stopped going to the doctor, and about a friend from the rheumatology clinic, who ices swollen hands and feet because she’s missed four months of appointments in a row.

“Somebody has to wake up or people are going to start falling apart outside on the streets and they’re going to die,” she said.

This article was produced by KFF Health News , which publishes California Healthline , an editorially independent service of the California Health Care Foundation .

©2025 KFF Health News. Distributed by Tribune Content Agency, LLC.