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“Climate change is a huge public health concern”
When Gaurab Basu saw the news about wildfire smoke from Canada hitting the U.S. earlier this month, one of the first things he did was check his patient chart.
“I was scanning my chart for pregnant patients and thinking about whether we could reschedule or maybe do a televisit and have them stay at home instead of taking a bus to come in,” said Basu, a physician in Boston and health equity fellow at the Harvard T.H. Chan School of Public Health.
It was a prescient concern: One of Basu’s patients who already suffered from asthma had to be hospitalized for an aggressive cough and low oxygen levels, which Basu suspects were related to the air quality. A few hundred miles south in New York City, which saw even worse pollution from the wildfires, there were more than 1,000 asthma-related emergency department visits over the weekend after the smoke event. “It’s been a hard few months for my patients with asthma. I had more conversations about air quality with my patients and colleagues than ever before,” Basu told me.
These conversations are becoming more and more common. Across the country, healthcare providers are watching in real time as climate change affects their patients’ health, from wildfire smoke to particularly bad allergy seasons, extreme heat, and vector-borne diseases like Lyme and dengue fever. In response, clinicians of all stripes are increasingly talking about climate change in their practice — and in effect becoming climate educators.
“Climate change is a huge public health concern, and part of my role as a physician is to highlight awareness,” said Neelu Tummala, an otolaryngologist (an ear, nose, and throat specialist, or what’s colloquially known as an ENT) and co-director of the Climate and Health Institute at George Washington University in Washington, D.C. “It’s not to scare people and say that global warming is going to be the end-all of society, but to make them conscientious of it and maybe inspire them to act on it.”
Healthcare providers occupy a rarefied space in American society. Nurses consistently rank as the most trusted profession in the country in an annual Gallup poll, followed closely by doctors and pharmacists (high school teachers were fourth in the 2023 poll; journalists are distrusted by a plurality of Americans). Patients tend to listen to what their clinicians have to say. That makes them uniquely placed to talk about climate change.
“We make it human,” Basu told me. “There’s a lot of translational work we can do, because emissions and pollutants are confusing and abstract and kind of invisible.”
As climate change increasingly moves from concept to lived reality, bringing it up in the doctor’s office is just a natural progression of the conversation a healthcare provider has with their patient. Take Tummala, whom I first met as a patient myself: I have a history of allergy-induced asthma, and before being taught how to calm my body down I would sneeze and wheeze my way through allergy season. So when I went to Tummala for a consultation this spring, it made sense that she mentioned, as our visit was wrapping up, that climate change was making allergy season worse.
Education has always been part of the job for healthcare providers; they routinely discuss medical science with their patients, whether when discussing individual diagnoses like diabetes or broader public health concerns like, say, COVID-19 or Mpox. But all of the clinicians I spoke with told me that for many patients, their conversation was the first time someone had drawn a connection between climate change and health, and in some instances the first time they’d heard of climate change at all.
The main difference between educating their patients about climate change and other public health concerns, Tummala pointed out, is that the solution to climate change lies not in medical research but in policy. There is no vaccine for climate change; the most a healthcare provider can do to address the problem within the confines of their clinic is give their patients tips for living with the impact of a global issue far beyond their control.
That also means this is new territory for clinicians, some of whom may not even know much about climate change themselves. As Karen Pennar wrote for STAT News in April, there’s a growing, student-led movement to incorporate climate change at medical schools across the country, and some programs, like those at George Washington University and Harvard Medical School, have begun adding climate change to their curricula. But there are already millions of clinicians at work across the country, and reaching them is just as important as training the next generation.
“It’s great to say we’re going to train the next generation of healthcare professionals, but the reality is climate impacts are here,” said Cecilia Sorensen, director of the Global Consortium on Climate and Health Education at Columbia University. “We can’t wait ten years for kids to grow up and start doing their own jobs. We have to train the existing health workforce.”
That means training not just doctors but also nurses and other clinicians who often spend more time with patients than doctors do. Academic initiatives like the Global Consortium are developing workshops, webinars, and other training programs to close the gap, and clinicians are also coming together on the local level: Tummala is on the steering committee for a group called Virginia Clinicians for Climate Action, or VCCA, which organizes educational events for clinicians at hospitals and clinics across the state of Virginia.
“Many of us in practice are figuring this out together and learning together,” said Samantha Ahdoot, a pediatrician and founder of VCCA. “It’s really a whole new field of medicine that’s developing quite quickly.”
As the name would suggest, VCCA goes beyond education. Its members directly advocate for climate policy at the state level, from an annual lobby day in Richmond to testifying on the health impacts of climate change at public hearings. This kind of political organizing is a tricky line to walk: Doctors are pressed for time and energy already, and their involvement in advocacy of any sort is sometimes frowned upon — as illustrated by the recent case of Indiana doctor Caitlin Bernard, who was reprimanded after speaking publicly about an abortion she provided for a 10-year-old girl.
Climate change is just as embroiled in the culture war as COVID-19 and abortion are, and the clinicians I spoke with told me they’re careful to separate any advocacy work they do from their conversations with their patients. Instead, they focus on the patient’s experience of the changing world, as Tummala did with me. That grounds those conversations in the health impacts and makes clear she’s speaking from a perspective of transparent, science-driven healthcare rather than advocacy.
“We have the ability to depoliticize this. We can talk about this as a health issue, not a political issue,” Tummala told me. “You have to meet people where they’re at. If you, for example, try talking to a patient about losing weight, they may think you’re judging them. But if you bring it up in a way that shows it could help their sleep apnea or heart disease, they may be more willing to listen. I think it’s the same with climate change.”
In Cheryl Holder’s experience, those health realities are harder to deny than the high-level concept of climate change. “I get pushback from folks who are not experiencing it like my patients experience it,” said Holder, founder of Florida Clinicians for Climate Action (FCCA) and a physician who primarily treated members of lower-income communities until she retired last December. As part of her advocacy mission with FCCA, she started using Instagram and TikTok to talk about the connection between climate change and health — and she would inevitably see comments from climate deniers.
Her conversations with patients, however, were a different story. Most of them worked outdoors, where they could tell things were changing. “If you work outdoors and you feel the heat, see the grass growing faster and the trees flowering earlier, you know something is happening,” Holder told me. “When I tell them it’s because of pollution from humans, they accept it.”
But just as a patient may decide not to follow a doctor’s advice for treating a medical condition, Basu accepts that sometimes the climate conversation just won’t land. That doesn’t make him any less likely to bring it up, however.
“Hopefully, the patient can trust in a pattern of me making good decisions about their care enough that they believe in [the climate connection],” Basu told me. “I think that’s a critical moment to bring people into the conversation, and to do it with care.”
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Investing in red states doesn’t make defying Trump any safer.
In the end, it was what the letters didn’t say.
For months — since well before the 2024 election — when asked about the future health and safety of the clean energy tax credits in the Inflation Reduction Act, advocates and industry folks would point to the 20 or so House Republicans (sometimes more, sometimes fewer) who would sign on to public statements urging their colleagues to preserve at least some of the law. Better not to pull out the rug from business investment, they argued. Especially not investment in their districts.
These letters were “reassuring to a lot of folks in clean energy and climate communities,” Chris Moyer, the founder of Echo Communications and a former staffer for longtime Senate Majority Leader Harry Reid, told me.
“I never felt reassured,” Moyer added.
Plenty of people did, though. The home solar company Sunrun, for instance, told investors in a presentation earlier this monththat a “growing number of Republicans in Congress — including 39 overall House members and four Senators — publicly support maintaining energy tax credits through various letters over the past few months.” The company added that “we expect a range of draft proposals to be issued, possibly including draconian scenarios, but we expect any extreme proposals will be moderated as they progress.”
Instead, the draft language got progressively worse for the residential solar industry, with the version that passed the House Thursday morning knocking billions of dollars off the sector, as tax credits were further squeezed to help make room for other priorities that truly posed an existential threat to the bill’s passage.
What Sunrun and others appear to have failed to notice — or at least publicly acknowledge — is that while these representatives wanted to see tax credits preserved, they never specified what they would do if their wishes were disregarded. Unlike the handful of Republicans who threatened to tank the bill over expanding the deduction for state and local taxes (each of whom signed one of the tax credit letters, at some point), or the Freedom Caucus, who tend to vote no on any major fiscal bill that doesn’t contain sizable spending cuts (so, until now, every budget bill), the tax credit Republicans never threatened to kill the bill entirely.
Ultimately, the only Republicans to outright oppose the bill did so because it didn’t cut the deficit enough. All of the House Republicans who signed letters or statements in support of clean energy tax credits voted yes on the legislation, with a single exception: New York’s Andrew Garbarino, who reportedly slept through the roll call. (He later said he would have voted for it had he been awake.)
“The coalition of interests effectively persuaded Republican members that tax credits were driving investment in their districts and states,” Pavan Venkatakrishnan, an infrastructure fellow at the Institute for Progress, told me in a text message. “Where advocates fell short was in convincing them that preserving energy tax credits — especially for mature technologies Republicans often view skeptically — should take precedence over preventing Medicaid cuts or addressing parochial concerns like SALT.”
The Inflation Reduction Act itself was, after all, advanced on a party-line basis, as was Biden’s 2021 American Rescue Plan. Combined, those two bills received a single Democratic no vote and no Republican yes votes.
In the end, Moyer said, Republican House members in the current Congress were under immense political pressure to support what is likely to be the sole major piece of legislation advanced this year by President Trump — one that contained a number of provisions, especially on SALT, that they agreed with.
“There are major consequences for individual house members who vote against the president’s agenda,” Moyer said. “They made a calculation. They knew they were going to take heat either way. They would rather take heat from clean energy folks and people affected by the projects.”
It wasn’t supposed to be this way.
White House officials and outside analysts frequently touted job creation linked to IRA investments in Republican House districts and states as a tangible benefit of the law that would make it politically impossible to overturn, even as Congress and the White House turned over.
“President’s Biden’s policies are leading to more than 330,000 new clean energy jobs already created, more than half of which are in Republican-held districts,” White House communications director Ben LaBolt told reporters last year, previewing a speech President Biden would give on climate change.
Even after Biden had been defeated, White House climate advisor Ali Zaidi told Bloomberg that “we have grown the political consensus around the Inflation Reduction Act through its execution,” citing one of the House Republican letters in support of the clean energy tax credits.
One former Biden White House climate official told me that having projects in Republican districts was thought by the IRA’s crafters to make the bill more politically sustainable — but only so much.
“A [freaking] battery factory is not going to save democracy,” the official told me, referencing more ambitious claims that the tax credits could lead to more Democratic electoral victories. (The official asked to remain anonymous in order not to jeopardize their current professional prospects.) Instead, “it was supposed to make it slightly harder for Republicans to overturn the subsidies.”
Congresspeople worried about jobs weren’t supposed to be the only things that would preserve the bill, either, the official added. Clean energy and energy-dependent sectors, they thought, should be able to effectively advocate for themselves.
To the extent that business interests were able to win a hearing with House Republicans, they were older, more traditionally conservative industries such as nuclear, manufacturing, agriculture, and oil and gas.The biofuels industry (i.e. liquid Big Agriculture) won an extension of its tax credit, 45Z. The oil and gas industry’s favored measure, the 45Q tax credit for carbon sequestration, was minimally fettered. Nuclear power was the one sector whose treatment notably improved between the initial draft from the House’s tax-writing committee and the version voted on Thursday. Advanced nuclear facilities can still claim tax credits if they start construction by 2029, while other clean energy projects have to start construction within 60 days of the bill’s passage and be in service by the end of 2028.
“I think these outcomes are unsurprising. In places where folks consistently engaged, things were protected,” a Republican lobbyist told me, referring to manufacturing, biofuels, and nuclear power, requesting anonymity because they weren’t authorized to speak publicly. “But assuming a project in a district would guarantee a no vote on a large package was always a mistake.”
“The relative success of nuclear is a testament to the importance of having strong champions — predictable but notable show of political might,” a second Republican lobbyist told me, who was also not allowed to speak publicly about the bill.
But all hope isn’t lost yet. The Senate still has to pass something that the House will agree with. Some senators had made noises about how nuclear, hydropower, and geothermal were treated in the initial language.
“Budget reconciliation is, first and foremost, a fiscal exercise,” Venkatakrishnan told me. “Energy tax credits offer a path of least resistance for hitting lawmakers’ fiscal targets. As the Senate takes up this bill, the case must be made that the marginal $100 billion to $200 billion in cuts seriously jeopardizes grid reliability and energy innovation.” Whether that will be enough to generate meaningful opposition in the Senate, however, is the $600 billion question.
A loophole created by the House Ways and Means text disappeared in the final bill.
Early this morning, the House of Representatives launched a full-frontal assault on the residential solar business model. The new language in the budget reconciliation bill to extend the Tax Cuts and Jobs Act passed Thursday included even tighter restrictions on the tech-neutral investment tax credits claimed by businesses like Sunrun when they lease solar systems to residential buyers.
While the earlier language from the Ways and Means committee eliminated the 25D tax credit for those who purchased home solar systems after the end of this year (it was originally supposed to run through 2034), the new language says that no credit “shall be allowed under this section for any investment during the taxable year” (emphasis mine) if the entity claiming the tax credit “rents or leases such property to a third party during such taxable year” and “the lessee would qualify for a credit under section 25D with respect to such property if the lessee owned such property.”
This is how you kill a business model in legislative text.
“Expect shares of solar companies to take a significant step back,” Jefferies analyst Julien Dumoulin-Smith wrote in a note to clients Thursday morning, calling the exclusion “scathing.” Investors are “losing the now false sense of security that we had 'seen the worst' of it with the initial House draft.”
Joseph Osha, an analyst for Guggenheim, agrees. “Considering the fact that ~70% of the residential solar industry is now supported by third-party (e.g. lease or PPA) financing arrangements, the new language is disastrous for the residential solar industry,” he wrote in a note to clients. “We believe the near-term implications are very negative for Sunrun, Enphase, and SolarEdge.”
Shares of Sunrun are down 37.5% in mid-day trading, wiping off almost $1 billion worth of value for its shareholders. The company did not respond to a request for comment. Shares of fellow residential solar inverter and systems Enphase are down 20%, while residential solar technology company SolarEdge’s shares are down 24.5%.
“Families will lose the freedom to control their energy costs,” Abigail Ross Hopper, chief executive of the Solar Energy Industries Association, said in a statement, in reference to the last-minute alteration to the investment tax credit.
When the House Ways and Means Committee released the initial language getting rid of 25D by the end of this year but keeping a limited version of the investment tax credit, analysts noted that Sunrun was an unexpected winner from the bill. It typically markets its solar products as leases or power purchase agreements, not outright sales of the system.
The reversal, Dumoulin-Smith wrote, “comes as a surprise especially considering how favorable the initial markup was” to the Sunrun business model.
“Our core solar service offerings are provided through our lease and power purchase agreements,” the company said in its 2024 annual report. “While customers have the option to purchase a solar energy system outright from us, most of our customers choose to buy solar as a service from us through our Customer Agreements without the significant upfront investment of purchasing a solar energy system.”
The new bill, Dumoulin-Smith writes is “‘leveling the playing field’ by targeting all future residential solar originations, whether leased or owned.” The bill is “negative to Sunrun with intentional targeting of the sector.
Last year, Sunrun generated over $700 million from transferring investment tax credits from its solar and storage projects. The company said that it had $117 million of “incentives revenue” in 2024, which includes the tax credits, out of around $1.4 billion in total revenue.
But the tax credits play a far larger role in the business than just how they’re recognized on the company’s earnings statements. The company raises investment funds to help finance the projects, where investors get payments from customers as well as monetized tax credits. Fund investors “can receive attractive after-tax returns from our investment funds due to their ability to utilize Commercial ITCs,” the company said in its report. Conversely, the financing “enables us to offer attractive pricing to our customers for the energy generated by the solar energy system on their homes.”
Morgan Stanley analyst Andrew Perocco wrote to clients that “this is a noteworthy change for the residential solar industry, and Sunrun in particular, which dominates the residential solar [third-party owned] market and has recognized ITC credits under 48E.”
Current conditions: A late-season nor’easter could bring minor flooding to the Boston area• It’s clear and sunny today in Erbil, Iraq, where the country’s first entirely off-grid, solar-powered village is now operating • Thursday will finally bring a break from severe storms in the U.S., which has seen 280 tornadoes more than the historical average this year.
1. House GOP passes reconciliation bill after late-night tweaks to clean energy tax credits
The House passed the sweeping “big, beautiful” tax bill early Thursday morning in a 215-214 vote, mostly along party lines. Republican Representatives Thomas Massie of Kentucky and Warren Davidson of Ohio voted no, while House Freedom Caucus Chair Andy Harris of Maryland voted “present;” two additional Republicans didn’t vote.
The bill will effectively kill the Inflation Reduction Act, as my colleague Emily Pontecorvo has written — although the Wednesday night manager’s amendment included some tweaks to how, exactly, as well as a few concessions to moderates. Updates include:
The bill now heads to the Senate — where more negotiations will almost certainly follow — with Republicans aiming to have it on President Trump’s desk by July 4.
2. FEMA cancels 4-year strategic plan, axing focus on ‘climate resilience’
The combative new acting administrator of the Federal Emergency Management Agency, David Richardson, rescinded the organization’s four-year strategic plan on Wednesday, per Wired. Though the document, which was set to expire at the end of 2026, does not address specific procedures for given disasters, it does lay out goals and objectives for the agency, including “lead whole of community in climate resilience” and “install equality as a foundation of emergency management.” In axing the strategic plan, Richardson told staff that the document “contains goals and objectives that bear no connection to FEMA accomplishing its mission.”
A FEMA employee who spoke with Wired stressed that while rescinding the plan does not have immediate operational impacts, it can still have “big downstream effects.” Another characterized the move by the administration as symbolic: “There are very real changes that have been made that touch on [equity and climate change] that are more important than the document itself.”
3. Energy Department redirects Puerto Rican rooftop solar investment to upkeep of fossil fuel plants
The U.S. federal government is redirecting a $365 million investment in rooftop solar power in Puerto Rico to instead maintain the island’s fossil fuel-powered grid, the Department of Energy announced Wednesday. The award, which dates to the Biden administration, was intended to provide stable power to Puerto Ricans, who have become accustomed to blackouts due to damaged and outdated infrastructure. The Puerto Rico Electric Power Authority declared bankruptcy in 2017, and a barrage of major hurricanes — most notably 2017’s Hurricane Maria — have destabilized the island’s grid, Reuters reports.
In Energy Secretary Chris Wright’s statement, he said the funds will go toward “dispatching baseload generation units, supporting vegetation control to protect transmission lines, and upgrading aging infrastructure.” But Javier Rúa Jovet, a public policy director for Puerto Rico’s Solar and Energy Storage Association, added to The Associated Press that “There is nothing faster and better than solar batteries.”
4. EDF, Shell, and others to collaborate on hydrogen emission tracker
The Environmental Defense Fund announced Wednesday that it is launching an international research initiative to track hydrogen emissions from North American and European facilities, in partnership with Shell, TotalEnergies, Air Products, and Air Liquide, as well as other academic and technology partners. Hydrogen is an indirect greenhouse gas that, through chemical reactions, can affect the lifetime and abundances of planet-warming gases like methane and ozone. Despite being a “leak-prone gas,” hydrogen emissions have been poorly studied.
“As hydrogen becomes an increasingly important part of the energy system, developing a robust, data-driven understanding of its emissions is essential to supporting informed decisions and guiding future investments in the sector,” Steven Hamburg, the chief scientist and senior vice president of EDF, said in a statement. Notably, EDF took a similar approach to tracking methane over a decade ago and ultimately exposed that emissions were “a far greater threat” than official government estimates suggested.
5. The best-selling SUV in America will now be available only as a hybrid
Toyota
The bestselling SUV in America, the Toyota RAV4, will be available only as a hybrid beginning with the 2026 model, Car and Driver reports. The car will be available both as a conventional hybrid and as a plug-in that works with CCS-compatible DC fast chargers, meaning “owners can quickly fill up its battery during long road trips” to minimize their fossil fuel mileage, The Verge adds. The RAV4 will also beat the Prius for electric range, hitting up to 50 miles before its gas engine kicks in.
Toyota’s move might not come as a complete surprise given that the automaker already introduced a hybrid-only lineup for its Camry. But given the popularity of the RAV4, Car and Driver notes that “if you ever wondered whether or not hybrids have entered the mainstream yet, perhaps this could be a tipping point.”
Nathan Hurner/USFWS
The Fish Lake Valley tui chub, a small minnow threatened by farming and mining activity, could become the first species to be listed as endangered under the second Trump administration.