County health officials across the United States are preparing for a significant increase in uninsured patients following major changes to federal health policy. An estimated 10 million newly uninsured patients are expected over the next decade in the wake of federal legislation signed into law last year. This shift represents a dramatic reversal of progress made under the Affordable Care Act.
California’s Placer County provides a stark example of the challenge ahead. In 2013, before the ACA, the county provided care to about 3,400 uninsured residents. That number had dropped to zero in recent years, but the county now estimates that 16,000 residents could lose coverage by 2028. “This is the moment where a lot of hard decisions have to be made about who gets care and who doesn’t,” said Nadereh Pourat, director of the Health Economics and Evaluation Research Program at UCLA.
The situation is particularly acute in states where counties are legally required to provide care to their poorest residents through indigent care programs. Placer County closed its own clinics nearly a decade ago as enrollment in these programs plummeted. “Most of the infrastructure that we had to meet those needs is gone,” said Rob Oldham, the county’s director of health and human services. “This is a much bigger problem than it was a decade ago and much more costly.”
California faces potential federal cuts to Medi-Cal of approximately $4.4 billion a year. In November, voters in Santa Clara County approved a sales tax increase to backfill losses of federal funds. As states grapple with how to fund care for the newly uninsured, officials warn that without state investment and careful planning, the burden will fall disproportionately on the poorest Americans. “We’re going to need state investment,” said Michelle Gibbons, executive director of the County Health Executives Association of California, noting that progress made over the past decade could be undone.
This article is an AI-assisted summary. All facts and figures are drawn from the original report: https://us.headtopics.com/news/on-the-hook-for-uninsured-residents-counties-wonder-now-78047954