Special Episode: California Health Care - The Impact of H. R. 1

Let's start out with something I think that's really basic, and I'm just going to start here with Katie and move on down the line.

Maybe give me just really quick the nickel tour of how you see HR1 impacting California.

I know we're going to get into some specifics, but what is it that keeps you up at night mostly, I guess, about HR1?

I mean, it's kind of a where do you start, unfortunately, on H.R. 1.

I'll highlight a couple things.

I know my colleagues will add things.

One big bucket is around coverage and coverage losses.

I think we're really worried about the impacts of the work requirements, about changes to which immigrants get access to federal health coverage and what are the implications for California.

And then the other big bucket that I would really highlight is around financing.

Public hospitals in particular really depend on what are called state-directed payments.

We bring in billions of dollars in federal funding that way to really offset the low base rates.

And we're facing over $3 billion in funding reductions just from a loss of state-directed payments from HR1.

Financing and coverage are two big things that I would really highlight that we're definitely concerned about as California works to implement this and what are the implications for patients and for providers.

Great, Tim.

I think from my perspective, you and from the University of California, we are the state's public academic health care system that provides care to patients from 99% of California zip codes.

And that's because patients get referred to UC for just every, or patients go to UC for just everyday care, but they also go to UC for specialty care and hospital care that's not available locally in their communities.

And so with HR1 cuts, I feel like there's almost kind of like a triple whammy here for us in that sense that, you know, because of the coverage losses and the increase in compensate care, we and many other providers will have to absorb, right, those lower reimbursements And that do not cover the cost of providing care.

And then at the same time, other providers, including safety net providers, FQHCs, county health systems, private hospitals, are also going to be feeling the financial pressures.

And many of those providers will either close different service lines and not offer them anymore, like many have already done with services like inpatient psychiatric care or labor and delivery.

And then those patients are gonna be turning up at our hospitals when we are already at or above capacity as is.

And that's gonna be a major challenge for us to, again, continue to care for Californians, particularly those that are most vulnerable.

And at the same time, one of the things that we'll get into later in this panel is how HR1 will impact the healthcare workforce of today and our future healthcare workforce, because there are some significant changes that have been made to federal student loans that will impact who chooses to go into a health professional career, what specialties that they will go into, and where they will provide care as well, and that will have much longer-term impacts to our healthcare delivery system.

Thank you.

Similar to Tam's points, I think a big thing that we're looking at right now is the uninsured rate.

California very quickly went from a 17% uninsured rate to a 5% uninsured rate, something that I think we're all very proud of.