Napa hospitals and medical centers brace to inherit more uncompensated care under H.R.1
State, county and health care officials gathered Friday, July 25 at Providence Queen of the Valley Medical Center to discuss the impact President Donald Trump’s new megabill, H.R.1, will have on health care and services across Napa County.
Attendees outlined what life and care for residents may look like over the next 10 years, as billions of dollars are cut from health and nutrition services. Officials also discussed how health care providers may be forced to scale back or eliminate services due to a growing number of patients unable to pay for care.
Speaking about H.R.1, Rep. Mike Thompson said, “This was not about our ability to deliver quality, affordable healthcare; this was about making cuts to provide tax cuts to billionaires – people who do not need the help in this economic environment.”
Dr. Amy Herold, chief administrative officer at Queen of the Valley, said the hospital stands to lose $500 million due to Medicaid cuts, with additional losses expected from future Medicare cuts. Nearly 70% of the hospital’s patients could lose their health coverage and ability to pay for care. As a result, hospitals will likely face an increase in uncompensated care, she said.
“Health care infrastructure will be critically threatened,” Herold said.
Steven Herber, chief executive officer of Adventist Health St. Helena Hospital, said that under H.R.1, Medicaid is set to pay hospitals 21 cents less on every dollar.
He added that it’s unclear how hospitals will continue to pay all nurses, doctors and other providers a living wage if federal funding declines as projected.
Despite the challenges ahead, Herber said, Adventist Health and its staff will persist, but to do so hospital leadership will likely have to make adjustments.
Julie Chen, an ophthalmologist with Sutter Medical Group, warned that the organization anticipates a $4 billion loss in revenue over the next decade – about $400 million a year.
She said that could lead to the elimination of key programs and an increase in patients with preventable advanced conditions.
“We’re a very large provider of Medi-Cal services, and we expect that many people will not be able to afford preventive care,” Chen said.
Chephas Mugerwa, a patient with CommuniCare Health Centers who immigrated from Uganda, expressed concern that under H.R.1, immigrant families will face difficult choices, such as deciding between groceries and seeing a doctor.
“We shouldn’t be excluded from care just because of where we were born,” Mugerwa said. “It sends a painful message that we don’t belong and that our lives are less important just because we are immigrants.”
One Napa resident, who previously had to travel long distances for care, warned the audience of the dangers that can come with delayed or inaccessible treatment.
Health officials emphasized that this should be a time for county health systems to expand and improve — yet under H.R.1, the opposite may occur.
As Napa braces for the bill’s impacts, officials are beginning to draft plans to help community members meet new work requirements and maintain access to health and nutrition benefits, according to Jennifer Yasumoto, director of Napa County Health and Human Services.
Herber said H.R.1 is exposing how vulnerable the U.S. health system has become — and how reliant it is on federal support. He added a note of cautious optimism.
“I think we’re going to see an evolution because it’s not like we’re going to undo this,” he said. “Until this happens, I see this community banding together to figure out how to make ends meet and not let people suffer.”
