Get Full Government Meeting Transcripts, Videos, & Alerts Forever!
Get email alerts on the Healthcare Finance topic
No spam. Unsubscribe anytime.
Hospital CEO warns HR 1 could sharply worsen local hospital finances and ER strain
Summary
Andrew Golfrach, CEO of Arrowhead Regional Medical Center, told supervisors that San Bernardino County hospitals are heavily Medi-Cal–dependent and that HR 1 federal changes could remove coverage for hundreds of thousands locally, increasing uncompensated care, emergency-department use, and the risk of service reductions or closures.
Andrew Golfrach, chief executive officer of Arrowhead Regional Medical Center, briefed the Board of Supervisors on county hospital capacity and payer mix and warned that federal reconciliation known as HR 1 could substantially reduce Medicaid/Medi-Cal funding and coverage, with severe local consequences.
Golfrach said about 40% of inpatient care in San Bernardino County is paid through Medi-Cal (with approximately 83% of that through IEHP) and that over 70% of inpatient volume is paid by government programs (Medi-Cal and Medicare). He highlighted that the county’s ratio of residents per emergency-department bed (about 4,445 residents per ER bed) ranks poorly among counties, leaving emergency services “overutilized and under-bedded.”
Drawing on CBO and state analyses, Golfrach said HR 1 could reduce federal support and produce an estimated $6.4 billion impact in the Inland Empire region over 10 years. He warned this could drive a sizable increase in uncompensated care and force hospitals to cut service lines or close programs, which would affect patients regardless of payer. "We're taking a wrecking ball to the house of cards," he said, describing projected cuts to supplemental programs and changes that shift costs to states, hospitals and patients.
Supervisors thanked Golfrach and discussed coordination with Medi-Cal managed-care plans and county transitional assistance to mitigate enrollment losses; several supervisors suggested exploring alternatives such as mobile clinics and more proactive primary-care options to reduce avoidable ER use.
Golfrach said hospitals and health systems are coordinating mitigation plans and county staff will continue to participate in advocacy at state and federal levels; no specific county fiscal action was adopted at this hearing.
