A recent report from a left-leaning think tank found California has 83 hospitals at heightened risk of closing, cutting services, or laying off staff as a result of major federal Medicaid cuts included in the One Big Beautiful Bill Act, a budget reconciliation law signed last year.
The report — “The Big Ugly Threat to Safety Net Hospitals” by Public Citizen researcher Eileen O’Grady — finds the hospitals considered most vulnerable are those that rely heavily on Medicaid and have posted negative profit margins over multiple years.
Nationally, the report identifies 446 hospitals as “at heightened risk,” collectively serving about 6.6 million patients in 2024 and employing roughly 275,000 direct patient care workers, the analysis says.
“The cuts will be devastating to many low-income and disabled individuals who rely on Medicaid,” the report says, warning of “knock-on effects on hospitals that disproportionately serve these communities.”
California has one of the highest shares of hospitals at risk
Public Citizen’s analysis flags hospitals as “at risk” if they meet two conditions, averaged over 2022–2024:
California is one of five states where more than a quarter of hospitals are considered at heightened risk in the analysis.
The report emphasizes that the list is not a forecast of closure. “The list of at-risk hospitals is meant to be descriptive rather than predictive; it does not forecast that these hospitals will close,” the report says.
Where California’s 83 at‑risk hospitals are located
The 83 California hospitals on the list span every part of the state — from the far North Coast (Eureka/Arcata/Fortuna) to the border region (San Diego County and Imperial Valley) and from coastal and Bay Area hubs to inland and mountain communities. The list includes:
Central Valley (15)
Bay Area (14)
Los Angeles area (22)
Orange County (9)
Inland Empire (4)
San Diego County (3)
Central Coast (3)
Northern California and Far North (7)
Sierra and Desert (4)
Imperial Valley (2)
What hospital cutbacks could mean for patients
The study reported that even when hospitals don’t close, financial pressure can show up first as
The report says the law’s impacts will take time to play out, but points to layoffs and service cuts nationally as potential early signs of what financial strain can trigger.
Methodology behind the Medicaid hospital risk report
The report uses CMS hospital financial data (2022–2024) and identifies hospitals with both heavy reliance on Medicaid and negative margins, emphasizing that the list is intended to highlight heightened vulnerability, not to predict closures.
This article originally appeared on Palm Springs Desert Sun: 83 California hospitals at risk due to Medicaid cuts, report finds
Reporting by James Ward, Palm Springs Desert Sun / Palm Springs Desert Sun
USA TODAY Network via Reuters Connect
