The emergency department at Michael Garron Hospital was built to care for about 150 patients a day, but now sees more than 300 patients daily, amounting to about 107,000 patients last year in a space designed for 50,000 annually.
What are scientists, clinicians, and public health practitioners supposed to do in this moment? What use is research when our patients might be deported tomorrow? Why try to stem the tide of outbreaks when the world has fallen apart? This is why: because even in these times, enlarging the scope of human knowledge matters. The search for cures still matters. The fate of individual patients still matters.
Because of budget cuts, the Los Angeles County Department of Public Health has ended clinical services at seven of its public health clinic sites. As of Feb. 27, the county is no longer providing services such as vaccinations, sexually transmitted infection testing and treatment, or tuberculosis diagnosis and specialty TB care at the affected locations, according to county officials and a department fact sheet.
HHS Chief Information Officer Clark Minor stated that consolidating the CTO, CDO, and CAIO roles within his office allows the department to move faster on shared platforms and protect systems more effectively.
Federal cuts could strip about 1.2 million Californians of Medi-Cal coverage, with health experts warning the consequences could be dire. New work requirements and eligibility checks every six months will block even qualified people from coverage, while private insurance costs are skyrocketing. Lawmakers are being urged to close corporate tax loopholes, automate verification systems, and expand telehealth to cushion the blow to vulnerable Californians.
For Massachusetts emergency physicians, that dream captures a simple truth: long ER waits rarely steam from care inside the department. Instead, doctors say they're the result of bottlenecks across a system stretched thin by staffing shortages, aging patients, limited hospital beds, and gaps in primary care.
The most significant immediate change arrived Jan. 1 with the expiration of enhanced premium tax credits, which help defray the cost of monthly premiums for Americans enrolled in plans sold by health insurance exchanges such as Covered California. RELATED: Bay Area Affordable Care Act policyholders brace for price hikes With Congress not renewing these subsidies, which arrived in 2021 and are in addition to the initial income-based credits made available under the Affordable Care Act, enrollees will see their payments increase significantly this year.
All of last year, and long before, we have demanded action to ensure our hospital system is ready for when demand for Emergency Departments would spike. This did not happen, we found ourselves in a particularly busy winter and now the wheels have come off. Demand spikes in the colder months; it always does. It cannot, should not, be the case that we have to pray for a quiet January for fear the system won't cope. We should simply plan for a normal one.
In 2026, the US healthcare system is changing. Enhanced Affordable Care Act subsidies have expired, causing premiums for marketplace plans to spike - and pricing some families out of health insurance entirely. President Donald Trump's One Big Beautiful Bill Act will reduce coverage for some patients with Medicaid and funding for hospitals, especially those in rural areas. Costs for Medicare and private insurance are also rising: Employer-based healthcare premiums have increased by 9%, the largest rise in more than a decade.
If you find yourself in need of emergency care in Massachusetts, it could take a while. The Bay State ranks No. 3 in the U.S. for longest average time patients spend in the emergency department, according to World Population Review. Patients here spend an average of 189 minutes - more than three hours - in the ER before leaving the hospital. Only Maryland (228 minutes) and Delaware (195 minutes) report longer average delays.