The prospect of federal immigation reform is complicating the issue of county health programs in the era of health care reform. The California State Association of Counties cited an estimate that changing immigration law could increase applications for county indigent care by 1 million people.
Counties such as Stanislaus stand to lose funding when a state-run expansion of Medi-Cal goes into affect next year. But county health programs will still be required to serve two sets of adults: those who aren't eligible for Medi-Cal under the new income guidelines and people who don't buy insurance under Obamacare. Immigration reform could add county residents who don't currently have legal status.
In addition to funding health care, the state funding for counties has paid the salaries of public health staff who respond to outbreaks of communicable diseases such as whooping cough.