Local safety-net systems provide care for uninsured and low-income persons with Medicaid. Passage of the Patient Protection and Affordable Care Act (PPACA), which promises to expand health insurance to 34 million persons by 2019,1 in large part by widening eligibility for Medicaid, raises fundamental questions about the future of local safety nets in the United States.
Corresponding Author: Mitchell H. Katz, MD, San Francisco Department of Public Health, 101 Grove St, Room 308, San Francisco, CA 94102 (firstname.lastname@example.org).
Financial Disclosures: Dr Katz reports serving as a paid independent consultant for Health Management Associates.
Additional Contributions: Tangerine Brigham, MPP, Terry Conway, MD, Colleen Chawla, MPA, and Patricia Terrell, MPH, provided many helpful suggestions in reviewing an earlier version of this article. No one received financial compensation for his or her contributions.