California plans to notify Affordable Care Act marketplace enrollees that their costs could rise sharply next year unless Congress extends subsidies to help people buy health insurance.

Premium increases could make coverage under the Affordable Care Act unaffordable for many households after Jan. 1 and add to the number of uninsured in the San Joaquin Valley.

Up and down the San Joaquin Valley, hospital programs for newly-hired registered nurses are providing a year of additional training and experience beyond what they received en route to their nursing degree.

The ratings are based on an analysis of 45 hospital quality measures in five broad categories including mortality, safety of care, readmission rates, patient experience, and timely and effective care.

The largest hospital operator in the San Joaquin Valley plans to close its pediatric specialty clinics over the coming six months, potentially creating a scramble for parents whose children need care for a wide array of health conditions.

A proposed ballot measure, backed by United Healthcare Workers West, would require some community clinics to spend at least 90% of their total revenue on direct patient care and “mission-related services.”

They voted for Trump — now his Medicaid cuts could leave their clinics and coverage at risk.

Amid ongoing uncertainty over federal funding of local health services, a project to prevent suicide and substance use among Native American youth in Kern County could be scaled back, or possibly eliminated.

Officials said reduced state and federal funding contributed to the cuts.

The San Joaquin Valley is expected to acutely feel the cuts. The region has the highest usage of the federal health insurance program in California.