This Rural California County Lost its Only Hospital, Leaving Residents with Dire Healthcare Choices

By Melissa Gomez, Hannah Fry
Photography By Genaro Molina
June 6, 2023

MADERA, Calif. — It was dinnertime when Sabrina Baker, a mother of six, felt the familiar twinge of contractions.
At first, she brushed it off as Braxton Hicks, false labor pains not uncommon in the late stages of pregnancy. But after dinner that night in early January, the pain sharpened and radiated to her back. The contractions intensified, and Baker knew this baby girl was coming fast.
She had a decision to make — and the options weren’t good.
Two days earlier, Madera County’s only general hospital had shut its doors. The abrupt closure of Madera Community Hospital and its affiliated medical clinics capped years of financial turmoil. Still, most residents in this rural county in California’s geographic center were caught off guard, unaware of just how much was at stake until their hospital was gone.
Baker knew she couldn’t make it to the next closest hospital, in Fresno, a roughly 45-minute drive.
Twenty-five minutes after the first contraction and two pushes later, she delivered her daughter, alone, on her tan love seat. The baby was breech, which upped the anguish and the risk during delivery. When it was over, Baker tied the umbilical cord with new shoelaces and wrapped Onax in a San Francisco 49ers blanket. An ambulance rolled up 20 minutes later to take mom and baby to the hospital.
“I mean, I’m lucky,” Baker said, standing outside her home in a swath of Madera County surrounded by cropland and almond groves. “We could have died.”
During its half-century run, Madera Community Hospital provided a crucial link to healthcare for the 160,000 people who call Madera County home. Spanning from the heavily farmed floor of the eastern San Joaquin Valley to the forested central Sierra, Madera is majority Latino, and 20% of the population live in poverty.
For most residents, the hospital was more than a place to go when disaster struck. Madera Community helped them sign up for Medi-Cal, the state’s version of Medicaid insurance for low-income adults and children. It was readily accessible by bus, and it coordinated services with community clinics where residents could receive routine care and prescriptions. Sometimes the hospital was the only place people saw a doctor. Unlike the many private providers that exclude certain types of health insurance — including Medi-Cal, with its notoriously low reimbursement rates — Madera Community served everyone.
“It’s the worst thing that could have happened to us,” Tony Camarena said of the closure. Camarena runs a business that enables sending money abroad, and many of his customers made use of the hospital’s services, he said.