Much of inland California is made up of towns just like Firebaugh, where large swaths of the population are uninsured, where traveling to a hospital means a long drive, and where doctors and pharmacists are in short supply. The nearest hospital to Firebaugh is 20 miles away, and the closest trauma center is nearly 40. The federal health reform law is designed to help improve healthcare in rural areas by expanding access to coverage and investing in primary care doctors and rural hospitals. But that is an uphill battle in places like the San Joaquin Valley, says Marlene Bengiamin, research director at the Central Valley Health Policy Institute.