HOUSTON -- For years, John Sealy Hospital at the University of Texas Medical Branch at Galveston has been known as the hospital of last resort for the uninsured and indigent in Texas.

Whether they drove hundreds of miles on their own or were shuttled in vans and buses by their local governments, they’ve come to UTMB from 160 of the state’s 254 counties.

But then the public hospital shut down after Hurricane Ike caused $710 million in damages. That’s left many communities that depended on UTMB to treat indigent patients scrambling to find alternatives. About 25 percent of Texans don’t have insurance, the highest rate in the country.

Now, the wounded hospital is slowly healing after 3,000 post-Ike layoffs and losing more than half of its 550 beds. But concerns mount over what the changes will mean long-term for indigent health care in Southeast Texas and the rest of the state.

The short-term affects on indigent health care were felt almost immediately. Nearly 80 percent of the patients treated by UTMB come from six counties: Jefferson, Galveston, Harris, Brazoria, Fort Bend and Montgomery.

Jefferson County, northeast of UTMB, had sent 600 to 800 patients a month to the hospital under its indigent care contract.  Now those patients are being seen in local clinics, creating waiting lists of two months or more.