Preserving Critical Healthcare Benefits Under the Affordable Care Act


All photos by Martin Zamora/Board of Supervisors

The Board of Supervisors unanimously voted to continue opposing the threatened repeal of the Affordable Care Act, particularly provisions of the landmark law that expanded health insurance coverage and public health services.

Acting on a motion by Board Chairman Mark Ridley-Thomas and Supervisor Sheila Kuehl, the Board called for exploring and supporting ways to minimize the number of people who could lose health insurance and, at the same time, maximize federal funding for the County’s safety net programs, should a repeal occur. It also instructed the Health Agency to work with stakeholders in developing options for how health insurance coverage could be maintained and/or extended within the County and the State.

“We have to make it abundantly clear that the ACA has tremendously benefited not only the state but the County of Los Angeles,” Chair Ridley-Thomas said during the Board meeting. “Five million people are now insured in the State of California alone, and a repeal is significantly detrimental or injurious.”

“The rhetoric that emanates from Congress is… rather alarming. That we must be prepared is the rationale for bringing forth what would ultimately look like the California solution,” he added. “There’s a lot at stake. We need to be prepared for it, that’s the prudent and responsible thing to do.”

The ACA enabled about 1.2 million County residents to gain health insurance through Medicaid and Covered California. Many more people benefited from other provisions, such as those that allowed children to stay on their parents’ coverage until age 26; required most employers to provide health insurance; prohibited insurers from denying coverage to persons due to pre-existing conditions and capping coverage for persons with catastrophic illnesses; mandated coverage of preventive care and family planning services; and established equity pricing for women.

The ACA also provided medical assistance to newly Medicaid-eligible individuals whose care otherwise would have been funded by the County. It provided more resources for the County’s In-Home Supportive Services program that serves the elderly and persons with disabilities, as well as for public health programs.

“Improve the ACA. Don’t take away the ACA,” Los Angeles County Health Agency Director Dr. Mitch Katz said during the Board meeting. “If there are things that need to be addressed, let’s make the ACA better.”

Board Chair Ridley-Thomas and Supervisor Kuehl warned that aside from potentially stripping people of their health insurance, a repeal of the ACA could have dire consequences for the County’s economy. They cited a recent study by the UCLA Center for Health Policy Research and UC Berkeley Labor Center, which warned a repeal could trigger a loss of 63,000 jobs in healthcare and other industries and of $5.8 billion in gross domestic product.

“It’s easy to say the ACA will be repealed when you are campaigning. It is another thing to take healthcare away from 20 million people without a plan,” said Bob Schoonover, president of SEIU Local 721, who testified at the Board meeting. “The ACA was created to lower healthcare costs that were out of control. It’s working in Los Angele County and it’s essential that we not lose the progress we have made.”

States have special powers and resources for creating insurance coverage – Massachusetts, for example, passed a health plan that predated the ACA. A health plan has also been considered in California, and Board Chair Ridley-Thomas and Supervisor Kuehl stressed that the County be involved in its development, considering the massive size of its uninsured population.

IMG_0538“The new administration in Washington and its threats to repeal the ACA pose a very serious challenge to the health and wellbeing of County residents,” Supervisor Kuehl said. “Should repeal or any significant diminution occur, LA needs to be at the forefront of helping to craft a way to protect those we serve because if it doesn’t work for LA County, it won’t work for California.”

The Board approved sending a five-signature letter to the County’s Congressional delegation expressing the County’s support for preserving the ACA, especially provisions that expanded health insurance coverage and public health services, and opposing a reduction in Medicaid funding for California and the County.

Their motion instructed the County’s Health Agency Director and CEO to develop options for maintaining and/or extending health insurance coverage for residents of the County and state. Their report, due in sixty days and monthly thereafter, is to include input from stakeholders, including patients, patient advocates, health care providers, organized labor, insurance groups, hospitals, public health and mental health advocates and professional associations.