Editor’s note: This essay has been updated to account for the Los Angeles County Board of Supervisors vote.
Los Angeles County has never stood by silently when residents are in need, especially when our health is on the line.
H.R. 1, the massive federal budget bill passed last year, delivered devastating cuts to Medicaid. Those cuts threaten the very foundation of our health care safety net. In Los Angeles County, these cuts will not be confined to those who rely on Medi-Cal. They will reach every insured household, because health care is a shared system. When one part collapses, access shrinks and costs rise for everyone.
That is why Los Angeles County leaders have put the issue in the voters’ hands. The Los Angeles County Board of Supervisors passed the motion “Securing Funding to Preserve Critical County Services Cut by H.R.1.” This motion placed a measure, now called Measure ER, on the June ballot as a temporary half-a-penny funding measure, giving voters a chance to provide reliable, locally controlled funding that stabilizes critical services like our health care system and protects residents from the effects of federal cuts. H.R. 1 is expected to claw back $750 million every year from the Los Angeles County Department of Health Services, which operates four public hospitals and roughly two dozen clinics. These cuts would force layoffs of thousands of health care workers, reduce services and close access points across the county. Since last year’s funding cuts, L.A. County has already had to close seven of its public health clinics.
At the same time, more than one million low-income Angelenos are expected to lose Medi-Cal coverage, while health insurance premiums for middle- and working-class families could nearly double. When people can’t afford coverage, they delay care until it becomes urgent. Emergency rooms become the only option left.
Overcrowded emergency rooms mean longer waits, worse outcomes and rising costs that hospitals pass on to patients and insurers. Even Angelenos with private insurance will feel it: higher premiums, larger deductibles, longer wait times and longer travel to access care.
Across the county, over 2 million residents rely on community health clinics for primary and preventive care. These clinics are not just a safety net; they are a pressure valve. They keep people out of emergency rooms, provide high-quality care close to home, and lower health care costs for the entire system. Over the past decade, they have become the primary source of care for one in three Medi-Cal recipients in Los Angeles County.
But clinics cannot do this work without stable funding, and H.R. 1 will cause drastic cuts to clinic finances.
Beyond health care services, H.R. 1 will impact our economy. The most common employment sector for Los Angeles residents is health care and social assistance, employing 13.2% of our workforce and outpacing all other industries in total payroll. Health care employment has been the driving force in national job growth, but H.R. 1 will jeopardize that. The county has already begun hiring freezes and is considering additional layoffs of 5,000 staff. The private sector will soon follow, and our local economy will suffer.
While Angelenos didn’t make these cuts, we’re the ones facing the consequences. Measure ER, supported by the Community Clinic Association of Los Angeles County and Restore Healthcare for Angelenos, would generate revenue to protect critical services, preserve the health care workforce and help prevent medical costs from spiraling further out of control.
Importantly, a part of the funding would be dedicated to protecting safety-net hospitals – facilities that serve our most vulnerable residents and which are a critical element of our safety net. The measure would give residents a chance to provide stability in a time of uncertainty. It would protect access to timely care, preserve frontline health care jobs, and help shield Angelenos from the cascading cost increases triggered by deep Medi-Cal cuts.
By voting yes on Measure ER, Angelenos are taking action to protect the health and well-being of their loved ones, friends, and neighbors. At a time of unprecedented federal disinvestment, Los Angeles County must act to protect essential services, rein in rising health care costs and keep control of our collective health. A half-a-penny is a small price to pay to help people keep their health care.
Louise McCarthy is the president and chief executive of the Community Clinic Association of Los Angeles County, a member of the Restore Healthcare for Angelenos Coalition.
