Los Angeles County and the state of California stand to be hit the hardest with the potential repeal of the Affordable Care Act.

The picture is just as devastating for counties nationwide, which was a major topic of discussion at this year’s National Assn. of Counties Conference and Exposition.

County Supervisors Mark Ridley-Thomas and Kathryn Barger traveled to Columbus, Ohio, for NACo’s annual non-partisan meeting with 2,000 county delegates from nearly every state.

The conference is the only meeting that draws a cross-section of elected officials and county staff from across the country.

Attendees from rural and urban counties, with large and small staffs and budgets – all come together for four days of education, networking and sessions aimed to help improve residents’ lives and the efficiency of county government.

Amidst federal uncertainty about the future of the Affordable Care Act, health care was a focus.

“Healthcare is not to be treated as a partisan issue,” said Mr. Ridley-Thomas. “We operate in a non-partisan environment. We aim to serve our constituents irrespective of their political orientation.”

According to the National Assn. of Counties, it is the duty of local government to fulfill public health and safety services for the most vulnerable residents — children, older adults, and people with disabilities.

The association asserted that the healthcare debate should be about improving health outcomes, not simply a budget exercise.

It concluded that Congress is orchestrating a massive cost shift beyond the capacity of states and local communities to bear.

Every proposal to date would adversely impact the federal, state and local partnership for Medicaid.

Medicaid is a key tool in the battle against the opioid epidemic and is the largest single funder of mental health services and substance abuse treatment.

Counties in 26 states help fund Medicaid and to administer the program. For these reasons.

The association is engaged in the health reform debate on Capitol Hill.

Mr. Ridley-Thomas and Ms. Barger

“This is a non-partisan issue that impacts all counties,” said Ms.  Barger. “This is a crisis and people’s lives are being played as a political pawn.”

“The County of Los Angeles would be the most adversely impacted county in the nation,” said Mr. Ridley-Thomas.

County Chief Executive Officer Sachi Hamai estimates that the County stands to lose $1 billion in funding should the Affordable Care Act be repealed.