The Supreme Court's ruling today upholding the healthcare reform law will have a major effect close to home. In Los Angeles County, some 2.2 million people do not have health insurance.

Thanks to the ruling, 1.7 million of them will have access to coverage, according to a statement from Mitchell Katz, the director of the county Department of Health Services. Of those, nearly 1 million residents will be eligible through the expansion of Medicaid. The remainder will have access through the California health insurance exchange.

The county has already signed up about 200,000 people through its Healthy Way L.A. program, but it's got a lot of work to do between now and 2014 to fully implement the health reform law.

“Today's decision by the Supreme Court affirms the principle that access to affordable, quality health care is a right, not a privilege,” said Supervisor Zev Yaroslavsky, in a statement. “With the Supreme Court decision behind us, we can now turn our attention to full implementation of the law in 2014.”

In a statement, Assembly Speaker John Perez said that California has been “the national leader on implementing federal healthcare reform,” and vows that “we will continue to move full-speed ahead.”

Update: Per the county, the 440,000 or so L.A. County residents who will not be entitled to health insurance under Obamacare are either A) undocumented immigrants or B) legal immigrants who have been here for less than five years.

The full statement from Katz, the county health director:

Supreme Court Ruling a Victory for Los Angeles County's Uninsured Population

As a result of today's decision by the Supreme Court to uphold the Patient Protection and Affordable Care Act (ACA), over 80% of the 2.2 million people who are currently uninsured in Los Angeles County stand to gain access to affordable insurance coverage.

Over half of these individuals are eligible to receive coverage through Medi-Cal in 2014. This coverage will be contingent on the State of California's participation in the Medicaid expansion component of the legislation. In anticipation of this expansion of Medicaid, the Department of Health Services (DHS) has already enrolled over 200,000 low-income County residents into Healthy Way L.A., the County's coverage program known as the “Bridge to Reform.” While the ultimate decision on California's participation is yet to be determined, the Supreme Court's decision preserves a path for enrollment into Medi-Cal on January 1, 2014 for these individuals, as well as for three-quarters of a million other low-income Los Angeles County residents.

In addition to those who will be newly eligible for Medi-Cal, three-quarters of a million additional County residents will be able to purchase affordable health insurance through the state's health insurance exchange, take control of their health, and reduce pressure on our strained County-run health care system. With a sustained commitment to serve as the safety net for low-income Los Angeles County residents, over the coming 18 months DHS will continue to transform our clinics and hospitals into a system of choice for these newly insured.

Beyond the impact of the ACA's coverage components, DHS will continue to contend with the effects of other aspects of the legislation. Notably, this will include efforts to advocate for fair allocation of the Disproportionate Share Hospital funding cuts which were included in the legislation. These funds are an important revenue stream for Los Angeles County in that they provide a mechanism to reimburse hospitals for provision of uncompensated care. On this issue, DHS will advocate for a fair level and allocation of DSH funding. Finally, in recognition of ongoing fiscal challenges at the federal level, DHS will closely monitor the political environment and advocate for fiscal policies that safeguard DHS' ongoing ability to serve as a safety net provider in Los Angeles County.

Over the coming weeks to months, DHS will continue to assess the full impact of the Supreme Court's decision and take the steps necessary to secure a robust health care safety net for Los Angeles County residents.

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