Los Angeles County supervisors on July 29 directed county counsel to explore all legal remedies after federal reporting indicated Medicaid eligibility information for millions of enrollees could be made available to immigration enforcement.

Motion and rationale
Supervisor Hilda Solis introduced the motion and asked county counsel, in consultation with departments including health services, mental health and social services, to examine whether the county should initiate or join litigation or other legal efforts in response to a reported Centers for Medicare & Medicaid Services agreement to provide certain Medicaid eligibility files to the Department of Homeland Security.

Solis and other board members described how confidential eligibility files can include names, addresses and demographic details. County and health‑plan leaders told the board the disclosure risks deterring immigrants and other vulnerable people from seeking lifesaving care and community health services.

County and department concerns
- Health department leaders said they already are seeing increased no‑show and cancellation rates at clinics. St. John’s clinic and Los Angeles General reported double‑digit increases in missed appointments after public notice of the federal action.
- Department of Public Social Services staff described how federal administrative match rates and changes to CalFresh and WIC administration could shift costs to the county; county staff said some of those program administrative changes could cost the county tens or hundreds of millions of dollars.

Legal options and next steps
The motion explicitly asks county counsel to evaluate legal options, including joining the State of California in litigation already filed against CMS and DHS, and to return to the board with recommendations. Supervisors expressed interest in a rapid response, citing the effect the news has already had on beneficiary access and public‑health operations.

Vote and public comment
The board approved the motion unanimously. Dozens of public commenters — including doctors, community health providers, immigrant‑rights groups and health plans — urged immediate action, and asked county leaders to defend privacy protections under HIPAA and related law.

Ending
The board’s formal direction starts a county legal review and interdepartmental analysis. County counsel and affected departments were asked to report back to the board with options to preserve enrollee privacy and to assess immediate steps the county can take to maintain access to care for immigrants and other vulnerable residents.