Los Angeles County is the most populous county in the United States, with more than 10 million residents. The population size creates a high demand for health care services, which strains available resources and services. L.A. needs to improve its access to adequate health care and is often considered disadvantaged due to inadequate resources. 

This lack of access to essential and affordable health care services threatens the well-being of low-income and marginalized communities. An important part of social work is the act of service, to cultivate change and resolve grand challenges responsible for suffrage among low-income, marginalized communities “to enhance human well-being and help meet the basic human needs of all people.” One grand challenge social workers prioritize is closing the health care gap to promote improved quality of health care services for all.

Daily headlines, sent straight to your inbox.

Subscribe to our newsletter to keep up with the latest at and around USC.

Even with the current policy in place under California’s Affordable Health Care Act, social workers still need reform to ensure that marginalized communities can obtain quality primary health care. Because of this ongoing challenge, social workers continue to fight to close this gap by bringing awareness and policy improvements for the ever-growing crisis with the lack of access to affordable, quality health care for communities in need.

As of 2023, the census data reflects that nearly one-third of the population relies on the Affordable Health Care Act policy in L.A. County. This reliance has slightly declined in the last seven years as the health care-driven policy lost its credibility. 

When the policy was developed in 2010, the goal was to establish affordable health care and prescription medication prices. However, it has done just the opposite, ultimately failing its reliant members. As a result of rising costs and failed promises, many patients neglected medical treatment to avoid the burden of unaffordable medical bills. 

The alternative consequence was seen with the influx of uninsured and underinsured patients using the emergency room as their primary source of care. This led to overcrowded emergency rooms, with demands disproportionately outweighing supplies. 

The two significant issues that arose were the shortage of physicians and the high individual costs with Covered California, which does not consider California’s high cost of living. Despite the recent health care expansion of the Affordable Care Act of 2010, people are still struggling to obtain adequate health care, and reformation of this policy is direly needed.

The consequences of inadequate health care services profoundly devastate individuals and communities across L.A. County. Affordable health care should not bankrupt individuals or families. Affordability should be a central focus to offset the negative impacts of this policy, which lacks the critical principle upon which it is built. 

As a solution, reformed policies should be implemented to cap medical expenses to ensure adequate health care is accessible to all, regardless of income. This fundamental goal for the health care system will reshape financial barriers and reduce unnecessary out-of-pocket costs to eliminate surprise medical bills. Reducing financial barriers will ultimately reinvent the meaning of affordability as it relates to health care.

Another essential part of the goal to improve health care affordability as an effort to close the gap is establishing health care equity. Health care equity will focus on reducing health disparities so everyone has an equal opportunity for good health status and access to health care services. 

This can be done by improving access to community health centers by expanding the accessibility of community health centers and clinics, particularly in underserved communities. Additionally, having cultural competency within the health care system can contribute to health equity by providing culturally competent care that respects patients’ values, beliefs, language preferences and cultural backgrounds. This helps to eliminate disparities in health care access and treatment outcomes.

The lack of adequate health care services is a crisis felt across L.A. County, regardless of background or circumstances. The problem perpetuates inequality and exacerbates suffering. The goals outlined above reflect the overarching morale that health care should be accessible to all, irrespective of socioeconomic status, location or culture, to close the gap. 

Achieving these goals will require a collaborative effort between the government, health care providers, insurance companies, social workers and the community. The health care crisis must be urgently resolved by reforming the policy to include medical expense caps and health equity to reduce community stigma that health care is unaffordable. 

The time for action is now for the sake of our health, our well-being and our shared humanity. By improving affordability and equity in the health care policy as a united front in California, we can promote positive change for the livelihood of our future.

Arianna Contarino & Jennifer Valdez

Masters Candidates in Social Work

Class of 2025