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Los Angeles aims to make Obamacare universal in more than just name

Obamacare is constitutional, and it's even an early success - but there are still 31m people left to cover. One California doctor has an idea how. Photograph: SAUL LOEB/AFP/Getty Images

On a sunny weekday morning just east of downtown Los Angeles, a crowd of about 75 people rallied outside the LA County/USC Medical Center. They toted signs with slogans like "Healthcare is a Human Right" and "Salud Para Todos" ("Health for All").

"How can we say we live in a just and humane society," said one speaker, "without providing for the sickest and most vulnerable among us?"

This wasn't 2009, when the Affordable Care Act was a hot point of debate. It happened just last week. The activists organized the rally to urge the LA County board of supervisors to increase funding to a program called Healthy Way LA that is spearheading an experiment to cover those who are uninsured or can't afford or qualify for Obamacare.

If it works, the concept could revolutionize healthcare in American cities C if it can handle the problems of scale for millions of patients and funding from strapped municipal budgets.

A bridge for the uninsured

While the Affordable Care Act has reduced the ranks of the uninsured across the country, it was never designed to provide fully universal health coverage. Estimates show that 31 million people nationwide will stay uninsured.

Los Angeles, with its massive low-income population and largest concentration of immigrants anywhere in the country, may be the epicenter of the continuing uninsured crisis in America. Somewhere around one million county residents will remain uninsured even after the law changes.

"You have one million people in a county without access to primary health benefits, there's a very good chance that you'll have a lot of sick people, who will get other people sick," says Tom Holler of OneLA, a faith-based coalition pushing for more funding for the uninsured.

The question the protesters were tackling is this: how do cities and states fill the gap between the people who are covered by Obamacare and those who aren't?

"In our view, the Affordable Care Act makes huge strides to reduce the uninsured, said Anthony Wright of Health Access California. Now its more feasible for states and counties to finish the job."

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