After President Donald Trump signed an executive order mandating the “swift repeal” of the Affordable Care Act, King County officials and local health care providers addressed efforts aimed at ensuring people in the region continue to receive adequate care.

At a press conference last week, King County Council Chair Joe McDermott, who represents Vashon, noted that King County currently provides immunizations to children, basic health care to people who are homeless and cancer screenings, dental care and family planning. He also called the Affordable Care Act (ACA), also known as Obamacare, the backbone of the health care system.

“Without the ACA, King County will just be left fighting to fix a broken arm with a Band-Aid,” he said.

Additionally, he urged Congress and the new administration to move forward in securing health care and stressed that King County Executive Dow Constantine, the council and many local health care providers remain committed to “finding, building and funding” innovative programs to deliver needed health care.

“We will leave no stone unturned, no partnership ignored, to deliver on this basic human right,” he said.

Neighborcare Health CEO Michael Erikson was among the health care leaders at the press conference and later spoke to what the public might see coming regarding health care.

Word from analysts close to the situation is that in the next 60 to 90 days, there will be an effort to “repeal and delay” the ACA. The repeal could happen — in part — with a simple majority vote as part of the budget reconciliation process. Then work would focus on creating replacements for the elements that were repealed. That could be a longer, more complicated process, Erikson noted.

“When you are in the mode of replacement, you have to have the majority agree to what replacement looks like,” he said. “Republicans do not have a 60-vote super majority, so the Democrats would have to agree.”

In that case, he said, even if the intent is to replace provisions as quickly as possible, that might not occur, leaving those insured through the ACA in a sort of limbo.

Talking about the ACA more broadly, he noted that across the country, 20 million people are insured through the ACA. In Washington, that number is 609,000, and 200,000 in King County.

“Specifically, with Neighborcare Health 16,000 of our patients are with us because of the ACA,” he added.

At the end of the 2016, providers at Neighborcare clinics had served 70,000 patients, and Erikson said he is projecting for 80,000 by the end of 2017.

A critical element of the ACA, he said, was the expansion of Medicaid, done by raising the income eligibility limit. It made Medicaid a Medicare “look-alike,” he said, with 31 of the 50 states participating in that aspect of the ACA.

On Vashon, Kathleen Johnson, the Executive Director of Vashon Youth &Family Services, is paying close attention to action Congress and the administration takes. She estimates that about 330 people a year seek mental health care from the agency, and she believes about a quarter of those rely on expanded Medicaid.

“It really makes a difference for people,” she said. “It was a lifesaver in every sense.”

Losing it without a good replacement will have large consequences, she warns.

“It is going to affect people. It will eliminate their ability to pay for care, which means they will not get care,” she said.

Erikson noted that the picture around the ACA is evolving, but its history — if not its future — is clear.

“In 2013, when the ACA was implemented, it was the single most important legislation to expand access to health care in decades,” he said. “It is unconscionable that we would take a step back from that without providing guidelines … on what is going to replace that.”

Erikson noted people from his agency will lobby in Olympia and Washington D.C. in the coming months. But for now, the focus is on caring for people.

“Our best strategy is to stay focused on delivering high quality, safe, effective and efficient health care,” he said.

He added that Neighborcare Health, as an organization, is stable.

“We have existed for nearly 50 years, in part because both Democrats and Republicans believe in community health centers,” he said. “We have a long history of being here before the ACA. We will be here after the ACA.”