The CSAC Board of Directors adopted a policy that opposes efforts to “reverse expansions to the Medi-Cal program, which will shift the responsibility of providing these individuals with healthcare from the Medi-Cal program to counties, which are required to provide services to the medically indigent.”  Consistent with that policy, this amicus brief, drafted by Lorraine Van Kirk in the Santa Clara County Counsel’s Office, informs that Fifth Circuit Court of Appeals of the serious negative consequences that counties will suffer if a trial court ruling striking down the Affordable Care Act in its entirety is affirmed.