MICHAEL P. HEIN COUNTY EXECUTIVE COUNTY OF ULSTER EXECUTIVE ORDER NO. 1-2017 TO ADDRESS A SERIOUS POTENTIAL PUBLIC HEALTH THREAT, THE ULSTER COUNTY COMMISSIONER OF HEALTH AND MENTAL HEALTH IS HEREBY DIRECTED TO STUDY, RECEIVE PUBLIC INPUT, EVALUATE AND REPORT ON THE IMPACT OF THE REPEAL OF THE AFFORDABLE CARE ACT AND ENACTMENT OF THE PROPOSED REPLACEMENT ON THE RESIDENTS OF ULSTER COUNTY WHEREAS, the Affordable Care Act, enacted into law on March 23, 2010, increased the health insurance quality and affordability for the citizens of the United States of America; and WHEREAS, the Affordable Care Act also provided opportunities for tens of millions of Americans to obtain health insurance, which was previously not available to them; and WHEREAS, the impact of the Affordable Care Act goes far beyond individual health insurance coverage and has major implications on Ulster County's healthcare delivery system, including our hospitals, health centers, and nursing homes and all healthcare professionals; and WHEREAS, the Medicaid program will be significantly impacted by the repeal of the Affordable Care Act, which could increase the local share of Medicaid costs and negatively impact local property taxpayers; and WHEREAS, one of the greatest public health threats facing the residents of Ulster County is the net effect associated with the potential repeal and replacement of the Affordable Care Act; and WHEREAS, the residents of Ulster County will be directly impacted by the proposed replacement plan and their input is critical to the decision-making process; and WHEREAS, it is important for Ulster County to document the impact of the Affordable Care Act, take public input and report these findings to our federal representatives as they debate the future of the Affordable Care Act; and WHEREAS, the magnitude of this issue and the grave risk to public health it represents necessitates a formal written directive;NOW, THEREFORE, I, MICHAEL P. HEIN, County Executive of the County of Ulster, in accordance with the aforementioned and in furtherance of my statutory duties, do hereby order and direct the following: 1, The Commissioner of Health and Mental Health shall study, evaluate and report on the impact of the Affordable Care Act, as well as the proposed replacement on the residents of Ulster County. 2. The Commissioner of Health and Mental Health shall hold a public forum or hearings to receive public input from the residents of Ulster County as to how the Affordable Care Act has impacted their lives and document their concerns or issues with any proposed repeal and replacement, 3. The Commissioner of Health and Mental Health shall be empowered to utilize any necessary county resources, such as securing financial and legal expertise from the Ulster County Department of Finance and Ulster County Attorney’s Office and any other county department deemed necessary, during the course of her evaluation. 4, The Commissioner of Health and Mental Health shall issue a report to the County Executive within 30 days of the execution of this order detailing the impacts of repealing the Affordable Care Act and the effect of the proposed replacement upon: a) The healthcare system in Ulster County; b) The Ulster County Budget and service delivery; and ©) The comprehensive impact on residents of Ulster County. The County of Ulst Ichael P. Hein, County Executive Dated: March £3 , 2017 Kingston, New York