Harris

On January 28, 2003, the Board of Supervisors of Los Angeles County 1 voted to reduce expenditures by closing Rancho Los Amigos National Rehabilitation Center (Rancho) and by reducing the number of hospital beds at Los Angeles County-USC Medical Center (LAC-USC). Ran-cho is a county hospital dedicated primarily to providing inpatient and outpatient *757 rehabilitative care; LAC-USC, also a county hospital, is an acute care facility that provides a full range of hospital services. Plaintiffs challenged the planned closure and reduction through this action. The district court granted plaintiffs’ request for a preliminary injunction, barring the County from going forward with its plan. The County appealed, challenging the district court’s decision that plaintiffs have standing to sue and the court’s issuance of an injunction. We have jurisdiction under 28 U.S.C. § 1292 (a), and we affirm.

I. Factual Background

A. The County Healthcare System

In March 2002, the County closed several primary health care centers that served the indigent and working poor. These closures effectively eliminated 54,000 office visits per year. Later that year, the County closed additional facilities,…