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We at CPEHN, condemn the violence that was committed last weekend by white supremacists and neo-Nazis. This year has been deeply troubling as white supremacy and hate-based violence has been on the rise. We mourned in February when Srinivas Kuchibhotla was murdered in Olathe after racist epithets were hurled at him and we were shocked once again when Ricky John Best and Taliesin Myrddin Namkai Meche were killed in Portland after intervening when anti-Muslim remarks were being yelled at two Muslim women. As a nation, we continue to feel the wounds of overt and institutional racism and its impacts on the health of our communities.

Over 25 years ago, CPEHN’s founders came together to create a unified voice for communities of color amid challenging times and potential opportunities. While we as a state and nation have made important strides towards improving systems and dedicating resources to heal our communities, it’s events like those in Charlottesville, Olathe, and Portland that again and again reminded us of the forces that seek to create barriers and harm communities of color, LGBTQ+, immigrants, and other marginalized communities. In these times, we need strong leadership to stand up and speak out against white supremacy and hate. And we have experienced that time and again. Even though the President of the United States demonstrates a stunning endorsement of racism through a lack of condemnation of these events, ordinary people across the country have taken a stand and continue to show us hope. The people in Charlottesville who had the courage to peacefully demonstrate against white nationalism in the face of violence provide us with great inspiration, and we particularly honor Heather Heyer for her bravery.
 

Covered California is set to announce its 2018 plan rates on Tuesday, August 1st. These rates will determine what health plans charge consumers for monthly premiums on the exchange. Covered California delayed announcing the premiums because of federal uncertainty over the future of the Affordable Care Act (ACA). Although Republican efforts to repeal the ACA failed last week, President Trump continues to rattle insurance markets by threatening to eliminate federal payments to insurers for cost-sharing reduction subsidies (CSRs). The subsidies are the subject of a lawsuit House v. Price, filed by House Republicans in 2014 which challenged the President’s authority to pay for the CSRs – even though they are an explicit part of the law. The case is now before the D.C. Circuit Court of Appeals, which has put the case on hold. Currently the federal government has only committed to funding CSRs through the month of May 2017.

The failure of Trumpcare for the second time in a row, shows the GOP’s health care overhaul is deeply flawed and cannot be fixed. The Senate GOP plan, the Better Care Reconciliation Act (BCRA), would have caused 4 million Californians, a majority from communities of color to lose their health care coverage. Additionally, the bill would have destabilized the insurance market and cost the state thousands of good paying jobs.

Despite this, California’s Republican Congressional delegation voted for an earlier version of this mean-spirited bill drafted in a closed door, partisan process with no hearings and virtually no input from the people most affected. 

Unfortunately President Trump and Senate leader Mitch McConnell are pushing to repeal the Affordable Care Act now and replace it later resulting in as many as 32 million Americans losing coverage. This plan too would be devastating for California and create havoc for the whole health care system.

Rather than repeating the same failed, closed door, partisan process, we call on California Republican Congressional representatives to set Medicaid aside, cease efforts to repeal and replace the ACA and work with Democratic leaders to identify a plan that actually improves the current health care system by reducing costs, ensuring long-term stability to the insurance market and creating greater access to quality care for all Californians including immigrant communities.

It’s time to make the Affordable Care Act work for everyone – with better care, for more people, at a lower price.

What happened?

This blog is part of a series that will highlight how structural racism in the health care system negatively affects the health of individuals of color. Community Catalyst is committed to exposing and dismantling policies, practices and attitudes that routinely produce cumulative and chronic adverse outcomes for people of color in the health system.

The Better Care Reconciliation Act (BCRA) would result in 22 million people losing their health care coverage over the next decade, cause long-term damage to the Medicaid program and raise health care costs to extremely unaffordable levels for consumers. Millions of low-income people of color, especially those with chronic health conditions, would be among the hardest hit. A recent analysis conducted by the Urban Institute estimates that by 2022 roughly 21 percent of those who would become uninsured because of BCRA are Latinos, and 12 percent are Black. This bill would reverse racial health equity gains made under the Affordable Care Act (ACA) and strike a blow against signature victories for racial equality in America.

CPEHN is proud to release our latest report, “Mind, Body, Spirit: Advancing Mental Health and Substance Use Equity.” This report builds upon the California Reducing Disparities Project draft Strategic Plan, which was produced in 2015 to highlight mental health disparities and community-driven policy solutions.

Mental health and well-being is a core component of overall health, but communities of color in California face myriad barriers to optimal mental health and necessary care. Decades of community disinvestment, over-policing, and poverty had produced toxic stress that pervade communities of color and immigrant communities. Coupled with a mental health care system that is often difficult to navigate, communities of color lack access to the right care at the right time.

Yesterday, the University of California at Berkeley released a study showing that 82% of Medi-Cal enrollees believe is very important for health plans to provide coverage for mental health and substance use care, but that only 47% believe their plan does provide this coverage. California has made significant strides in adding mental health benefits to the Medi-Cal program and ensuring the more Californians have coverage under the Affordable Care Act. Now, we must defend these important advances and improve access.

Download our report here.

The failure of the GOP’s American Health Care Act (AHCA) is a victory we can all be proud of.  Our calls, letters, town halls and vigils made a difference! The Affordable Care Act (ACA) remains the law of the land, and the GOP’s morally bankrupt AHCA went down in flames. The Republicans could not build a consensus to pass a plan that would cause higher premiums and deductibles, 24 million people losing coverage, the dismantling of Medicaid, and billions of dollars in tax breaks for the wealthy and corporations. Millions of us-- from all walks of life, have spoken out against this plan and CPEHN vows to continue to make our voices heard.

There are already other wins. Two states—North Carolina and Kansas will be expanding Medicaid to cover more people now that ACA will not be repealed.

But as Democratic Chair Perez said on NPR, “No one is spiking the football, yet.”  We know the attacks from the Administration are not over, with HHS Director Tom Price continuing to undermine the ACA administratively and Republicans still talking about defunding Planned Parenthood and Medicaid “reform.” The President also tweeted Saturday that he was ready to let the ACA explode.

URGENT ACTIONS NEEDED EVERY DAY THIS WEEK

Your actions are making a difference! Last week the GOP went from insisting Republicans in the House would fall in line behind the American Health Care Act (AHCA), the GOP’s plan to repeal the Affordable Care Act (ACA), to admitting the bill will need to change to pass. Despite talk of making small tweaks to the bill, (which would include work requirements for Medicaid recipients) and the president saying he is 100% behind it, passage is still in doubt.

"My whip count indicates that there are 40 no's," enough to defeat the bill, said Rep. Mark Meadows (R-North Carolina), who leads the hardline House Freedom Caucus. Across the Capitol, Sen. Dean Heller (R-Nevada), facing re-election next year, became the fourth Republican senator to announce his opposition. That left Senate GOP leaders at least two votes shy of what they need, even though they control the chamber 52-48.

Why the sudden case of nerves by GOP leaders after seven years of promising to repeal the ACA?

The energy was ecstatic on Sunday, March 12th, at the Ed Roberts Campus where over 300 people gathered to #Fight4OurHealth and defend the tremendous health care gains California has made covering over 5 million people.

We remember what it was like before the Affordable Care Act (ACA), close to seven years ago:

  • Young adults were kicked off coverage when they were around 23 years old.
  • If you were young and healthy and could afford coverage on the private market, access to the services you needed were not a guarantee if you had a certain condition or an expensive illness that meant you could hit a lifetime cap on coverage.
  • As a woman you had to pay higher premiums because maternity coverage was not considered an essential benefit.
  • If you had breast cancer, or allergies, or diabetes, you had a pre-existing condition and were either considered uninsurable or had to pay much, much more.

The ACA changed those things. Today we have more secure coverage because we are guaranteed a minimum level of benefits, meaning you get what you pay for no matter what happens, and prevention screenings are free. Low income families and individuals have options for coverage, where there were none before through the expansion of Medi-Cal. We strengthened private health care coverage so there are no longer lifetime caps for coverage yet your out of pocket costs are limited. At the town hall on Sunday, we heard courageous stories from Bay Area residents about their journey for health care coverage and what it has meant to their livelihood.

URGENT ACTION NEEDED DAILY FOR THE NEXT MONTH

Last week Republican leaders released the American Health Care Act (AHCA), their plan to repeal the Affordable Care Act (ACA). The plan was crafted secretly, with no debate or Congressional Budget Office (CBO) Score, so right now there is no official word on what it would cost and how many people would have access to insurance. Two key House committees, Ways and Means and Energy and Commerce released drafts of their respective reconciliation language and immediately started marking-up the bills, giving Democrats little time to analyze and respond to the GOP Plan. On Thursday, March 9 at 4:30am, the House Ways and Means Committee approved the tax penalty repeal provision of the ACA after an 18-hour session, while Energy and Commerce passed the policy provisions later that same day.

On Monday, House Republicans introduced legislation to gut mental health care for millions of Americans.

For individuals enrolled in Medi-Cal, the legislation will enact a per-capita cap, or a limit on federal spending for each Medicaid enrollee. For enrollees with significant health costs, including prescription drugs, on-going treatments, and hospitalizations, this will mean that costs above the cap must be covered by the state or by the enrollee. California stands to lose at least $20 billion, or one fifth of our Medi-Cal program, which will force the state to make dramatic cuts to eligibility and benefits.

The legislation also dismantles the Medi-Cal Expansion. Thirty percent of those newly eligible for coverage are living with mental illness and/or substance use disorders, the majority previously uninsured. While people who are currently enrolled in Medi-Cal will be able to remain covered, new enrollment will be frozen in 2020. Additionally, anyone with a coverage gap of more than one month will lose his/her coverage.

Additionally, beginning in 2020, the Essential Health Benefits requirement in Medicaid would be eliminated, including mental health and substance use treatment. California will have the option of whether or not to require Medi-Cal Managed Care plans to provide these benefits in light of decreased federal funding for the program.

For individuals enrolled through Covered California, income-based tax subsidies will be eliminated and replaced with an unspecified and discretionary fund for states. Additionally, for commercially insured individuals, the prohibition on discriminating on the basis of pre-existing conditions, including mental health conditions, will be eliminated. Individuals who have not maintained continuous coverage will be required to pay a 30% penalty beginning in 2019.

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