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Voices for Health Equity

Voices for Health Equity

In July, Covered California announced proposed 2018 rates for the individual market.  The proposed rates included a statewide average rate change of 12.5 percent, as well as the potential for a separate surcharge related to the lack of federal funding for cost-sharing reductions (CSRs).  The surcharge averages an additional 12.4 percent on Silver products, with a range of 8 to 27 percent across carriers. 

As noted in previous emails, Covered California delayed the announcement of final rates pending ongoing federal policy discussions and the potential for Congressional action to fund CSRs.  However, today Covered California announced final rates for the 2018 plan year, and in the absence of a federal commitment to continue funding CSRs, Covered California plans will include the CSR surcharge on Silver-tier products for the upcoming year.  Attached is a press release with more information about today’s announcement.

With this announcement are some important items to note:

Lacking the votes for repeal, McConnell announces transition to tax reform

Lacking the votes for repeal, Senate Republicans announced yesterday that they will NOT be voting on the Graham-Cassidy bill, which would have taken away health care from millions of Americans, including 6.7 million Californians. This bill was the latest and cruelest attempt to date to repeal the Affordable Care Act (ACA). It would have explicitly and intentionally inflicted massive cuts to California, which embraced the ACA and enrolled millions, and diverted funds to those states that did not.

We want to thank you, our partners and tireless advocates in California and across the country who again defended health care for millions. And we thank our California Senators for never wavering in their opposition to these latest harmful repeal efforts.

But, let’s be perfectly clear. The fight is not over! We must remain vigilant. As we’ve seen time and again, Republican repeal efforts never seem to stay dead for long. September 30 is the deadline for Congress to use the current budget reconciliation process, which allows the Senate to pass a bill on a majority vote rather than 60 votes.

What’s next?

Even after this deadline and as Congress moves on to tax reform, the threat is not over. We renew our calls to California’s Congressional leaders to protect Medicaid and Medicare from devastating cuts as part of tax reform and federal budget proposals. As this latest repeal attempt has failed, we echo calls for a return to bi-partisan efforts to strengthen and fix the ACA by shoring up the insurance marketplace. We need stability and certainty, not unpredictability and sabotage.

Upcoming Activities:

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?

The latest issue of our Health Equity Forum newsletter came out today and it includes several great articles and dozens of resources!

CPEHN’s Executive Director, Sarah de Guia, opens the newsletter affirms CPEHN's commitment to defending the Affordable Care Act (ACA) and announces CPEHN's role in convening a California Oral Health Network. 

Our newsletter features an article from the Latino Coalition for a Healthy California (LCHC) that spotlights their work on oral health. We also highlight our partners, Asian Americans Advancing Justice-Los Angeles who are also working hard to ensure equity in oral health. We have also included an article summarizing CPEHN's work in oral health and how our community campaign to restore dental benefits was a success. Finally we have a federal and state legislative updates. 

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.

CPEHN is humbled and excited to lead and convene the California Oral Health Network! We look forward to working with many of our partners to improve oral health equity in California. See below for the DentaQuest Foundation and The California Wellness Foundation statement announcing the new statewide network to advance oral health policy. 

Assembly Bill 391 (Chiu), successfully passed out of the Assembly Health committee with bipartisan support (11-0). The bill is co-sponsored by CPEHN and the Regional Asthma Management & Prevention and Children Now, and it will allow California to better deliver care for Medi-Cal beneficiaries with asthma by adopting policies to expand access to cost-effective preventative care and provide healthcare workforce opportunities for communities of color.

Asthma is a significant public health problem and driver of health care costs. Over 5 million Californians have been diagnosed with asthma[i] -- about 1 in 7 state residents. Asthma is of particular concern for low-income Californians enrolled in Medi-Cal. Low-income populations, like the nearly two million Medi-Cal beneficiaries who have been diagnosed with asthma at some point in their lives,[ii] have higher asthma severity, poorer asthma control, and higher rates of asthma emergency department visits and hospitalizations. [iii] In 2010, Medi-Cal beneficiaries represented 50% of asthma hospitalizations and 42% of asthma emergency department visits, even though they represented only 30% of Californians. [iv]

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