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.
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]
The California Pan-Ethnic Health Network continues to move the needle on health justice by integrating health equity into statewide policies including mental health. Assembly Bill 470 (Arambula), sponsored by CPEHN, passed out of the Assembly Health committee with bipartisan support. The bill aims to reduce mental health disparities by establishing robust tracking and evaluation measures to ensure Medi-Cal beneficiaries are receiving timely access to quality mental health services that meet their cultural and language needs as required by law.
During the committee hearing Assemblyman Arambula shared a striking statistic: Approximately 92% of adults in California who do not speak English as their primary language report unmet needs for mental health services, with about 70% receiving no treatment at all.
Finding a provider who will treat them can be extremely challenging for smaller, rural communities for which English is not their native language. As Genevieve Flores-Haro, Associate Director of the Mixteco/Indigena Community Organizing Project indicated that though they have a good partnership with their county mental health department, and "regularly refer community members to county mental health services," "families claim there is a time gap from the moment they are referred, deemed eligible (3 weeks), and until they ultimately receive service (3 months). Timely access is crucial for seasonal farmworkers who are constantly migrating and are unable to attain mental health care due to the lengthy process.”
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.
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.
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.