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Health Equity Forum: Executive Director Article – December 2016

CPEHN Will Remain a Steadfast Voice for Health Care in These Trying Times

By Sarah de Guia, Executive Director, CPEHN

I don’t know about you but since the election I have felt like I’m on a never-ending roller coaster with lots of ups and downs and a sense of steady unease. In October, just weeks before the election, CPEHN held our Voices for Change conference with an inspiring panel of young leaders, an overview of our Landscape of Opportunity report from Dr. Ponce from UCLA, and an informative and riveting keynote by Steve Phillips on the potential of the new majority. We were inspired to build upon the strong foundation for health equity we have all contributed to these past several years.

While the tone was different, the day after the election, I released a statement with a similar message about how we need to come together but this time to protect our communities and all of the gains that we have made. Today, I feel that need even more. Not only are we facing significant challenges to our policies -- but even worse -- our communities and children are being harassed, made to feel that we don’t belong, and intimidated into silence. Over the next few years, we will be tested and challenged but we must channel the strength of our leaders past and present to stand up for what is right.

At CPEHN, we will be standing up for our communities by defending the Affordable Care Act (ACA) but also our greater vision for health equity meaning that everyone has a just and fair opportunity to attain their full health potential.

We know that many of our allies will be challenged in many other ways, including through threats to our basic civil rights, immigrant and LGBTQ rights all of which can negatively impact health outcomes for our communities. CPEHN will continue to stand in solidarity with our diverse communities to resist these new threats. We will also remain a steadfast voice for you in our fight to save our health care. The success of the ACA has been a pivotal turning point for our communities, cutting uninsurance rates by more than half for Asian Americans and African Americans and reducing rates for Latinos between 2013 and 2015, as well as providing long needed preventive, mental health, and chronic care services.[i]    

It is no secret that President-elect Trump and House Speaker Ryan have prioritized the repeal of the ACA. Many of these changes could be made within the first few weeks of the new Administration through the budget reconciliation process which only requires a simple majority (51 votes) for passage. Republican-led efforts to dismantle the ACA will undo the extraordinary progress California has made. Taken together these proposals could:

  • Drastically cut spending for Medi-Cal which covers 14 million Californians (9.3 million people of color) by restructuring the program into block grants or per capita caps on enrollment and/or eliminating the Medi-Cal expansion which provides coverage to close to 3.7 million Californians (~2.3 million people of color).
  • Eliminate tax credit subsidies and cost-sharing in Covered California for 1.2 million Californians (~570,000 people of color) who rely on this assistance to purchase coverage in the exchange, effectively dismantling our state exchange and the gains we made this last year in prioritizing the elimination of health disparities in our state.
  • Privatize Medicare and roll back prescription drug coverage for 5 million enrollees (~2.15 million people of color) who are relying on Medicare for comprehensive health care and prescription drug coverage which could mean higher costs for seniors.
  • Gut consumer protections for health insurance by allowing the sale of insurance plans across state lines. This proposal could prevent consumers from getting medically necessary services in a timely manner and in the language that they speak.
  • Eliminate the ten Essential Health Benefits which include coverage for certain health and mental health conditions and services including addiction treatment, preventive services, prescription drug coverage, and maternity care.

CPEHN is gearing up to respond and we need your help! Here is what you can do:

When I look back on our hopeful gathering at our Voices for Change conference, there were two significant messages I took away from our leaders that day. They challenged us to be bold and take the long term view. While at first these messages may seem counterintuitive, I think they are exactly what we need to remind ourselves of everyday. That we cannot back down now – this is a fight we must face squarely – and that we must be strategic in our efforts to plan a hopeful future for our children, elders, families and communities. Let’s make a pledge to work together, be bold, and take the long view as we protect and defend the important gains we have made. ¡Sí se puede!

[i] “Federal Health Care Reform Generated Broad Coverage Gains Through 2015,” but These Gains Are Now in Jeopardy”. November 2016. Center on Budget & Policy Priorities.