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Health Equity Forum: Federal Update – March 2018

Federal Update: CA Fights Back as GOP Assaults on Immigrants & Health Continue

 “We are a proud safe haven, a proud sanctuary city, a proud sanctuary state, and we stand with our neighbors.” -- Sacramento Mayor Darrell Steinberg 

The hostile political atmosphere surrounding immigration and health care continues in Washington, D.C. While California lawmakers shore up state protections for communities of color, at the federal level, there is no end in sight to the persistent battles.


  • Sessions vs. California: This week Attorney General Jeff Sessions came to Sacramento to talk about federal legal action against the state over three recently enacted laws protecting immigrants. The laws make it a crime for business owners to help federal agents detain undocumented workers, prohibit local law enforcement from alerting immigration agents when detainees are released from custody, and create a state inspection program for federal immigration detention centers. The state is vowing to vigorously fight to uphold the laws.
  • DACA: Congress failed to create a new legal status for DACA by March 5, and while recent court decisions have allowed some Dreamers to renew their status, Dreamers could still be subject to deportation despite the court rulings. Many agencies that work with Dreamers report that the government is dragging its feet on issuing renewals. The President told a Latino trade group on Wednesday that Democrats were the reason for the impasse, that the Administration is “ready, willing and able to make a deal.” Another Senate attempt to pass legislation failed this week. Lawmakers on both sides of the aisle say there is no clear path to agreement on DACA, as long as the fate of Dreamers is tied into other more complicated immigration issues like the wall between Mexico and the US.

Health Care

As of March, 2018, the President’s promise that Americans “can expect to have great health care” is ringing hollow. Instead, many individuals, especially in communities of color, are finding their health care is in a precarious position as the Administration continues to undermine the Affordable Care Act (ACA). California has been able to cushion the blow of higher premium rates in 2018 by enacting consumer friendly state policies and workarounds.

  • Affordable Care Act: Trump and congressional Republicans have undermined the Affordable Care Act by repealing the individual mandate in their tax bill. Trump stopped making cost-sharing reduction (CSR) payments to health insurers, the payments had helped to lower out-of-pocket costs for the marketplace’s poorest customers. Because of uncertainty about CSR payments, enrollment outreach, and the mandate, plans hiked their rates an additional 20 to 30 percent on average for 2018. There are currently two deals on the table to offset some of that damage:
    • The Alexander-Murray deal would fund the CSR payments for 2018 and 2019.
    • The Collins-Nelson bill provides $10 billion in federal reinsurance funding over 2018 and 2019 to help lower insurance premiums by compensating insurers for their costliest patients. The Administration is now muddying the waters on both these plans, by demanding anti-abortion legislation is attached to them, which would make them a no-go for Democrats.
  • Junk Health Insurance: The Administration is pushing harmful changes that would expand short-term ‘junk insurance’ plans, hike premiums on older adults and impose abortion restrictions.  By California law, the sale of these types of short term limited duration plans is impermissible. A newly introduced bill, SB 910 (Hernandez) will dispel any confusion caused by the Administration's actions.
  • Prevention Funds for Health Equity Under Threat!: The Centers for Disease Control and Prevention’s Racial and Ethnic Approaches to Community Health (REACH) program has been zeroed out in spending bills currently under consideration in the House and Senate. California received over $8.7 million in REACH grants in FY 16. These grants are awarded to critical programs like Mandela Marketplace which provides access to healthy food and beverage options for diverse low-income communities in West Oakland and UC San Diego’s Asian Language Tobacco Quit-line which provides phone counseling services to smokers who speak Asian languages and have low English proficiency. This short-sighted move threatens the only current federal source of community-based funding to improve health and wellbeing that directly addresses the wide racial and ethnic health disparities that exist in the U.S. Funding for the REACH programs will be discontinued unless it is included in the FY 18 and FY 19 budget negotiations, which are currently underway. Tell Congress to Fund the Reach Program TODAY!