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Health Equity Forum: News from the Executive Director – October 2015

Policies Advance Health Equity, but Fiscal Challenges Remain

This year California saw monumental policy changes that will both improve and strengthen access to quality health care in our state. The Governor took a huge step towards bridging the gap in coverage for undocumented immigrants with the expansion of Medi-Cal to all children regardless of immigration status. We at CPEHN are also extremely excited to announce that all three of our sponsored bills were signed this year – paving the way towards more equitable access to health care services. Our bills seek to provide greater information and services to consumers, especially those who do not speak English well including updating language assistance policies in hospitals, ensuring health benefit information is available in non-English languages, and requiring up-to-date provider directories with information about bilingual providers in a health plan’s network.

At the same time, impending financial challenges in health care, education, and transportation could endanger these gains. In the Medi-Cal program, California must raise $1.3 billion or face deep cuts next year. While the Administration, legislature, and health plans tried to find a path forward, no agreement has been reached for a new health plan tax to replace the one set to expire late summer 2016. In addition, the legislature failed to pass a tobacco tax which could have raised up to $1.5 billion in funding toward health care for low-income families and assistance for programs dedicated to curbing tobacco use. In addition to health care shortfalls, the state’s transportation infrastructure requires an estimated $5.7 billion in additional funding each year to address unmet maintenance and road improvement needs. This funding shortfall means fewer resources and an uphill climb for projects promoting health by more fully integrating active transportation into our streets.

If that wasn’t enough, parts of Prop. 30 begin to sunset in 2016 and will fully expire at the end of 2018, which means that California will need to identify new revenues for our schools and public safety. There are already proposals underway to extend the Prop. 30 revenue measures, including one led by the California Teachers Association that would generate between $7 billion and $9 billion in revenue each year and last until 2030. Any significant changes to tax policy will likely have to be made through ballot propositions, and we will be closely following these proposals in the lead up to Election Day 2016.

We know that our health is influenced by factors that go beyond access to health care such as income, employment, education, housing, and the environment. Expanding access to care, especially to undocumented children, is a critical first step towards leveling the playing field. But more needs to be done to address the social and environmental determinants of health. While the financial gaps are worrisome, these challenges also provide an opportunity to think about how to better integrate health and equity into our state infrastructure. From prioritizing equity in our health care delivery system to promoting health in our transportation infrastructure, CPEHN stands ready to engage and inform these fiscal opportunities to create better health for all.