Last month, Greenlining hosted our 24th annual Economic Summit which brought nearly 1,000 attendees together for critical panels, discussions, and networking all focused on “Racial Justice on the Frontlines.” Given the turmoil in Washington, DC, perhaps no other issue has been as sensationalized as congressional efforts to repeal and rollback the Affordable Care Act.
As part of the Summit, Greenlining’s Health Equity team hosted a panel titled, “Defending Health Equity: Building Health Equity for Communities of Color while Obamacare is Under Attack.” This panel examined the policy and budget implications if the ACA was repealed, and emphasized the importance of broadening our work as health advocates to defend health equity. Joining us for this discussion were four stellar health equity champions:
- Sinsi Hernandez-Cancio, Health Equity Director with Families USA
- Cynthia Buiza, Executive Director with the California Immigrant Policy Center
- Jahmal Miller, Deputy Director of the California Department of Public Health’s Office of Health Equity
- Genoveva Islas, Program Director with Cultiva La Salud.
Since its passage in March 2010, congressional Republicans have attempted to repeal the ACA nearly 70 times. The most recent repeal effort – the American Health Care Act (AHCA), introduced by Speaker Ryan on March 5, 2017 and passed through the House of Representatives on May 4 – is consistent with the failed ideology that seeks to limit the federal government’s role in governance and to return to a time where states’ rights rule the land (sound similar to the system of slavery, anyone?). On March 24, House Republican leaders had to pull the bill from the floor because they lacked the votes required for passage. For a brief moment – that included our Summit discussion — advocates took a sigh of relief as the AHCA would have spelled chaos for working class poor and communities of color across the nation.
Many AHCA provisions seek to reduce federal monies for the health care system, through reducing the amount of cost-sharing subsidies and capping federal subsidies given to states for Medicaid enrollees, amongst other provisions. Sinsi Hernandez-Cancio noted, “It wasn’t a health care bill, it was a ‘wealthcare’ bill.”
That’s still true of the updated version the House finally passed and sent on to the Senate May 4.
Prior to the ACA, communities of color made up nearly three-quarters of California’s uninsured. In 2015, the Center for Disease Control released a report, Health Insurance Coverage: Early Release of Estimates From the National Health Interview Survey, detailing the significant decrease in uninsured rates as a result of the ACA passage for Asians, African Americans and Latinos. Even with this reduction of uninsured and underinsured, Cynthia Buiza shared, “We have not come to a political and social consensus around what to do with the 11 million or so immigrants. …many are not covered due to their documentation status. Even if they are covered, issues [remain] with cultural competent and linguistically appropriate care. Discrimination is in the system.”
This statement reminded panel attendees that we must understand that ACA repeal efforts represent only one tactic of a larger system designed to disenfranchise and disempower communities of color. Panelist Jahmal Miller noted the striking correlation between health care and voting: “The effort to repeal the ACA is consistent with attacks we see on voters’ rights and is consistent with the attacks we see on civil rights.” He continued, “Politics is one key determinant of equity. Sick people and dead people don’t have the agency to vote and be civically engaged. Disabling the communities so that they cannot be politically active to shape policies that inform their day to day lives.”
As the struggle to defend the ACA looms, advocates must juggle two balls: fighting the rollback and repeal efforts while expanding our fight to defend health equity. Our panelists left us with strategies to do just this. Jahmal shared, “We need to think about the co-benefits of health that care and coverage will allow communities to become more politically activated. … We are still focused on disease management, and we need to have a radical shift to go towards primary care and preventive health, and look at investing in upstream policies in transportation, social services, housing.”
Sinsi reminded us, “When it comes to politics, we are in a post-moral situation. We are shaken out of the reality that if we have truth and justice on our side, we will win. We have to move past that naïveté. Stating facts is not enough. Be loud. Be authentic.”
Panelist Genoveva Islas stated, “Community has withstood colonization and deportation and I am sure we will survive.”
Time and time again, California has led the charge to defend health equity. Let’s show up and show out for our community’s health!
Liz is Greenlining’s Health Equity Manager. Follow her on Twitter.