I am one of millions of Californians celebrating the decision of leaders in Washington not to bring the misguided American Health Care Act (AHCA) to a vote in the House of Representatives. Because of this surprising and historic turn of events last week, the tremendous gains our state achieved under the landmark Affordable Care Act remain intact. That is good policy for vulnerable people, for the health care system, for democracy, and for California’s cherished values of inclusivity and social justice.
Millions of poor children, seniors, persons with disabilities, and other vulnerable people in the Golden State will maintain vital coverage and protections through the Medi-Cal program, which the AHCA had targeted for significant cuts. More than one million Californians will continue to get financial assistance through the robust Covered California marketplace for affordable health insurance. It is extremely significant that the health care providers that deliver essential care to people of all income levels will not be subjected to destabilizing financial cuts.
The decision to leave the Affordable Care Act in place means we will continue supporting and innovating around comprehensive benefits in Medi-Cal and private insurance. Women will continue accessing reproductive health services and low- or no-cost contraception. Entrepreneurs will strike out on their own with confidence that they can obtain health insurance for themselves and their families regardless of pre-existing conditions. Expanded behavioral health services, including treatment of substance use disorders, will continue to save lives. No chronically ill person will be subjected to annual or lifetime caps in their benefits. Thousands of California nursing home patients — and their families — can continue to rely on Medi-Cal to cover their care. And policymakers will continue focusing on payment reform innovations that align the financial incentives of the health care system with the best interests of patients and families.
The AHCA is dead, but there still are forces interested in rolling back the key gains of coverage and comprehensive services provided by the Affordable Care Act. It’s on us to be vigilant and speak out when they do, and I pledge that the California Health Care Foundation will remain on guard.
Along with our many partners, we stand committed to preserving access to quality, affordable health care — especially for the most vulnerable people who have the least. We must gear our health care system to the real needs of real people.
California has shown the nation what can be achieved under the framework of the Affordable Care Act. The portion of the population without health coverage has plummeted to historic lows. We have a robust Medi-Cal program that covers 14 million people — more than the entire population of Pennsylvania. And we have a strong, functional health insurance exchange with Covered California, which has deftly stabilized the individual health insurance market in the nation’s largest state. Each program remains unchanged now. Californians should continue to enroll in Covered California and Medi-Cal based on their eligibility.
We must of course continue tackling the tough challenges that remain in our health care system: bringing down the cost of care and coverage for more Californians, improving access to care, and making our health care system accountable and transparent.
For two decades, this has been the mission of CHCF and our partners across the state. Regardless of what happens in Washington, we will continue working together to move California forward.
Dr. Sandra R. Hernández is president and CEO of the California Health Care Foundation. Prior to joining CHCF, Sandra was CEO of The San Francisco Foundation, which she led for 16 years. She previously served as director of public health for the City and County of San Francisco. She also co-chaired San Francisco’s Universal Healthcare Council, which designed Healthy San Francisco, an innovative health access program for the uninsured.
Sandra is an assistant clinical professor at the University of California, San Francisco, School of Medicine. She practiced at San Francisco General Hospital in the AIDS clinic from 1984 to 2016. She was appointed by Governor Jerry Brown to the Covered California board of directors in February 2018. She currently serves on the Betty Irene Moore School of Nursing Advisory Council at UC Davis and the UC Regents Committee on Health Services. Sandra served on the External Advisory Committee at the Stanford Center for Population Health Sciences in 2016. Sandra is a graduate of Yale University, the Tufts School of Medicine, and the certificate program for senior executives in state and local government at Harvard University’s John F. Kennedy School of Government.