Like so many others who were surprised by Tuesday’s election result, I have been thinking a lot about how Donald Trump’s presidency will affect Californians and our health care system. Based on President-elect Trump’s campaign promises, we expect officials in Washington to immediately begin pursuing health policy changes that could undermine many of the gains we’ve achieved in health care. The most significant of these is the repeal of the landmark Affordable Care Act (ACA). This unexpected turn of events comes at a time when our state has been setting an example for the nation with the successful implementation of the ACA.
In our political system, election cycles periodically bring new administrations to power in Washington and Sacramento. While new administrations bring new policymakers, CHCF has for nearly two decades been dedicated to supporting a better system of care for the people of California — especially the underserved and disenfranchised. While the policy environment is surely going to change, bringing with it great uncertainty, CHCF will not change what we ultimately seek to accomplish, nor will we waver from following our beliefs and values.
We are enormously proud that California has led the nation in harnessing the ACA to make our state a better place to live and work. More than 91% of our residents now have coverage. Nearly 5 million Californians gained health benefits through expanded Medi-Cal eligibility or through Covered California’s subsidized insurance marketplace. Under the ACA, Medi-Cal enrollment has risen to about 14 million, providing necessary coverage to one of every three Californians. What California has built over the past five years isn’t just the product of a policy formed in Washington. It is also the result of Californians rolling up their sleeves and working together across the health care landscape, from public and private payers and providers to community health centers and consumer groups.
With so many Californians using this new coverage to gain health and financial security, we must not — we cannot — roll back the clock. Our friends, loved ones, and communities must not experience disruptions in access and care. CHCF’s mission is unchanged — to partner with others to help California build on its successes and to advance to the next level to provide universal access to care.
CHCF will work with public officials, consumer advocates, and industry leaders to ensure that California continues moving in this positive direction so it can remain the nation’s engine for health care innovation and social progress. We imagine a state where everyone has access to the health care they need, coverage is affordable, and care matches the needs and wishes of families. We imagine a world where people with complex health problems are served in a coordinated fashion that accounts for the needs of the whole person, both physical and mental. And we imagine a health care system that adopts value-based care as the right thing for patients and for the stewardship of public resources.
Working with our partners, CHCF will continue to bring together our staff expertise, research, analysis, and powerful human stories to inform policymakers and changemakers who are building pathways to improved care. We will need to adapt and be resilient. Most of all, we must remain bold in our vision that all the people of this very diverse state get the right care at the right place and time, consistent with their wishes.
CHCF will not back away from the values that are so deeply embedded in our mission — inclusivity, mutual respect, intellectual honesty, and a commitment to embracing diversity. It is what this moment in history calls on us to do.
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 served on the External Advisory Committee at the Stanford Center for Population Health Sciences in 2016. 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 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.