Recommitting to Racial Justice and Health Equity – Black Lives Matter

Adopted by the Health Access California board

Health Access California supports the Black Lives Matters movement, and stands with those in the streets to protest unacceptable police violence, and structural racism targeted at the Black community.

Responding to the Black Lives Matter movement, and building upon our previous organizational statement, Health Access recommits to the work of advancing racial equity and ensuring racism is addressed as a public health crisis.

It is our responsibility to work to abolish racism on a personal, structural, and institutional level, including in our health care system. As a leader in the movement for universal access to health care, we will work to counter the state-sanctioned violence and more broadly the anti-black racism that impacts the health and lives of Black Americans daily, in all facets of life, and the real stress and trauma it causes, which often has real personal health impacts.

The COVID-19 pandemic continues to shine a spotlight on long-standing systemic health and social inequities in our health system that disproportionately harm the Black community.

Health Access recognizes that racism and racial bias is a health and a health care issue, and seeks to spotlight the health equity movement that has raised these issues well before this moment. The fight for justice in health care is and always has been intertwined with the struggles for racial justice, and racism has been endemic to the inequities in our health system. But the health reform movement, and Health Access in specific, can do more to center racial justice in this work. If we don’t address structural and systemic racism, the quality of health care will not improve and health disparities and poor health outcomes will not change.

Health care has historically been a racialized issue, and a racial and health equity lens is needed to appropriately fulfill our ultimate goal of getting to universal, quality health care. It’s fundamentally the question of whether we *care* for one another, across races—not just literally, but figuratively, too.

Given who is left uninsured and underserved in our society, the question of expanding coverage, or of health justice—from Obamacare to Medicaid expansions and funding in state budgets—is fundamentally a question of whether Black Lives Matter. This moment requires that Health Access be more explicit in our advocacy, so we can be accountable to ourselves, our partners, and the public we serve.

Our efforts at “targeted universalism” require not just broad-based reforms, but also specific policies and remedies for communities with greater and/or specific needs, that then often benefit the whole community. Our targeted health equity work, which includes our leadership in immigrant and LGBTQ health spaces, must include more to focus on how these issues may impact the Black community specifically and extend our work to address how structural racism manifests in health care.

We seek to support existing movements for health equity, broadly and in specific areas like maternal and infant mortality. While we consult with key leaders from the community about their agenda, we will double-down on our support and expand our efforts where we have background and direction, including:

  • Focusing our policies with explicit attention to how race and racism impacts health status, such as ensuring the collection of race and ethnicity data in health coverage and treatment to better identify health disparities and how to combat them, and supporting our partners in the work to recognize racism as a public health crisis.
  • Supporting reforms to reduce disparities and inequities in areas like Black maternal mortality, with remedies such as implicit bias training, and directly address discrimination, like the advocacy around Section 1557 of the ACA. A major part of this work includes promoting and ensuring culturally competent providers and care.
  • Continuing to lead in campaigns to expand and improve coverage, including to make Covered California more affordable, to expand Medi-Cal without regard to immigration status, to remove enrollment barriers, and to develop and fund aggressive efforts for outreach and education campaigns that are focused on Black and other communities of color.
  • Advocating for state and federal funding for specific interventions, like the Black Infant Health Program, and for safety-net providers like public hospitals and clinics that serve Black communities.
  • Backing structural reforms that create the levers of transparency and accountability on the health industry to demand improvement on the “quadruple aim” (which includes health equity) such as the Health Payments Database, and the mechanisms to hold insurers accountable to equity (Covered California Attachment 7, Medi-Cal procurement), and providers (the proposed Office of Health Care Affordability). These accountability tools need to be explicitly developed to address racial inequities, or they could exacerbate them.

While universal solutions are foundational to our work, specific policy solutions like these and other reforms that target racial or ethnic injustices are imperative. Health Access can and must do more to support this work through policy development, advocacy, communications, and as we engage our partners broadly.

In preparation for next legislative session, Health Access commits to consult with our staff, board, and allies on how to be a better partner with Black-led organizations. Our Executive Director and staff teams will conduct outreach to existing and new coalitions and media partners in the community. We will explore other opportunities to build racial justice into our work and our upcoming strategic planning process.

With respect for those with a history of doing great work on health and racial equity, and building on our established relationships, we will consult with partner organizations and build into our policy development process additional efforts to advance health equity and racial justice. We will view pending health policies for their capacity to counter the racism that undermines racial and health equity.

As a health care consumer voice, Health Access should weigh in to actively work against systemic racism in health care, and toward racial justice more broadly where we can provide value to the broader discussion on a systemic or specific issue impacting Black and other communities of color. We will commit to this as a continuing conversation, for future meetings of the Health Access California board, and other forums.

With these commitments, we look forward to the ongoing work to reaffirm the rallying cry that Black Lives Matter.

Original Statement: Black Lives Matter