Implementing & Improving the Affordable Care Act

Our Healthcare at Risk

The election of Donald Trump, along with Republican control of both houses of Congress, threatens health coverage for millions of Americans and the progress we’ve made in the last half-century with the enactment of Medicaid, Medicare, and the Affordable Care Act.

Dramatic rollbacks in health care and coverage are at the top of the agenda of both President-elect Trump and Speaker Paul Ryan, who has re-committed to his longstanding plan to cut Medicaid and Medicare. Many of those changes, as well as repeal of many (but not all) elements of the Affordable Care Act, could be passed through budget reconciliation, which only requires 51 votes in the Senate, a majority vote of the House, and the President’s signature.


BLOG: Election Results: The Trump Presidency and the Threat to Health Care


Implementing and Improving on the Affordable Care Act

Making the Full Promise of Health Reform Real

Since its inception, Health Access has focused on expanding health coverage through public programs, employer-based benefits, or a universal, single-payer proposal. Throughout its history, Health Access has worked to advance comprehensive health reforms and the vision of quality, affordable, universal health care for all Californians.

With the passage of the Affordable Care Act, Health Access has focused more directly on implementing and improving upon the ACA. The remaining challenges and opportunities are significant, including new efforts to educate, enroll and engage consumers, and the public campaign to defend the ACA nationally. Health Access will continue as the lead proponent of health reform in California, the spirit of the movement’s continued growth and collaboration. It will also be the bulwark against attempts to “repeal and replace,” staying mindful of the need to fix the ACA’s flaws and fulfill its promise.

Health Access will work to:

  • Support and improve Medi-Cal and Covered California, key pillars of our health system.
  • Monitor the industry response to health reform and work to prevent loopholes or unintended consequences in insurance market reforms, consumer protections, or other aspects of the ACA.
  • Continue to promote the ACA and California’s progress in implementing and improving on it and prevent efforts to undo its key guarantees and protections.
  • Secure our victories in California, from Covered California’s active purchasing authority and standardized benefits, to efforts at increased inclusion.
  • Defend the integrity of core federal health programs, Medicaid, Medicare, and ACA, and fend off political attacks, privatization, defunding, and other problems.
  • Improve the benefits of “Obamacare” in both public programs and private coverage, including affordable vision and dental options.
  • Shift the state and national conversation from a debate about whether the ACA should exist to one about the ongoing reforms and improvements that are still needed.
  • Develop ideas and seek opportunities to advance federal improvements to the ACA and other key federal health laws, from advancing 1332 waiver concepts to efforts toward positive federal legislative and administrative changes. This would include improved affordability, and improved financing while mitigating against mechanisms like the excise tax that discourage comprehensive benefits.
  • Continue to secure the “fair share” contribution of employers into our health system, to better secure and expand coverage for working families, to protect taxpayers and ensure the sustainability of our health system for the long-term, and to promote fairness and a level playing field for employers who offer health benefits but compete against those who don’t.
  • Support reforms that improve our health system to be more universal, progressively financed, cost-effective, streamlined and efficient, comprehensive, and prevention-oriented, helping to advance the principles and the goal of a single-payer system. Support both a single-payer health system and help articulate, develop and support steps to such a reform.
  • Advance the spirit of health reform as an ongoing effort.

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Health Access Analysis & Advocacy (2013-2016)

Health Access Analysis & Advocacy (2012 and Older)