Californians have a lot at stake in the current healthcare debate. Under the Affordable Care Act, nearly four million people in California gained healthcare coverage, and the scope of coverage improved for all. We must insist this coverage be maintained, stand strong in support of the Affordable Care Act, and oppose the American Health Care Act. At the same time, California must push forward in setting the gold standard for a true system of health that includes prevention of illness and injury, and high-quality healthcare for all.
With our size and purchasing power, California has the might to push back--and forward. As hospitals, clinics, insurers, businesses, the Health Agency, and state lawmakers band together to craft California’s response to the AHCA--which begins first with preserving the ACA--we must encourage bold actions that advance a basic notion: Every Californian has the right to healthcare AND to maintain their health.
The Affordable Care enabled California to more fully provide healthcare to its population. Equally important, it established the Prevention and Public Health Fund, which supports the kinds of innovative community prevention and public health approaches that are critical to making any national healthcare policy work. It created incentives for hospitals to invest in population health, most notably the Center for Medicaid and Medicare Innovation’s (CMMI) Population Health section, and encouraged healthcare to bring its credibility and resources to strengthening community wellbeing. This spurred investments in healthier, safer communities, which is precisely what is needed to improve people’s health, strengthen businesses and families, and lower healthcare costs without sacrificing quality.
California would lose over $300 million in the next five years if the AHCA’s proposed repeal of the Prevention Fund goes through. That’s more than a simple loss of funds: it’s a loss of jobs and the ability to do prevention work. Removing prevention from health reform is like building a house on sand.
As we stand strong in support of the Affordable Care Act, let’s do what it takes to move our state forward—let’s create our own statewide Prevention and Public Health Fund, establish our own State Innovation Models, and maintain strong and clear community benefit requirements for non-profit hospitals. California has a track record of making effective investments in prevention that not only save lives but are fiscally wise. It’s time to continue our leadership in this realm.
Clearly, Californians are already poised to take strong stances to protect some of the most fundamental determinants of community health: the rights of immigrants, women, and people of color to fully participate in society; the health of the environment; equitable investments in our parks and natural resources, and fair housing laws. These actions will ensure that California doesn’t just stand still, but leads. As we defend the ACA and hammer out California’s contingency plans, let us not forget that community prevention and public health are critical to preventing illness and injury in the first place, and to bolstering equity.
A sustainable healthcare plan depends on serious investments in quality prevention and effective public health, emphasizing the communities that need these the most. Prevention is the bedrock upon which California’s health plan for all should be built.