Editor’s Note: This National Health Law Program blog series authored by Executive Director Elizabeth G. Taylor delves into the achievements and challenges the organization continues to face in its 50-year fight to make health care a reality for low-income people and underserved communities. The third post in this 3-part series centers on our current work and our vision for the future. Read Part one here and part two here.
Given the obstacles, is the vision of a country where everyone has the opportunity to achieve their health potential a pipe dream? We don’t think so.
Promising things are happening and there is work for all of us to do. For starters, we are having a national conversation about health care. Voters went to the polls in November because they want to keep or get health care coverage. When reporters write about provisions of the Medicaid statute, their readers understand what they are talking about. Everyday people are starting to realize that what happens in Washington impacts their health care at home.
Members of Congress are discussing bills that would provide universal health care and address some of the challenges still facing implementation of the ACA. (We are optimistic about those discussions, though we want to make sure that the particular health needs of low-income people are addressed in any ultimate plan by including appropriate services. This includes Medicaid’s coverage for children, which is often more comprehensive than that available in private insurance.) The fact that we are talking seriously about universal health care means that more people are thinking about health care as fundamental to our country’s future and that’s huge, even though we are currently battling partisan efforts that would take us in the opposite direction.
It is also promising that much attention is being paid to the health care and other support that children growing up in stress need to have a real chance to succeed. “Trauma-informed” educational policies are increasingly common. The National Health Law Program leads work to implement and enforce Medicaid’s comprehensive coverage for children and youth. We work with the Healthy Schools Campaign to help school systems connect school children with the health care services they need, including the broad range of services guaranteed to children in the Medicaid statute. We are also holding states across the country accountable to provide, through Medicaid, comprehensive behavioral health services to children and adolescents who need them. There is much more to be done, of course, but many voices are naming the obstacles confronting low-income children and identifying strategies to address them, including taking advantage of the resources currently available through Medicaid.
Reproductive health remains under constant threat, but states are stepping up, especially because of the current administration’s non-stop efforts to demonize reproductive health care and block access to quality care. Using the National Health Law Program’s model Contraceptive Equity Act as a blueprint, 11 states have enacted contraceptive equity statutes, state laws that guarantee women access to the full range of contraceptive health services. We continue work to expand our success and in 2019 believe that even more states will take up legislation to guarantee access to contraception.
We also believe that abortion must be safe and legal and accessible to low income women and we are working against policies that restrict that access.
We are optimistic that we can make progress in addressing health disparities. Until our country’s leaders are ready to address the economic inequality that is so intertwined with racism in perpetuating health disparities, we won’t fully address the problem, but naming racism rather than race as the source of health disparities is an important step. Understanding that no medical reason exists why people of color should be less healthy than their white counterparts takes away an excuse and means that we have an obligation to do something. Promising ideas abound, like using Medicaid funds to cover doula care, because doulas help women manage the stress of pregnancy and childbirth and stress is a killer. In addition, in 2018, forward-thinking members of both houses of Congress introduced the Health Equity and Accountability Act to address and eliminate health care disparities experienced by communities of color and other underserved communities
Where does this leave us, as an organization turning 50?
We are national experts in the laws and policies that determine whether and how low-income people have access to quality health care and a leader in enforcing health and non-discrimination rights, in policy arenas and in court. We have played an important role in making the promises of the Medicaid statute, the Americans with Disabilities Act, and other civil rights laws realities for low-income people, both through our direct advocacy and by serving as a resource to advocates in all 50 states and D.C. Should we continue to be and do what we have been and done for the last 50 years?
There is no doubt that we are needed in the current fights to protect health care against an administration bent on sabotage. We bring the knowledge and litigation expertise to lead this defense. And what about the future, when the current dangers do not exist, and we get back to the business of working to ensure everyone a chance to achieve their health potential? What will our role be then?
We have spent some time thinking about these questions and they are ones that everyone who cares about health should be asking. What is our role going forward? What is your role? What can you do?
For the National Health Law Program, while we wish for a day when we would not be needed to protect access to health care, we doubt that that day will come soon. So we will continue to pursue our passion – ensuring access to quality health care for low-income individuals. And we’ll continue doing what we are extraordinarily good at – understanding the details, translating them for policymakers, and enforcing them in court. But we are still learning and growing and we will do more. We will continue to learn about how inequality and racism affect health so that we see and help others see and address those issues. While continuing to be the organization that digs deep into the weeds of health law and policy, we will also continue to collaborate with individuals and groups that bring different perspectives and expertise so that together, we magnify our impact.
I commend this approach to anyone interested in being involved in our country’s health. Find your passion and pursue it; look for ways to contribute your skills and resources to the effort and for ways to magnify your impact through collaborations. And support organizations like the National Health Law Program that are on the front lines of the fight!