Academy Insights:  An update on the foundation’s health equity advocacy and leadership program

May 10, 2017

Today on our blog, we hear from our Academy facilitators, Licy DoCanto and Jonathan Kent, who provide a recap of the March Leadership Academy seminar.

 

On a cold (but sunny) day in January, the foundation celebrated the long-awaited launch of the Academy for Health Equity Advocacy & Leadership (Academy).  Comprised of nine established non-profit and public sectors leaders from across the state, the mission of the Academy is to expand health equity by equipping leaders with the health policy knowledge, advocacy skills, and the partnerships necessary to drive sustainable system change efforts throughout Connecticut.

While the launch of the Academy represents the foundation’s continued commitment to investing in advocacy and leadership to ensure diverse perspectives are represented at key decision-making tables, the launch also coincides with a changing political and economic reality (both here in Connecticut and nationally) that has the potential to undermine the progress made towards a more fair and equitable (but far from perfect) health care system.  It is with this backdrop, understanding, and sense of urgency that our leaders approach each seminar.

The second seminar of our Academy for Health Equity & Advocacy gathered national and Connecticut-based experts on the Affordable Care Act (ACA) and Medicaid to give our academy leaders a master class in health policy.

The seminar coincided with a busy week on Capitol Hill for health care reform. By the end of our first day, the U.S. House of Representatives discussed raising—and then cancelled—a vote to repeal parts of the ACA. That legislation, the American Health Care Act, was the focus of talks by Joy Johnson Wilson, former health policy director for the National Conference of State Legislatures, and by Cindy Mann, former director of the Center for Medicaid and CHIP Services at CMS.

Cindy joined us by video conference from the frontlines of the health care debate in Washington DC. She provided an in-depth analysis of the proposed reforms and their likely impacts on Connecticut and the nation. Media reports now indicate that leadership in Congress and the White House are again pursuing legislation that would be similar in form and scope.

In her presentation, Cindy noted that, while the ACA is far from perfect, it has been very effective in lowering the uninsured rate, especially for communities of color. Before the law was passed, 25 to 30 percent of Latinos in Connecticut did not have health insurance; today that rate has fallen to between 21 percent to 17 percent. Among blacks, the uninsured rate decreased from 18.9 percent to 11.2 percent.

The ACA also significantly expanded Medicaid. Despite many states deciding against Medicaid expansion, the program now covers over 70 million people, most of them children. Proposed changes, though, would restrict future growth of Medicaid funding to states in the form of per capita caps or block grants.

Our academy leaders speculated that these proposals could lead to changes in eligibility requirements. Demand for health care, however, would be unchanged and the end result would be increased numbers of uninsured patients seeking care at community health centers or going without crucial preventive care. The legislation proposed in March would also have required states to redetermine eligibility every six months for adults covered by the Medicaid expansion, an added burden that would reduce enrollment.

Cindy also offered calculations of the impact on Connecticut’s budget. According to her analysis, the original House proposed American Health Care Act would cut federal Medicaid funding to Connecticut by $9 billion over 10 years, a 24 percent reduction compared to current levels. While that bill has been tabled, new proposals will likely include similar cuts.

The presentation left leaders with a clear understanding of what is at stake and how federal reform would directly and immediately impact health equity in our state.

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