The presidential election has left healthcare advocates reeling. The candidate who promised to repeal the Affordable Care Act (ACA), who lost the popular vote, has been announced the winner. Of even greater concern is that the leadership of both the executive and the legislative branches of government have the ACA in their gunsights.

Turning Back the Clock

President-elect Trump plans to turn back the clock on healthcare reform, disenfranchising some 20 million Americans according to a September 2016 study of his plan by The Commonwealth Fund. Fulfilling this promise is, according to Senate Majority Leader Mitch McConnell, “…a pretty high item on the agenda.” McConnell should know. He’s besieged the ACA since its beginning.

The consequences of repeal are so sweeping and appalling that even as we write this, Trump is backing away from it. But, as detailed by Timothy Jost in a Health Affairs blog, using budget reconciliation and other strategies, Trump can easily and significantly undermine our progress to date even without repeal. We expect to face uncertainty for years to come.

Impact of Repeal

The impact of repeal (or even “editing”) of the ACA on The Golden State – our people, families, businesses, hospitals and healthcare providers – will be unimaginably devastating.

That’s because California jumped into healthcare reform with both feet. When Obamacare rolled out, California was by far the most successful state to implement it, with our innovative education and outreach programs and simplified enrollment.

And California has continued to lead on healthcare reform. We are the only state that extended Medi-Cal to income-qualified undocumented children, and the only state to introduce legislation to extend it to income-qualified undocumented adults. We are the only state to request the federal government’s approval to allow undocumented adults to purchase unsubsidized health insurance through Covered California.

What’s less talked about is how repeal will impact California’s hospitals and clinics that must assume the heavy burden of unreimbursed care. In the wake of the election, Fierce Healthcare noted in an updated report on November 9, 2016 that higher volumes of uninsured patients would financially harm healthcare providers and indeed, hospital stocks have tanked during the past week.

Yes, if Trump and the federal legislature pulls the funding for all the progress we’ve achieved to date, Californians from all walks of life will feel the pain. But those who will suffer the most are the most vulnerable among us.

The Most Vulnerable

Our brothers and sisters in immigrant communities stand directly in the cross hairs of the new administration. Disenfranchised for generations, but now publicly insulted, dehumanized, threatened with deportation – their very lives hang in the balance. They are in shock and afraid as never before.

Forbes reports that acts of hate-based violence against people of color, Muslims and Asians are widespread across the country. They also report a spike in sexual assaults on women and girls.

It is essential that we in the universal healthcare movement continue to support equality and human rights for everybody regardless of their documentation status. 

It cannot be overstated how important it is that white people – of which there are many in our movement – step up to create safe spaces for people of color and minorities, support local organizations who serve their communities, and especially, organize within white communities to fight bigotry.

The California Difference

The political leadership in California has made clear their commitment to democracy and diversity. The morning after the election, California Senate President pro Tempore Kevin de León (D-Los Angeles) and California Assembly Speaker Anthony Rendon (D-Paramount) released the following excerpted comments in a statement:

Today, we woke up feeling like strangers in a foreign land, because yesterday Americans expressed their views on a pluralistic and democratic society that are clearly inconsistent with the values of the people of California….

California has long set an example for other states to follow. And California will defend its people and our progress. We are not going to allow one election to reverse generations of progress at the height of our historic diversity, scientific advancement, economic output, and sense of global responsibility.

We agree! This election has highlighted a rift within our nation – one that weakens our democracy. We are in a crisis. But every crisis presents opportunities.

An ACA repeal will leave millions of Californians and our healthcare institutions in crisis. In view of that threat, California legislators may be more open than ever to consider proven strategies to minimize damage to our hard-fought gains. One key strategy to eliminate the most useless of healthcare expense – administrative waste – is Medicare for All.

California Needs Medicare for All

We support Medicare for All Californians because we believe that health care is not just for the privileged; it is a human right. We also support it because we believe it could reframe the relationship between our nation and its citizens, and thereby strengthen our democracy.

Now is the time for our state to lead the nation in healthcare reform as we have led the nation in consumer and environmental protection.

Now is the time to create a healthcare system consistent with California values of sustainability, equality and fairness.

Now is the time for Medicare for All Californians.

We can do this. We can fix healthcare for real.  The perfect place to start is “California” and the perfect time is “Now!” 

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