Anthony Wright has been an influential leader in California’s health care reform movement for more than 20 years. Consumer Advocacy Coalition At Health Access California, Wright helped craft critical reforms that expanded insurance coverage and access to health care for millions.
Under his leadership, Health Access helped lay the foundation for California’s successful enactment of the Affordable Care Act (ACA), the expansion of Medicare to undocumented immigrants, state subsidies to Covered California Plans, enhanced consumer protections, new quality and equity standards for health insurance plans, and the creation of State Gov. Office of Affordable CareThe California Health Care Foundation has been funding health access for many years.
This month, Wright left California. Families USAis a national health policy advocacy group based in Washington, D.C. In late June, I spoke with Wright about his eventful years in California, the lessons he learned from them, and the obstacles and opportunities he faces going forward. This interview has been edited for length and clarity.
Q: During your 22-year tenure as Health Access executive director, you’ve witnessed great strides in improving health insurance and access to health care in California. What would you say are the most significant milestones along the way?
a: Clearly, the Affordable Care Act is the largest social policy reform in a generation, if not several. In California, the ACA laid the foundation for both policy and funding for the state to take further steps toward a more universal, affordable, and equitable health care system. Prior to the ACA, California had attempted health care reform multiple times, but it was extremely difficult to achieve without a federal framework and funding.
It was an honor for me that Health Access was a lead advocate in the campaign to pass the Affordable Care Act here in California. It was a challenge in terms of organizing, countering Tea Party town halls, and getting our representatives to understand how the ACA would benefit California. After the ACA passed, California went from a laggard to a leader in terms of people with health insurance. We had the largest decrease in the uninsured rate of all 50 states.
Q: Is there anything else worth noting about the progress California has made recently under the ACA?
aA lot of our work is about the budget. More than a third of the state budget is Ministry of Health and Human Servicesand Medi-Cal is the largest program. It provides Californians with the revenue they need to maintain their budget, including health care, and Change the criteria for passing a budget This is to ensure that it is not held hostage by a minority in Congress.
California is in a much better position today than it was 10 years ago. Despite facing tough fiscal conditions this year, the state delivered a balanced budget and protected the progress we have made. This budget stability has allowed us to invest in our health care system, which is Cal Aim Initiatives or additional expansions under the ACA.
Finally, the affordability of health care remains a major concern among Californians. Access to Health Care Successfully obtained investment from the state Providing early relief, including lowering copayments for Covered California plans, measures to address rising health care costs, Unexpected medical expensesand more broadly, reforms such as Office of Affordable Care (OHCA).
Q: Looking ahead, what do you think are the biggest issues in the area of health insurance and access to health care in California?
answer: We’ve made great strides toward universal health care, but we’re not done yet: We need to open Covered California to everyone, regardless of immigration status, win increased Medicaid subsidies, and provide more automatic insurance so the burden of buying health insurance falls on the system, not on individuals.
We have done a great job Eliminate the deduction The Covered California Silver Plan needs to do more to ensure that health insurance recipients don’t face financial barriers that prevent them from getting the care they need.
In terms of benefits, the council: Essential Health Benefits package. This could mean mandating that plans cover certain items like in vitro fertilization and durable medical equipment, as well as opening up broader discussions about achieving universal coverage for dental and mental health care.
Holding the health care system and industry accountable for reducing costs, improving quality, increasing equity, and ultimately improving value is fundamental. We also need to correct market failures. OHCA and other oversight activities are intended to address those. There is currently a debate in Congress about giving the Attorney General more tools to address those issues. Provider IntegrationAt least that’s the case when it comes to private equity.
These are all things that my colleagues in Health Access will continue to work on and that I will be working on nationally.
Q: Looking back at the work you’ve led at Health Access, what are you most proud of?
answer: I am incredibly proud of the work we have done to empower people and organizations to engage with health policy and advocate for themselves.
I am proud of our work Prevent unexpected medical bills Our campaign is successful when people go to the hospital and see an out-of-network doctor. The ambulance bill suddenly arrivesThe efforts of the entire #Health4All coalition will help make Medicare available to children, young people, seniors, and ultimately All adults, regardless of immigration statusWe also stopped efforts to roll back expansion, which I think makes us safer. And the other thing is efforts to make Covered California more affordable. Government subsidies This is to ensure that the middle-income class is not cut off from home buying assistance. Changes at the national level.
Speaking of costs, I’m excited about the new Affordable Care Administration putting in place rules to limit the growth of health care costs. 3 or less By 2029This is a signal to our health care system and the health care industry that health care costs cannot rise faster than our salaries.
Q: What were the key factors that enabled these advances?
answer: One is to form coalitions to empower consumers. There are a lot of wealthy interests on Capitol Hill and in the health care system, and the patient voice is not necessarily even in the conversation, or even where it should be. When the patient voice is not organized, when it’s not unified, it’s easily ignored.
The other is persistence: many of the reforms we adopted took more than a year. Hospital Fair Pricing Act It was a five-year campaign. Prescription Drug Transparency Act It was a three or four year battle, and if you don’t give up, it’s never a defeat, it’s just a delay.
Q: You’re taking the helm of Families USA, an important national advocacy organization, on the eve of a presidential election. What does this election mean when it comes to health care for Americans?
a: Our health is on the ballot. I fear that the outcome of this election could lead to the repeal of the Affordable Care Act, which would result in significant losses of coverage and patient protections, disruption to our health care system, and a clear risk of further erosion of access to reproductive health and abortion care.
There are a couple of other issues. Over the last few years, we’ve allowed Medicare to negotiate lower prices for prescription drugs. Will that be expanded or reduced? Also, there are additional affordable premium assistance in insurance marketplaces like Covered California. Currently, you don’t have to spend more than 8% of your income on insurance. Will we extend that or let it expire as scheduled next year? When these tax credits expire, average monthly premiums will increase by more than $400.
Q: Some people say, “Well, California will make up for it somehow,” can you comment on that?
answer: If the federal government were to repeal the ACA or allow this additional financial support to lapse, there would be a significant loss of federal funding and California would struggle to make up for it. California has pumped in about $200 million in state aid for Covered California. The additional federal financial support would be approaching $2 billion. It is hard to imagine California being able to make up for that.
The latest projections are that 5 million Americans could lose their health insurance as a result of the Medicaid expiration, and that doesn’t include the ripple effects that will ripple through the health care system and affect everyone who relies on it.
Q: What are you most looking forward to about your new role?
answer: If we have to fight defensively, I want to be in that fight, but I am hopeful that we are committed to the next phase of health care reform, some of which has been piloted and pioneered here in California.
I’m excited to work on areas where I can have a bigger impact at the federal level, like improving employer insurance, Medicare, health care costs, and prescription drug costs. Other things are best addressed at the state level, and I look forward to working with my successor at Health Access California and my colleagues in other states to help determine next steps.
Our system is complex and confusing. How do we change that? What excites me is the opportunity we have to envision what a better health system could look like by empowering diverse voices.
Jose Luis Villegas
Jose Luis Villegas is a freelance photojournalist based in Sacramento, California who does editorial and commercial work. He has co-authored three books on Latino baseball. His work has also appeared in Ken Burns’ documentaries. Top of the 10th Inning and, Playbol! The exhibition debuted at the Smithsonian Institution’s National Museum of American History and has since been shown in museums across the country. Read more
