Real,Meaningful,andEquitableUniversalHealthCarethat

Guarantees:ProximitytoNearbyComprehensiveHealthCenters,
CulturallyCompetentServicesForAllOurPeople,SpecificServices
forQueer,GenderNonconforming,andTransPeople,FullBodily
Autonomy,FullReproductiveServices,MentalHealthServices,Paid
ParentalLeave,andComprehensiveQualityChildandElderCare

Whatistheproblem
Compared

to

white
peopleintheU.S.,

studies

show

that

Blackpeople
areless

likely

to

work

in

jobs

that

make

health

insurance

available,

they

are

less

likely

to

be

offered
health

insurance,

and

they

are

less

likely

to

take

it

when

offered.

Just

53percent

of

Blackpeopleget

insurance

through

work

as

compared

to

72percent

of

white
people.

Blackpeople

constitute

12percent

of

the

overall

U.S.population,

but

16percent

of

the

uninsured.

53percentof

Blackpeoples

earn

less

than

200percentofthe

Federal
PovertyLevel
(FPL)
as

compared
to
25percent

ofwhite
peopleintheU.S.

20percent

of

Blackpeople

are

uninsured

compared

to

12people

of

white
peopleintheU.S.and]
24percent

of

Blackpeople
are

covered

by

public

insurance

(Medicaid)

as

compared
to
16percentofwhitepeopleintheU.S.

DespitethepassageoftheSocialSecurityAdministrationAct,whichcreatedMedicare
andMedicaid,andthepassageofthePatientProtectionandAffordableCareActs
(PPACAorACA)Medicaidexpansion,healthdisparitiescontinuetopersistamong
peopleofcolor.Communitieshistoricallydeprivedofresourceshaveexperiencedworse
healthoutcomesduetodiscriminatoryandracistpoliciesthatlimittheabilityofpeopleof
colortoachieveoptimalhealth.
Thereisacriticallackofqualityandaffordablehealthcareanditisravaging
communitiesofcolor.The(ACA)wasaninadequateattemptatprovidinghealthcare
coveragetothespectrumofBlacklivesincluding,butnotlimitedtopeoplewhoare:
underemployed,undocumented,transgender,young,andelderly.Despitethepassage
ofthebill,manySouthernstateshavenotacceptedtheMedicaidexpansion,leaving
manyworkingclassandlowincomepeopleofcoloruninsured.Underapatriarchal
racializedcapitalistsystem,Blackpeoplearetwiceaslikelyaswhitepeopletogo
withouthealthinsuranceeventhoughwesufferchronicillnesseslikehighblood
pressureanddiabetesatadisproportionateandescalatingrate.
Communitiesofcolorexperiencehighratesofhospitalclosing,understaffed,
underresourcedandpoorlymaintainedhealthcarefacilities,culturallyincompetent
physiciansandunfairandunequalaccesstopreventativescreeningsandtreatment.

Furtherexacerbatingthisissuearethesignificantlowernumberofhealthprofessionals
ofcolortoprovidecompetentandculturallyappropriateclinicalservicesforpeopleof
color.
Specificpopulationswhohavetraditionallyfoundchallengeswithinthehealthcare
systeminclude,butarenotlimitedto:undocumentedresidents,peopleofcolorwith
physical,mentalanddevelopmentaldisabilities,andBlacktransfolkstryingtofree
themselvesfromthecagesoftheirbodies,butbeingtoldthattheproceduresarenot
consideredworthyofbeingmedicallyinsured.AllofBlacktranspeoplesmedicalneeds
shouldbeincludedinhealthcoverage.Blackidentifiedwomenhavebeenmetwith
violentandinvasiveactionswhenitcomestoourhealthcaresystem.Whetherhaving
insuranceornot,Blackwomenhavehistoricallyandcurrentlybeenthevictimsof
sterilizationmethods.i

Whatwouldthissolutiondo?
NationalPaidParentalLeavelegislationthatgoesbeyondthecurrentFamilyand
MedicalLeaveAct(FMLA)whichguaranteesunpaidjobprotectedleave.Paidparental
leaveispolicyinmanywealthycountriesaroundtheworldwhichensurestimetonurture
andproperlyparentchildren.
Provideaccesstocomprehensivehealthcentersinneighborhoods.
Providefullaccesstopreventiveandcurativecareforthediversecommunitiesofcolor
throughouttheU.S.,ofallages.
ProvideBlackcisandtranswomenfullagencytosaywhatlevelandtypeofcaretheir
bodiesneed.
ProvidelovingandadequatemaintenanceandmanagementofhealthtoouragingBlack
peopleanddifferentlyabledpeople,aswellastherestoftheBlackcommunity.
ProvideBlackpeopleaccesstoservicesthatspeaktoourculturalneedsinsteadof
tryingtomakeourneedsfitintotheboxofotherracesandcultures.
Increasethenumberofmedicalandpublichealthprofessionalsincommunitiesofcolor,
providingcompetentandculturallysensitivecare.

FederalAction:
PassabilltoexpandpublichealthcaretoallU.S.residentsandmandatethatthe
wealthyresidentspayforaportionoftheirserviceswhilelowincomeandworkingclass
folksreceivefreeservices.
Passabilltoensureallserviceprovidedbycommunityhealthworkers,includingbutnot
limitedtoDoulas,healthcoaches,patientnavigatorsandoutreachworkersarebillable.

StateAction:

PassabilltoexpandpublichealthcaretoallFloridaresidentsandmandatethatthe
wealthyresidentspayforaportionoftheirserviceswhileworkingclassfolksreceivefree
services.
Passabilltoensureequitableandaccountablemeasurestodistributefederalcharity
caredollarstohealthcarefacilitiesservingcommunitiesofcolor.
Provideloanforgivenessforallmedicalandpublichealthprofessionalofcolorworkingin
communitiesofcolor.
Passabilltoensureallserviceprovidedbycommunityhealthworkers,includingbutnot
limitedtoDoulas,healthcoaches,patientnavigatorsandoutreachworkersarebillable.

LocalAction:
Passabilltoensureallserviceprovidedbycommunityhealthworkers,includingbutnot
limitedtoDoulas,healthcoaches,patientnavigatorsandoutreachworkersarebillable.

Howdoesthissolutionaddressthespecificneedsofsomeofthemostmarginalized
Blackpeople?
Childrenwouldhaveaccesstopreventativecarewhichallowsforhealthierdevelopment
andlesssicknesslaterintheirlives.
ProvidesworkforcedevelopmentopportunitiesformarginalizedBlackpeopletobecome
paidprovidersintheircommunities.
Createsholistic,communitycenteredhealthcaresupportsoindividualscanreceive
comprehensivecareintheirhomesandlocalenvironments.
Specificpeoplewhohavetraditionallyfacedchallengeswithinthehealthcaresystem
include,butarenotlimitedto:undocumentedpeople,peopleofcolorwithphysical,
mentalanddevelopmentaldisabilities,andBlacktranspeoplewhoaretryingtofree
themselvesfromthecagesoftheirbodies,butbeingtoldthattheproceduresarenot
consideredworthyofbeingmedicallyinsured.
AllofBlacktranspeoplesmedicalneedsshouldbeincludedinhealthcoverage.
Blackidentifiedwomen,whohavebeenmetwithviolentandinvasiveactionswhenit
comestothehealthcaresystem.Whetherhavinginsuranceornot,Blackwomenhave
historicallyandcurrentlybeenthevictimsofsterilizationmethods.

ModelLegislation
Francehasasystemofuniversalhealthcarelargelyfinancedbygovernmentthrougha
systemof
nationalhealthinsurance
.Itisconsistentlyrankedasoneofthebesthealth
caresystemsintheworld.
CountriessuchasEgypt,AlgeriaandGermanyhavesomeformofuniversalhealthcare.
AllaremodelstolookatandpotentiallyadapttotheU.S.

MinnesotaandOregonhaveincludedDoulaservicesintheirMedicaidcoverage.

Resources:
TheConsequencesofBeingUninsuredForAfricanAmericans
UniversalHealthCoverageByCountry
U.S.HospitalsandtheCivilRightsActof1964
TheImpactoftheCoverageGapforAdultsinStatesnotExpandingMedicaidbyRace
andEthnicity
AddressingUnequalTreatment:DisparitiesinHealthCare
BlackMamasMatter:AToolkitforAdvancingtheHumanRighttoSafeandRespectful
MaternalHealthCare

OrganizationsCurrentlyWorkingonPolicy:
CommissiononPublicHealthSystem
DoctorsforAmerica

Authors&ContributorsofthisPolicyOverview
WhitneyMaxey,MiamiPublicSchoolTeacher
KwameTorianEasterling,MD,MPH
MonicaMcLemore,PhD,MPH,RN,UniversityofCalifornia,SanFrancisco
JoHannaThompson,MPA
NimaakoBrown,MPH,CHES