April 17, 2024
The Honorable Mia Bonta
Chair, Assembly Health Committee
1021 N Street, Suite 390
Sacramento, 95814
RE: SUPPORT AB 2200, the Guaranteed Health Care for All Act (CalCare)
Dear Assemblymember Bonta, RE: AB 2200 (Kalra) – SUPPORT:
As a statewide network of advocates for equitable healthcare for all, Asians and Pacific Islanders for CalCare supports AB 2200, the Guaranteed Health Care for All Act (CalCare), which creates a single- payer system of healthcare to provide comprehensive and culturally competent healthcare to all Californians.
AB 2200 is a bold and visionary legislation that provides CA lawmakers an opportunity to demonstrate their commitment to the cause of delivering healthcare to all Californians in a fiscally responsible way. This bill is a policy framework bill, with no financial burden attached to it, but it should be noted that bipartisan studies including those acknowledged by Governor Newsom have established that a single-payer system will save CA billions of dollars.(1) AB 2200 is the policy framework required by Federal regulations which was lacking in SB 770 that is necessary to begin negotiating for waivers for CalCare financing.(2)
More than most past bills have done, AB 2200 establishes a comprehensive framework for how CA can begin to dismantle discriminatory practices and disparities in healthcare insurance and delivery that plague tens of millions in underserved communities in our diverse state. For example, amongst other things, establishing an Office of Health Equity within CalCare under the Director of the Department of Health Care Access and Information to ensure health equity under the program,(3) as well as including a “Special Projects Budget” to address inadequacies in healthcare infrastructure in underserved communities.(4)
Asian and Pacific Islander Americans are the fastest-growing demographic in CA over the past decade. With a population of over six million,(5) we contribute to the tax base of the state but suffer from numerous healthcare disparities to varying degree according to specific communities.(6)
Per the Lancet, “Asian Americans are at increased risk for liver and stomach cancers and are the only group for whom cancer remains the leading cause of mortality. Type 2 diabetes is more prevalent in Asian Americans as a group (9%) compared with non-Hispanic Whites (7·2%), but it is substantially higher in subgroups of Asian Americans such as Filipino men (15·8%). Understanding such differences could inform the use of prevention or earlier screening strategies.”(7) CalCare will enable CA to not just review such disparity data but take decisive steps to rectify inadequacies in preventative practices, resulting in not only cost savings to the healthcare system but saving human lives.
APIAs are also impacted on the frontlines of healthcare delivery. Filipino nurses make up approximately 4% of the nursing work force nationally, but they made up 21% of all COVID-19 nurse deaths.(8) In CA, Filipino nurses were 20.6% of the Registered Nurse (RN) workforce in 2018. CalCare will oversee the effectiveness of health care workforce programs including minimum safe staffing requirements and investment in personal protective equipment and occupational safety and health programs.(9)
Many individual communities of the distinct Asian and Pacific Islander communities face barriers to health insurance and services because of limited English proficiency (LEP). “In 2019, about 3 in 10 (30.8 percent) Asian American adults and 1 in 8 (12.1 percent) Native Hawaiian/Pacific Islander (NHPI) non-elderly adults had LEP, compared with 32.9 percent of Hispanic adults, 3.1 percent of Black adults, and 1.4 percent of white adults. An estimated 14.9 percent of Asian American adults lived in a household in which all members ages 14 and older reported having LEP.” This simple barrier leads to a wide assortment of healthcare disparities, including highly disproportionate COVID-19 mortality rates.(10)
We support AB 2200 for its vision of delivering culturally, linguistically, and structurally competent care and to improve health outcomes for those currently facing disparities in healthcare insurance, access and services. AB 2200, also known as “CalCare” will help us deliver these things. Legislators brave enough to advance AB 2200, in the most diverse state in the nation, are taking a stance for healthcare equality to save lives.
For these and many other reasons, we look forward to working with the authors in advancing AB 2200 and the effort to win a true “single-payer” healthcare system in California.
Sincerely,
Linda Okamura
Asians and Pacific Islanders for CalCare
- https://drive.google.com/file/d/1CNlsIOL4wtcrc8Nv6fCLn3420juYB6vI/view
- https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=202320240AB2200 Chapter 7. Funding, Article 1. Federal Health Programs and Funding
- https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=202320240AB2200, Chapter 6. Program Standards, Article 2. Health Equity, 100665 (a)
- https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=202320240AB2200 Chapter 7. Funding, Article 2. CalCare Trust Fund, 100677
- https://capiaa.ca.gov/
- https://apiforcalcare.com/healthcare-disparity-news/
- https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)00769-8/fulltext
- https://nationalnurses.medium.com/celebrating-filipinx-nurses-0b31fc49ffd6
- https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=202320240AB2200 Chapter 8. Transition, 100686.
- https://ajph.aphapublications.org/doi/10.2105/AJPH.2021.306370