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By Kevin Epps
I recently attended an informed and deeply engaging community event hosted by Covered California, Umoja Health, and UCSF Helen Diller Family Comprehensive Cancer Center, which took place at the Rafiki Coalition, focusing on the most pressing health issues facing the Black community. Moderated by Andre Aikins, Rafiki Coalition’s Director of Programs, the event asked a pivotal question: “What inequities and structural racism limit our community’s access to comprehensive health insurance?”
Historical Inequities and Mistrust
Destiny William, Health and Wellness Program Manager at Rafiki Coalition, acknowledged the complexity of the issue, stating, “We can talk about economic disparities in employment, racial policies, the Tuskegee Syphilis Study, forced sterilization of young Black men, the resistance of Medicaid expansion, and geographic disparities. But what I feel is most urgent to this discussion is the distrust we have in the health care system itself and its ability to serve us equitably.”
She continued, “Most of us have experienced something in the healthcare system that made us not want to return. Those regular checkups and small preventive measures can stop bigger problems down the road.”
To illustrate this mistrust, Williams referenced Harriet A. Washington’s Medical Apartheid, sharing a quote that resonated with her: “One and a half times as many African-American adults as white adults die every year. Blacks have dramatically higher rates of nearly every cancer, AIDS, heart disease, diabetes, liver disease, infections diseases, and even higher rates of accidental death, homicide, and mental illness.” Personal experiences, like William’s account of her mother’s pregnancy complications due to a lack of insurance, underscore the devastating impact of these inequities. She added, “Now that I’m older, I understand how important health insurance is, even though our community faces many barriers to accessing it.”
Dr. Monica Soni, Chief Medical Office at Covered California,highlighted efforts to address these barriers. “Our job has been to make accessing care as simple as possible,” she explained. “Yes, the system is complicated on the back end, but we aim to simplify it for those trying to get care or preventive services.
Covered California offers tools to streamline enrollment,including an accessible website that asks just four basic questions about household size, health conditions, and income. Based on the answers, individuals can learn if they qualify for low-cost plans, including some as affordable as $10 a month, or even free plans. We also provide resources like chatbots, seven-day-a-week phone support during open enrollment, and in-person navigators to guide people step by step,” Dr. Soni said. “It’s our commitment to make this process as seamless as possible.”
Dr. Kim Rhoads, founder of Umoja Health and Director of Community Engagement at UCSF Helen Diller Family Comprehensive Cancer Center, emphasized that structural racism affects Black Americans in every interaction with the healthcare system. “Even when there are beneficial resources available, people may feel reluctant to jump through the hoops required to access them, ” she said. She shared an example of a community member screened for colorectal cancer, whose positive result required follow-up care.
Despite efforts to connect him with a nearby clinic the man opted to visit the emergency room for a colonoscopy—a service unavailable in the setting.
“Not having insurance means delayed care,” Dr. Rhoads explained. “Even when you do have insurance, barriers still exist, like navigating networks and finding providers who accept your plan. But having even basic insurance at least gives you a chance to access care.”Not having insurance means delayed care,” Dr. Rhoads explained, “Even when you do have insurance, barriers still exist, like navigating networks and finding providers who accept your plan; But having even basic insurance at least gives you a chance to access.”
Dr. Soni reiterated the importance of affordability and simplicity in health care access. “Affordability has to be addressed. Federal support has been key in making plans more accessible, but our work continues to ensure people understand their options and feel empowered to use them.”
Open enrollment for Covered California runs from November 1 through January 31, and coverage begins February 1 for those who enroll by the deadline. www.coveredca.com
Kevin Epps is a Dad, award-winning filmmaker, community activist, author, executive editor of the SF Bay View “National Black Newspaper” and a boardmember for the SF Bay View Foundation. Reach him at kevin@sfbayview.com or on ig: kevinepps1.
