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Healthcare Racial Disparities Continue Despite ACA

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More Californians than ever before have health insurance, but coverage isn’t care, and the Affordable Care Act (ACA) has magnified the deep racial, ethnic and cultural disparities in accessing quality health care in California.

<p><p>Latino and African Americans especially remain heavily uninsured and struggle to receive health care.

Language and cultural barriers, lack of Internet or an email address, a lack of experience in using health insurance, a shortage of doctors and clinics in poor and rural communities, and high costs are preventing many from receiving health care and medications.

A new report “Breaking Barriers: Improving health insurance enrollment and access to health care in California,” reveals a deep divide between social class, income, culture and ethnicity emerging under the state’s Covered Care.

“It’s unconscionable that so many have been left out of something as basic as the chance to enjoy good health,” said Gary Delgado, author of Breaking Barriers. “Lack of Internet access or speaking another language is not a reason to be locked out of a health system that purports to be open to all.

“Obamacare did not cause the widespread racial disparities we found, but neither did it solve them. Now we have to take them on directly,” said Delgado.

“Breaking Barriers” is a year-long study that includes a survey of nearly 1,200 low-income people in 10 states in Spanish, Cantonese, and English. They were contacted at food banks, health clinics, and homeless centers.

Alfredo DeAvila did surveys and interviews for the Breaking Barriers California report.

“If the ACA is going to be successful, we need to help people transition not only into the health insurance system, but also into the health care system,” he said. “We must invest in public education about how to get ongoing preventive care.”

The Korean America community, especially seniors are struggling because of costs, said DJ Yoon, executive director of NAKASEC (National Korean American Service and Education Consortium.)

“California can be a leader in assuring quality health care for all people. We have let people of color again slip through the cracks in our system, we can do better – and here is a roadmap for how we get there,” said Delgado.

Key recommendations in the report include:

Improve language access. Make provider directories available in multiple languages and list addresses, phone numbers, languages spoken, hospital affiliations, and specialties;

Simplify the insurance-shopping experience. Make cost information transparent and communicate clearly about deductibles, co-pays, and preventive services that are included;

Covered California should enforce and impose penalties on insurers who do not reduce racial health care disparities within required timeframes;

Assure that primary care providers are within 30 minutes driving or public transit time. Enrollees who must travel further should be offered free transportation;

Expand school-based health centers, especially in medically underserved communities;

Address underlying causes of poor health, especially in poor communities, (mold, infestations, domestic violence) Expand medical-legal partnerships as an avenue toward addressing poor health in low-income communities;

Reinforce the ACA-mandated “well-woman preventive” care and provide education about the value of preventive care for all. Ensure that all plans include reproductive health care services.

The full Breaking Barriers in California report is available at http://allianceforajustsociety.org/wp-content/uploads/2015/04/BBReport_CALIF.pdf

 

More Californians than ever before have health insurance, but coverage isn’t care, and the Affordable Care Act (ACA) has magnified the deep racial, ethnic and cultural disparities in accessing quality health care in California.

Latino and African Americans especially remain heavily uninsured and struggle to receive health care.

Language and cultural barriers, lack of Internet or an email address, a lack of experience in using health insurance, a shortage of doctors and clinics in poor and rural communities, and high costs are preventing many from receiving health care and medications.

A new report “Breaking Barriers: Improving health insurance enrollment and access to health care in California,” reveals a deep divide between social class, income, culture and ethnicity emerging under the state’s Covered Care.

“It’s unconscionable that so many have been left out of something as basic as the chance to enjoy good health,” said Gary Delgado, author of Breaking Barriers. “Lack of Internet access or speaking another language is not a reason to be locked out of a health system that purports to be open to all.

“Obamacare did not cause the widespread racial disparities we found, but neither did it solve them. Now we have to take them on directly,” said Delgado.

“Breaking Barriers” is a year-long study that includes a survey of nearly 1,200 low-income people in 10 states in Spanish, Cantonese, and English. They were contacted at food banks, health clinics, and homeless centers.

Alfredo DeAvila did surveys and interviews for the Breaking Barriers California report.

“If the ACA is going to be successful, we need to help people transition not only into the health insurance system, but also into the health care system,” he said. “We must invest in public education about how to get ongoing preventive care.”

The Korean America community, especially seniors are struggling because of costs, said DJ Yoon, executive director of NAKASEC (National Korean American Service and Education Consortium.)

“California can be a leader in assuring quality health care for all people. We have let people of color again slip through the cracks in our system, we can do better – and here is a roadmap for how we get there,” said Delgado.

Key recommendations in the report include:

Improve language access. Make provider directories available in multiple languages and list addresses, phone numbers, languages spoken, hospital affiliations, and specialties;

Simplify the insurance-shopping experience. Make cost information transparent and communicate clearly about deductibles, co-pays, and preventive services that are included;

Covered California should enforce and impose penalties on insurers who do not reduce racial health care disparities within required timeframes;

Assure that primary care providers are within 30 minutes driving or public transit time. Enrollees who must travel further should be offered free transportation;

Expand school-based health centers, especially in medically underserved communities;

Address underlying causes of poor health, especially in poor communities, (mold, infestations, domestic violence) Expand medical-legal partnerships as an avenue toward addressing poor health in low-income communities;

Reinforce the ACA-mandated “well-woman preventive” care and provide education about the value of preventive care for all. Ensure that all plans include reproductive health care services.

The full Breaking Barriers in California report is available at http://allianceforajustsociety.org/wp-content/uploads/2015/04/BBReport_CALIF.pdf

 

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Activism

COMMENTARY: The Biases We Don’t See — Preventing AI-Driven Inequality in Health Care

For decades, medicine promoted false assumptions about Black bodies. Black patients were told they had lower lung capacity, and medical devices adjusted their results accordingly. That practice was not broadly reversed until 2021. Up until 2022, a common medical formula used to measure how well a person’s kidneys were working automatically gave Black patients a higher score simply because they were Black. On paper, this made their kidneys appear healthier than they truly were. As a result, kidney disease was sometimes detected later in Black patients, delaying critical treatment and referrals.

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Sen. Akilah Weber Pierson, M.D (D-San Diego). File photo. Sen. Akilah Weber Pierson, M.D (D-San Diego). File photo.
Sen. Akilah Weber Pierson, M.D (D-San Diego). File photo.

By Sen. Akilah Weber Pierson, M.D., Special to California Black Media Partners 

Technology is sold to us as neutral, objective, and free of human flaws. We are told that computers remove emotion, bias, and error from decision-making. But for many Black families, lived experience tells a different story. When technology is trained on biased systems, it reflects those same biases and silently carries them forward.

We have seen this happen across multiple industries. Facial recognition software has misidentified Black faces at far higher rates than White faces, leading to wrongful police encounters and arrests. Automated hiring systems have filtered out applicants with traditionally Black names because past hiring data reflected discriminatory patterns. Financial algorithms have denied loans or offered worse terms to Black borrowers based on zip codes and historical inequities, rather than individual creditworthiness. These systems did not become biased on their own. They were trained on biased data.

Healthcare is not immune.

For decades, medicine promoted false assumptions about Black bodies. Black patients were told they had lower lung capacity, and medical devices adjusted their results accordingly. That practice was not broadly reversed until 2021. Up until 2022, a common medical formula used to measure how well a person’s kidneys were working automatically gave Black patients a higher score simply because they were Black. On paper, this made their kidneys appear healthier than they truly were. As a result, kidney disease was sometimes detected later in Black patients, delaying critical treatment and referrals.

These biases were not limited to software or medical devices. Dangerous myths persisted that Black people feel less pain, contributing to undertreatment and delayed care. These beliefs were embedded in modern training and practice, not distant history. Those assumptions shaped the data that now feeds medical technology. When biased clinical practices form the basis of algorithms, the risk is not hypothetical. The bias can be learned, automated, and scaled.

For us in the Black community, this creates understandable fear and mistrust. Many families already carry generational memories of medical discrimination, from higher maternal mortality to lower life expectancy to being dismissed or unheard in clinical settings. Adding AI biases could make our community even more apprehensive about the healthcare system.

As a physician, I know how much trust patients place in the healthcare system during their most vulnerable moments. As a Black woman, I understand how bias can shape experiences in ways that are often invisible to those who do not live them. As a mother of two Black children, I think constantly about the systems that will shape their health and well-being. As a legislator, I believe it is our responsibility to confront emerging risks before they become widespread harm.

That is why I am the author of Senate Bill (SB) 503. This bill aims to regulate the use of artificial intelligence in healthcare by requiring developers and users of AI systems to identify, mitigate, and monitor biased impacts in their outputs to reduce racial and other disparities in clinical decision-making and patient care.

Currently under consideration in the State Assembly, SB 503 was not written to slow innovation. In fact, I encourage it. But it is our duty must ensure that every tool we in the healthcare field helps patients rather than harms them.

The health of our families depends on it.

About the Author 

Sen. Akilah Weber Pierson (D–San Diego) is a physician and public health advocate representing California’s 39th Senate District.

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Activism

As California Hits Aging Milestone, State Releases Its Fifth Master Plan for Aging

“California’s Master Plan for Aging started a powerful movement that is shaping the future of aging in our state for generations to come,” Gov. Gavin Newsom said in a statement, calling the initiative a “future-forward” model delivering real results for older adults, people with disabilities, and their families.

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iStock.
iStock.

By Bo Tefu, California Black Media  

On Jan. 27, California released its Fifth Master Plan for Aging Annual Report,titled “Focusing on What Matters Most,” outlining the state’s progress and priorities as its population rapidly grows older.

The report, issued by the California Health and Human Services Agency (CalHHS), provides updates on the Master Plan for Aging’s “Five Bold Goals”: housing, health, inclusion and equity, caregiving, and affordability.

The report comes as Californians aged 60 and older now outnumber those under 18 for the first time, a demographic shift expected to accelerate over the next decade.

“California’s Master Plan for Aging started a powerful movement that is shaping the future of aging in our state for generations to come,” Gov. Gavin Newsom said in a statement, calling the initiative a “future-forward” model delivering real results for older adults, people with disabilities, and their families.

Launched in 2021, the Master Plan for Aging takes a “whole-of- government” and “whole-of-society” approach, coordinating state agencies, local governments, community organizations, and private partners. The annual report highlights significant milestones, including more than 100 California communities joining AARP’s Age-Friendly Network and $4 million in state funding awarded to local organizations to develop aging and disability action plans in 30 communities statewide.

The report also underscores California’s leadership at the national level, noting that dozens of states have followed its example and that federal legislation inspired by the plan was reintroduced in the U.S. Senate in December 2025.

CalHHS Secretary Kim Johnson emphasized the plan’s focus on equity and resilience amid ongoing challenges.

“The Master Plan for Aging continues to provide a vision, a focus, and a platform for collaboration,” Johnson said. “Equity is at the center of all that we do.”

Looking ahead, the report notes that by 2030, one in four Californians will be age 60 or older, positioning the Master Plan for Aging as a central framework for meeting the state’s long-term social, economic, and health needs.

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Community

Candidates Vying for Governor’s Seat Debate at Ruth Williams–Bayview Opera House in San Francisco

The gubernatorial debate participants included Antonio Villaraigosa, former Los Angeles mayor; Matt Mahan, San Jose mayor; Betty Yee, former California state controller; Xavier Becerra, former U.S. Secretary of Health and Human Services, and attorney general of California; Steve Hilton, political commentator and political adviser; Tom Steyer, entrepreneur, and Tony Thurmond, California’s superintendent of public instruction.

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The gubernatorial debate was hosted by KTVU’s Greg Lee, KTTV’s Marla Tellez and KTVU’s Andre Senior. The candidates are (l.-r.): Xavier Becerra, Steve Hilton, Matt Mahan, Tom Steyer, Tony Thurmond, Antonio Villaraigosa, and Betty Yee.
The gubernatorial debate was hosted by KTVU’s Greg Lee, KTTV’s Marla Tellez and KTVU’s Andre Senior. The candidates are (l.-r.): Xavier Becerra, Steve Hilton, Matt Mahan, Tom Steyer, Tony Thurmond, Antonio Villaraigosa, and Betty Yee.

By Carla Thomas 

 

On Tuesday, Feb. 3, seven candidates took the stage at the historic Ruth Williams–Bayview Opera House in San Francisco for the gubernatorial debate, hosted by the Black Action Alliance (BAA) in partnership with KTVU and sister station KTTV Fox 11 in Los Angeles.

 

For many voters, it marked a first opportunity to hear directly from several candidates seeking to lead the nation’s most populous state.

 

The gubernatorial debate participants included Antonio Villaraigosa, former Los Angeles mayor; Matt Mahan, San Jose mayor; Betty Yee, former California state controller; Xavier Becerra, former U.S. Secretary of Health and Human Services, and attorney general of California; Steve Hilton, political commentator and political adviser; Tom Steyer, entrepreneur, and Tony Thurmond, California’s superintendent of public instruction.

 

Crucial topics and issues addressed throughout the debate included housing, crime, immigration, climate change, health care and homelessness.

 

The debate was moderated by KTVU political reporter Greg Lee alongside KTVU’s Andre Senior and KTTV Fox 11’s Marla Tellez.

 

Candidates also addressed inflation and the rising costs across the state, impacting everything from groceries to childcare and health care. 

 

Thurmond vowed to generate 2.3 million units of housing by placing 12 units on each parcel of available land in the 58 counties of California. Steyer agreed that billionaires should pay their fair share of taxes.

 

Hilton wanted to cut taxes, help working-class families, and end the Democrats “climate crusade and insane regulations.”

 

Yee offered a more transparent governmental approach with accountability, given the state’s debt.

 

Gonzalez said, “This debate was a great way to see who has great ideas and who has substance.”

 

“It’s important to have the debate within a community that requires the most,” said business leader Linda Fadekye.

 

Attendees included State Controller Malia Cohen, representatives of the National Coalition of 100 Black Women, the National Coalition of 100 Black Men, the San Francisco African American Chamber of Commerce, and Black Women Organized for Political Action, among others. 

 

Event host, the Black Action Alliance (BAA) was established to amplify the voices of the Bay Area’s Black community, whose perspectives have too often been overlooked in politics and public policy.  

 

Loren Taylor, CEO of BAA, said it was important to bring the event to the Bayview in San Francisco and shared his organization’s mission.

 

“The Black Action Alliance (BAA) stands for practical, community-driven solutions that strengthen public safety, address homelessness, support small businesses, expand affordable housing, and ensure access to quality education—issues at the heart of the Black experience in the Bay Area,” said Taylor. 

 

California’s primary election will take place on June 2 and the general election will take place on Nov. 3. 

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