By Tamara Toles O’Laughlin, Executive Director, Environmental Health Network
Even with a temporary reprieve, the latest “health care” bill is another disturbing chapter in modern history. Reports from the CBO estimate that 22 million human beings will be uninsured by 2026, with 15 million uninsured in the next year.
This news is particularly disturbing to environmental health practitioners. We care about population health or health of the whole lot of us. Rollbacks of this scale bring us into the discussion because it flies in the face of the best tactic we have, prevention. Prevention is the best option because without exposure, there can be no overexposure, which leads to toxicity.
I will be the first to admit that Medicaid is no panacea. While Maryland’s expansion of the program provides access to affordable care for a greater number of humans it will, overall, be very costly to ensure that birth, aging and the human tendency to deteriorate can be sustained without long range planning. Fortunately, Maryland is doing just that, with Commissions on Health Insurance Coverage and Health In All Policies, the Old-Line State is putting in the work to manage the unvarnished truth—that we’ve got to grapple with human lives and resources at the same time. Federal repeal is the opposite of planning. It is cowardly and dangerous.
In the meantime, frontline communities —or the humans that we have made vulnerable by our choice to pair housing with the siting of toxic activities– are still under threat. It should not be a matter of political will to protect human health. No one should have to depend on the whims of federal funding to enjoy basic health services. Humans of color, humans with limited language proficiency, and those who are poor are already facing the first and worst exposure to the effects of climate change. And climate affects health. The proposed Senate “health bill” is determined to create additional environmental threats to societal well-being.
Insurance coverage and preventative health services are critical to a safe and sustainable environment. Health outcomes should not depend on the circumstances of birth, zip code, age or ability. Attacks on health programs based on social status of financial ability needlessly increase risks and ratchet up harms. Environmental health codifies these critical relationships as the social determinants of health and mental health. To foster positive outcomes, we must consider these connections and broadly invest in greater access to affordable care across Maryland.
Health doesn’t happen in a vacuum, it is connected to economics, norms, and politics. If we allow the for the repeal of health protections, and deteriorated norms, medications will become expensive to the point of being out of reach. Marylanders will take more sick days which means less income. In short, repeal will worsen health and increase the risk of poverty. Similarly, mental health care will become unaffordable and harder to access, even as the events that trigger it will increase.
Cuts to Medicaid will decrease access to basic and complex services, and increase incidences of acute health issues which untreated can become pathologies. Cuts to Medicaid will trigger an increase of preventable death, as states will be unable to support the vulnerable humans. Those humans will be forced, to make impossible choices between paying for healthcare and meeting basic needs.
Let’s stop pretending that these bills are about health, rather than money. Medicaid serves low income families and provides care for vulnerable humans. This version of the “health care” bill rolls back progress and shifts the burden of the social safety net onto individuals. Environmental health connects the complete picture of human health to the ways it shows up in the body, mind and in between. There is nothing in the “health care” bill that provides for better treatment or prevention.
This latest iteration of the “health care” bill is a brazen attack on environmental health, not just because removes access to services for the elderly, pregnant, disabled or anyone who could ever become sick, but because the unfolding drama around increasingly targeted cuts (that amount to a wealth transfer) also disturbs plain old well-being.
Unless we act up (now) to stop rollbacks on basic service protections we are sentencing the members of our society with the least access to resources to a lower standard of health and then taking away any chance they could have to get better and stay better.
It’s time for all of us to connect well-meaning to well-doing and push back against rollbacks to health protections.