Every person in the U.S. should have access to quality, comprehensive, and affordable health care. The Affordable Care Act (ACA) has expanded coverage for millions of Americans, providing subsidies for people with moderate incomes and important protections for health care consumers, including a ban on lifetime benefit caps and a prohibition on denying coverage based on pre-existing conditions. There is more to be done. States that have opted not to expand Medicaid have uninsured rates that are almost twice as high as states that have accepted Medicaid expansion. Prescription drugs are still too expensive. Too many people remain uninsured, and even for those who do have coverage, it may not provide comprehensive, quality care. Public health programs, prevention, and community health centers play a critical role in the health care system.

The ACA has been under attack from its first day of implementation, and it remains under attack. The number of people with access to health care rose year after year after the ACA became law; there is evidence, however, that the growth rate of insured Americans has slowed. But the federal government has a role to play in guaranteeing that Americans from all walks of life have access to affordable health care — that includes all age groups and people with disabilities, through the Children’s Health Insurance Program to Medicaid and Medicare. Health care must be adequately funded without shifting costs to those who can least afford them. Finally, health care should be broadly available for immigrants; this means no unnecessary documentation requirements, or any other barriers to health care for citizens and immigrants.

The epidemic of substance use disorders has taken more American lives than the Vietnam War and urgently requires a multi-pronged federal response emphasizing access to treatment. Such a response should also include ensuring a stable and professional behavioral healthcare workforce, research into non-addictive pain medication, effective approaches to treatment, and controls over abusive practices by the pharmaceutical industry that have led to massive over-prescribing of addictive drugs.

The federal government must play a more aggressive role in protecting people from life-threatening public health hazards. Lead poisoning remains a serious threat to children’s health. Lead contamination of Flint, Michigan’s water supply was a preventable tragedy whose harm to children and the whole community will require continued services for years to come. We know that many other communities’ water supplies have high levels of lead contamination that must be addressed. Further, the biggest threat of lead poisoning to children is from lead paint and dust in public buildings and residences. The scientific consensus is that there is no safe blood lead level in young children. Nevertheless, children continue to be poisoned by lead in publicly supported housing and other units available to low-income families.

Lead poisoning is just one of many public health dangers that require federal leadership and investment. Pollution in our air and water and improper protections against toxic substances disproportionately endanger low-income communities and agricultural and other workers.  In addition, it is an urgent priority to protect as many people as possible from the devastation of hurricanes and other natural disasters, and to provide extra help for the poorest people and communities, not only in immediate rescue efforts, but also in the rebuilding that must follow.

You can learn more about the positions that CHN takes on various issues reviewing our public policy document.