Saturday, January 25, 2020

At Health Action 2020: Once more unto the breach, dear friends

I've had my yearly fix from Health Action 2020, Families USA's annual conference for healthcare advocates, policy people, scholars, and, most importantly I think, front-line ACA enrollment counselors.

I attended my first Health Action conference in January 2017, days after Trump was "sworn," aka perjured, into office. Republicans were promising swift ACA repeal -- "repeal and delay" was their watchword of the moment, meaning they would sunset the marketplace and Medicaid expansion swiftly and fill in the details later. The conference was composed of several hundred people devoted to preventing that. "Our action should lead to their inaction," declared incoming FUSA president Frederick Isasi. And mirabilis, that's exactly what happened.

In 2017 I felt keenly that the conference was run and attended by people who had devoted years or decades to expanding healthcare access in the U.S. -- all now faced with the prospect that their work would be unraveled. I wrote about an emanation of collective strength, institutional and individual, from the participants.  And this year I kept flashing back.

Since the impeachment process got into gear this year, I have often felt that American democracy is going down. It's terrifying to watch the entire Republican party fall in behind Trump to neuter Congress's power to hold a corrupt would-be autocrat accountable for on-the-record abuse of power.  Once again, the people on the stage and in the room reminded me that despite the grave threat to democracy posed by a party in power that's given up on democracy, the country has huge reserves for resistance: people who know how to be free; institutions that know how to wield political influence in service of the common good; courts that at least sometimes uphold the rule of law.

Keynote speaker Xavier Becerra, attorney general of California, has filed 67 suits against the Trump administration -- and won some major victories, though many could yet be unraveled. His recap had an elected official's necessary self-promotional aspect but was none the less bracing for that:
We're protecting our and our water from pollution...our LGBT fellow Americans...our students. We're protecting our hardworking immigrant families against the relentless attacks from this administration. We've even fought against this president in court on the upcoming Census...We beat him, we beat him bad, all the way to the Supreme Court. People don't think he can be beat, but we beat him, repeatedly. ..On the facts, on the science, on the law.  
A reelected Trump could reverse most of those victories while irredeemably corrupting the courts with a flood of extremist and often unqualified new appointments. Nothing said at a conference can materially diminish that clear danger. Nonetheless, the Health Action conference showcases the strength of another America -- all the more in the last two or three years because of an intensified focus on equity issues and a commitment to give voice to people of color, LGBTQ activists, advocates for the disabled, and other minorities. So you hear from people who can calmly document institutionalized inequity -- via statistic, survey, personal narrative, field report -- but have learned to drill the hard boards of political and bureaucratic influence.

So, for example, you have Ola Ojewumi of Project ASCEND, which creates educational opportunities for disadvantaged young people, talking about putting pressure on any and every public institution.  "Contact your polling place -- is it accessible?"  And Marielena HincapiĆ© of the National Immigration Law Center, illustrating the power of narrative to reach voters (and judges), recounting that her parents, immigrants from Colombia and factory workers, relied on food stamps when laid off, and raised nine children who are "teachers, lawyers"...productive citizens.  And Chanel Porchia-Albert, an African American onetime commodities trader turned doula, who both cites the appalling stats on black maternal deaths and brings home , from her experience as a doulah, the impact of inherent bias in the hospital:
going to a birth and seeing someone have Child Protect Services used as a tool to get them to comply with a medical procedure...or seeing individuals who were trying to advocate for their loved ones have security or police officers called on them and get escorted out of the hospital.
For Portia-Albert, witnessing such treatment on a daily basis is not cause for despair but fodder for a commitment to "connect on a human level" to make change person by person. Much of the conversation in plenary sessions was about the technique of connecting with voters, healthcare workers, elected officials. 

And that's where, big picture, the conference gives me a sense of strength. We are all witnessing national political institutions as we have known them decay before our eyes. Some 30% of the population or more has been brainwashed over two decades by the alternate reality constructed by Fox News and other corrupt media outlets to abandon the core values we're raised to think America stands for.  But there are tens of millions of people in this country who know how to be free. Some have learned through decades of patient work how to work the levers of power. Others have just grown up with the reflexes of a free people -- and, shocked by Trump's election, have learned how to work those levers, or create new levers.

It's that upsurge that led Michele Johnson of the Tennessee Justice Center, to say, "I've never been as hopeful as I am now. Something happened in 2017...people are connecting their frustration [with the political system] with their own experience."

The conference was about making that connection and sharing learned experience on how to communicate it -- in the workplace, in outreach to voters, in putting pressure on and working with elected officials.

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