Cornell professor Jamila Michener testified March 29 before a congressional committee that universal health insurance coverage would not only address health inequities among people of color, but strengthen the U.S. democracy.
Michener, associate professor in the College of Arts and Sciences and a faculty member in the Cornell Jeb E. Brooks School of Public Policy, told the Committee on Oversight and Reforms that health care for marginalized communities would allow them to participate more in politics.
"Access to high quality, affordable health care offered to all, in ways that convey dignity and respect, has great potential to amplify the voices of those who are most economically and racially marginalized in American society," said Michener, also associate dean of public engagement at the Cornell Brooks School and the co-director of the Cornell Center for Health Equity. "To build their power, and to create a more robust democracy."
Michener spoke at the "Examining Pathways to Universal Health Coverage" hearings, held by the committee chair Rep. Carolyn B. Maloney (D-NY). The purpose of the hearing was to evaluate the need for reforms that would expand access to affordable health care and move the nation toward universal coverage, including the Medicare for All Act.
Michener said that due to long-standing patterns of racial residential segregation, the disadvantages generated from being uninsured or underinsured are concentrated in the places where people of color live.
"These racial disparities are just the tip of a much larger iceberg," Michener said. "Crucially, such inequitable health outcomes are a product of systemic forces, not individual choices."
According to Michener's testimony, uninsured rates are generally higher for Black, Latino and Indigenous adults compared with white adults. This means people of color are more likely to delay care or forgo treatment, struggle to afford prescribed medication and adhere to treatment regimens. Black people are also at higher risk for chronic health conditions such as diabetes and hypertension.
Michener said health coverage for all would make the democracy stronger, citing Medicaid expansion's association with short-term boosts in voter turnout, while Medicaid disenrollment is associated with significant declines in voting rates.
"Over and above the material and health benefits that such coverage would provide, it would also position people of color as full and equal members of the polity, reinforcing their civic status and strengthening our democracy," Michener said. "Though this connection is too often overlooked, health and health policy have crucial consequences for democratic participation."
Michener's research focuses on poverty, racial inequality, public policy and health policy. Her recent book, "Fragmented Democracy: Medicaid, Federalism and Unequal Politics," examines how Medicaid affects democratic citizenship.
She also recently contributed to a report by the Congressional Caucus on Black Women and Girls, "An Economy for All: Building a Black Women Best Legislative Agenda." The 133-page report details the potential benefits for all of potential government policies to pull Black women out of economic precarity and into economic prosperity. The report includes several specific policy solutions that could ease the challenges facing Black women, including instituting a guaranteed income, closing the Medicaid gap and funding community-based organizations to combat the maternal mortality crisis.
Rep. Bonnie Watson Coleman (D-N.J.) plans to introduce a House Resolution encouraging the use of this framework as a guideline to implement better public policies to benefit all people, specifically Black women.
