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Dear Community:
This week, the news has been heavy – and deeply relevant to the health and wellbeing of Black communities. During Black History Month, new reports warn that proposed Medicaid and Affordable Care Act cuts, along with the expiration of enhanced ACA premium tax credits, are widening long-standing racial health inequities. These policy decisions are not abstract. They threaten coverage, raise costs, close hospitals, and increase preventable illness and death in Black neighborhoods across the country.
At the same time, research continues to show how voting restrictions and barriers to civic participation are linked to poorer health outcomes, especially for Black Americans. When communities lose both access to care and access to power, disparities deepen.
These stories are featured in more detail below, and they remind us why our work matters. Health equity requires vigilance, advocacy, and action at every level — local and national. We must protect progress, demand accountability, and stand together for systems that value every life.
Now more than ever, our message remains clear: We Must Save Us. Wishing you a safe and healthy week ahead.

Renee Mahaffey Harris
President & CEO
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Trump and Republican Health Care Cuts are Deepening Racial Health Inequities
A new report released this week during Black History Month finds that Donald Trump and Republican policies are actively worsening health outcomes for Black Americans, widening long-standing disparities in access to care and affordability. The report is authored by Protect Our Care, the National Association for the Advancement of Colored People (NAACP), the National Council of Negro Women (NCNW), and the National Urban League (NUL).
First reported on Roland Martin Unfiltered, the new report details how more than $1 trillion in cuts to Medicaid and the Affordable Care Act (ACA), combined with the ending of the health care tax credits and rollbacks of public health funding, are hitting Black communities hardest — threatening coverage, closing hospitals, and driving up preventable illness and death.
“The evidence is obvious. The Trump Administration is actively seeking to create a system of medical apartheid,” said Derrick Johnson, President and CEO of the NAACP. “Trump is Making Americans Sick Again, Black people in particular. From gutting Medicaid and defunding ACA tax credits to sabotaging vaccines and research, this policy violence is a sustained attack on the health and economic security of Black America. In just one year in office, this administration has worked to undo decades of progress, all because of its policy of cruelty towards Black people. As the midterm elections draw closer, the NAACP will continue to remind Americans of this dangerous political agenda and encourage them to vote to protect themselves and their families.”
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For Massachusetts health leaders, racial equity and health equity go hand in hand
Across Massachusetts — from the State House to Boston City Hall to efforts from local organizations — improving the health of residents has long been a priority. For leaders at Boston’s community health centers, improving those outcomes means closing gaps in access and outcomes that often fall along racial lines.
“Health equity and racial justice are inseparable,” said Jordina Shanks, CEO at Fenway Health. “You can’t address one without addressing the other.”
How that plays out tends to vary in particulars at a local level — “it’s going to look different in Boston than it will in Tucson than it will in Brownsville, Texas than it will on the Canadian border, because you have different populations of people,” said Dr. Guy Fish, CEO at Codman Square Health Center.
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How to conduct health equity work amid politicization, threats
A new report from the Institute for Healthcare Improvement (IHI) offers a framework for healthcare organizations to continue health equity efforts amid politicization.
The report was based, in part, on a literature review and extensive interviews with 27 participants across health systems and community organizations. The report identified appropriate policies that support ongoing health equity initiatives and created a framework for maintaining equitable care.
“I want leaders to take away the understanding that there’s still opportunity and space and reasons and importance around continuing to do this work,” Camille Burnett, Ph.D., vice president of health equity at the IHI, told Fierce Healthcare.
In recent years, diversity, equity and inclusion (DEI) efforts have come under scrutiny during the Trump administration. Corporate and academic institutions alike have pared back their initiatives or entire departments. The report cited several such examples within the government, such as the Centers for Medicare & Medicaid Services (CMS) pulling information on health equity for the Medicaid and CHIP programs through Section 1115 waivers. Health equity plans were also removed from the CMS’ Enhancing Oncology Model, while the National Institutes of Health canceled grants that touched on DEI and LGBTQ+ health, and a CMS committee on health equity was disbanded.
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How Rush University Medical Center is closing the 'death gap'
As financial pressure mounts and the healthcare safety net continues to strain, academic medical centers are drawing on their culture of innovation to pursue better outcomes — and narrow life expectancy gaps in the communities they serve. In this episode of Radio Advisory, host Rae Woods sits down with leaders from Rush University Medical Center to explore how health systems can stay focused on results amid tightening margins, political scrutiny, and ongoing uncertainty in grant funding.

Dr. Omar Lateef, President and CEO of Rush, and Dr. David Ansell, Senior Vice President for Community Health Equity, describe how Rush treats gap-reduction as a long-term operating strategy rather than a moral or messaging exercise. They share practical examples of how local partnerships, targeted investments, and day-to-day operational choices can improve outcomes while still making financial sense — and why avoiding battles over language helps keep the focus squarely on results.
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Failing to extend the enhanced ACA premium tax credits is an attack on working-class Black families and major metro areas
Millions of working families will lose health care coverage, while millions of others are facing higher premiums, following the expiration of the enhanced Affordable Care Act (ACA) premium tax credits in January. Losing the subsidies will substantially reduce coverage for Black families in particular, as they are both more likely to live in states without Medicaid expansion and more likely to face uninsurance due to lower and less stable incomes. Our analysis projects Black losses in health care coverage attributable to the premium tax credits expiring for 10 major metro areas with large Black populations, along with the additional costs to those cities of said coverage losses, including: preventable Black deaths, increased annual premiums for remaining enrollees, increased costs to employers, lost worker productivity, and reduced local spending and economic activity. Acting to reinstate and extend the ACA premium tax credits is equity-enhancing, race-conscious economic and public health policy.
Families who lose insurance and families who remain covered both face significant new burdens, and the costs are substantial across the 10 metropolitan areas.
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Voting Rights in Jeopardy: Implications for Health Care Disparities
Health care is consistently ranked among the top concerns of the nation’s voters. A special issue for health care voters is electing candidates who are committed to making high-quality health care accessible and affordable to all. A 2025 article reported that restrictive state electoral environments resulting in barriers to voting were associated with lower self-reported health outcomes. The association was especially pronounced among Black Americans. Although this research cannot establish a causal relationship between voting restrictions and poorer health, the strong association suggests that causation is at least plausible.
Recent political issues on which health care voters may be aligned include state Medicaid expansion, Medicaid spending reductions in the One Big Beautiful Bill Act, and the threat to the extension of the Affordable Care Act premium tax credits now in the hands of the Senate. Each of these important health care issues may especially affect minority populations.
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