Health Equity Requires Systemic Change
At the Health Foundation for Western & Central New York, we believe that health care is a human right. We advocate for quality, affordable care and support initiatives that make our health care system more accessible and equitable.
To transform the system, we must first address the policies, laws, and regulations that contribute—positively or negatively—to the health of our communities. Only when everyone has the coverage they need and deserve will we see better health outcomes.
Our Advocacy Strategies
· Defend existing programs and legislation that provide access to care
We monitor and respond to threats to existing programs and laws, such as the Affordable Care Act, and support opportunities to strengthen them.
· Improve the reach and affordability of existing programs that provide access to care as well as support the development of policies that improve the health of everyone in the community
We support measures that will expand the reach of existing programs as well as improve outreach and enrollment for uninsured people who are eligible for coverage.
· Continue to contribute to public education efforts related to increasing health care access and affordability
We partner with other health equity advocates to share information about expanding and improving coverage. The goal is to help more people understand how increased coverage for each one of us can lead to a healthier, more just community for all of us.
2026 Priorities
While many aspects of our health care system need reform, we choose to focus on issues that directly impact underserved communities in the regions we serve. These communities will suffer significant harm once residents and providers experience the full consequences of the 2025 budget reconciliation bill (better known as H.R.1 or the One Big Beautiful Bill Act). Our goal is to reduce the damage by exploring new funding solutions, educating our followers on why the legislation is a threat to public health, and championing reform in policy and regulations.
Our immediate advocacy priorities, on both the federal and state level, are:
Medicaid
This joint federal-state program has suffered substantial cuts, reducing its ability to serve diverse, low-income populations. We are concerned about how the expanded work requirements will be administered and whether they will lead to people disenrolling despite being eligible for the program. Over a million people are forecast to be kicked off New York State’s Medicaid program due to these new requirements from HR 1. A drop in enrollees will also hurt key safety net providers because of decreased revenue.
Medicare
Serving both older adults and people with disabilities, this program is increasingly dominated by privately insured Medicare Advantage plans. Our focus is on older adults, whose access to care may be affected as traditional Medicare continues to be weakened. We are paying special attention to practices like upcoding and prior authorization.
Community Health Centers
Community health centers, which include Federally Qualified Health Centers (FQHC), are a crucial part of our health care infrastructure. They provide care to underserved populations in both rural and urban communities.
Unfortunately, because of the cuts to Medicaid in H.R.1, they are poised to lose significant revenue, which will threaten their ability to serve patients, the majority of whom are insured through Medicaid. To make matters worse, community health centers have not seen an increase in their reimbursement rates for more than 25 years. Additionally, the 2026 340B Rebate Model Pilot Program will create a financial strain on under-resourced facilities, especially community health centers.
Our advocacy includes developing long-term strategies to support centers in the regions we serve. We invest in their primary care services, advocate for higher reimbursement rates, and educate the public about the critical role these centers play in our health care system. We are especially focused on policy decisions that can strengthen Federally Qualified Health Centers.
Maternal and Infant Health
Healthy pregnancies increase the chances for healthy babies. One of our focus areas—children ages 5 and under who grow up in poverty—reinforces the urgency of advocating for maternal and infant health, including comprehensive medical coverage through programs like Medicaid. Over the past eight years, we have partnered with community-based organizations and government agencies on innovative programs for healthy pregnancies, positive birthing experiences, and postpartum support. This includes training and reimbursing birthing doulas who work with Medicaid-insured individuals.
Rural Health
Across 16 counties, we serve a wide swath of rural communities. Each one is unique, but they all share a common trend: the closing of hospitals and clinics, resulting in health care deserts. We focus on policies and programs that can strengthen Federally Qualified Health Centers so they can provide care for residents in rural areas. FQHCs are uniquely qualified to care for rural communities, and we strongly believe that raising reimbursements rates for Medicaid services is a sound investment in their sustainability.
Telehealth Parity
The Covid-19 pandemic necessitated new solutions to decrease wide disparities in health care access. The pandemic is over, but the disparities persist. In rural communities, for instance, large numbers of hospitals and clinics have been forced to close, leaving residents without access to providers. To help close the coverage gap, we advocate for telehealth services to be offered by all insurers.
Health Care Workforce
Our health care system is only as strong as the people who work in it. We advocate for increased funding, novel approaches, and support for our essential workers to maintain an effective health care workforce. Here are two areas that we are monitoring:
· Scopes of practice—We agree with Governor Hochul’s decision to pursue expanding scopes of practice for certain health care professionals in New York State. We believe that dental assistants should be included, given the current dental health crisis, especially in our rural communities.
· First responders—The backbone of our emergency response system, these health care professionals deserve more funding and adequate mental health support.
Older Americans Act (OAA)
Originally passed in 1965, this landmark legislation ensures older adults receive the services they need to age in place. Congress should reauthorize the OAA so that a nationwide network of community-based organizations and agencies can continue to operate smoothly and provide vital services for our older citizens.
Achieving a ‘win’ and making policy or regulatory progress takes time, sustained effort, ample resources, and—most importantly—collaboration. The Health Foundation has been honored to do advocacy work alongside a variety of community partners in both western and central New York. 
