By Joe W. Bowers Jr., California Black Media
Nearly 6 in 10 Californians delayed or skipped medical care in the past year because of cost, and 4 in 10 reported their conditions worsened as a result — trends that disproportionately affect communities already facing disparities, including Black Californians.
Black Californians have the shortest life expectancy in the state — about 74.6 years compared to more than 80 years statewide — and they face higher rates of maternal mortality, chronic disease and preventable hospitalizations. Those realities are compounded by rising healthcare costs and new federal policy changes that state leaders say could reverse years of progress.
Against that backdrop, for the first time in California history, two Black women are leading the Legislature’s top health policy bodies — positions that will shape how the state responds to those challenges.
Mia Bonta (D-Alameda), who represents the 18th Assembly District, chairs the Assembly Health Committee. Dr. Akilah Weber Pierson (D-San Diego), a board-certified obstetrician/gynecologist representing the 39th Senate District, chairs the Senate Health Committee. Both are members of the California Legislative Black Caucus (CLBC), and Weber Pierson serves as the caucus chair.
Their leadership comes at a moment when policy decisions made in Sacramento and Washington, D.C., are expected to affect access to care for millions of Californians. Both lawmakers say their roles give them an opportunity — and responsibility — to address longstanding inequities affecting Black communities.
Bonta said her leadership is shaped by personal experience navigating inequities in healthcare.
“I’ve had to endure instances as a Black woman with healthcare providers questioning my need for different drugs, for questioning whether or not I had the right diagnosis,” she said.
“At the baseline of it all, I believe that healthcare is a human right… and our healthcare system… has a lot of inequities,” she added.
Weber Pierson, drawing on her experience as a physician, said her focus is on translating policy into better patient outcomes.
“We’ve put a lot of good laws in place. The next step is making sure those laws are actually improving outcomes for patients.”
Both lawmakers pointed to legislation they are advancing to address disparities in access and care.
Bonta highlighted measures like Assembly Bill (AB) 2368, which would codify CalAIM programs — a Medi-Cal initiative that connects patients to services like housing, food and other social supports — shown to improve outcomes in Black communities. She also pointed to AB 3161, a bill that would require hospitals to collect and report patient safety data by race, income and other demographic factors.
Weber Pierson pointed to proposals including Senate Bill (SB) 987, which would create a state fund to help offset federal Medicaid cuts, and SB 503,which addresses bias in artificial intelligence used in healthcare.
At a recent Assembly Health Committee hearing, Bonta advanced her bill AB 2651, the Informed Parents Healthy Schools Act, which requires schools to notify parents when vaccination rates fall below herd immunity thresholds.
Each year, the Legislature regularly passes health-related laws, many of which amend or add sections to the California Health and Safety Code.
Bonta said a key step is ensuring that those laws are backed by clear data and oversight.
“You can’t fix what you can’t measure,” Bonta said.
She said enforcement tools now include reporting requirements, corrective action plans and potential involvement from the Department of Justice.
Weber Pierson said the focus now is on how that data is used.
“We have to be intentional about collecting the right data and using it to drive change,” she said.
Both lawmakers pointed to rising costs and federal policy changes as immediate threats to access to care.
During a joint informational hearing of their committees in March, convened to examine the impact of federal healthcare changes on California’s system, they outlined how those pressures are already affecting Californians.
“When people are this worried about costs, they change their behavior… that means people will make life and death decisions,” Bonta said.
Weber Pierson said federal actions could reverse recent gains in coverage.
“At this point, this country is facing $1 trillion in cuts, mostly to Medicaid and other health programs,” she said.
She said the reductions could limit access to physicians and preventive care.
Bonta said as many as two million Californians could lose Medi-Cal coverage as a result of federal changes. She said the Legislature is preparing to respond.
“I’m focused… on making sure that we have as many Californians as possible covered,” she said.
She added the Legislature will work to prevent disinvestment in primary care.
Both chairs acknowledged that expanded coverage has not eliminated disparities.
“Health coverage is foundational, but we still need to do more to ensure that access… is appropriate, timely, and affordable,” Weber Pierson said.
Bonta said access must include culturally competent care.
“It’s one thing to have coverage on paper, but if you don’t have a provider… that provides culturally concordant care… then it’s not really access,” she said.
Maternal health remains one of the most significant disparities affecting Black Californians.
“We know where the disparities are,” Weber Pierson said. “The question is how we make sure every patient is receiving the same standard of care.”
Bonta pointed to gaps in access, including maternity deserts.
“We have parts of California now where a woman could have to travel up to two hours to deliver a baby,” she said.
Both lawmakers also highlighted chronic conditions such as hypertension and diabetes as ongoing drivers of inequities in Black communities.
“We have to make sure people can access care early and stay connected to care,” Weber Pierson said.
The March joint hearing demonstrated how the Assembly and Senate health committees are working in coordination as they prepare for budget and policy decisions.
“Even though we are in two separate houses, we are all dealing with the same issues and repercussions of what is happening at the federal level,” Weber Pierson said.
