Holding Institutions Accountable for Access and Equity

Hosted on May 21st, 2024

In this webinar, we hear from leaders at People’s Action, the Center for Health Progress in Colorado, and El Centro in Kansas City, each of whom bring tangible examples of work to hold health care institutions and insurers accountable for how their practices impact patients.

A public demonstration; people are leaning against Blue Cross Blue Shield of Michigan offices, with picket signs. The one in the forefront is a young man wearing a wide brimmed hat holding a yellow sign with dark text that reads "Your greed makes me sick".

Holding Institutions Accountable for Access and Equity

from Rx Foundation’s Power is a Social Determinant of Health series

Session description: The ability of each of us to get the care that we need, when we need it, and how we need it is often impacted by the harmful decisions and practices of the institutions that provide and pay for care. As issues like medical debt and debt collection practices, claims denials, health care costs, and community benefits transparency and accountability rise in prominence, there is increasing scrutiny of the decisions and practices of health care systems and insurers. This conversation will explore how non-profit groups at the local, state, and national levels are organizing people impacted by the practices of these institutions to advocate for change, and will illustrate the discussion with case studies and examples of corporate accountability strategies and campaigns around the US. 

We will dig into questions that include:
-What does corporate accountability mean in the context of health care and the systems for insurance and payment?
-Why does this lane of action include and go beyond expanding insurance coverage options?
-How could health care systems and insurers benefit from responding positively to calls for greater accountability?

As more states near universal health insurance coverage, the fight for health care justice doesn’t stop there. Recognizing how corporate interests inside the health care system are prioritizing profit and wealth generation over patient experience, holistic care, and population health, nonprofit organizing groups are launching accountability campaigns that fight against these trends.

Watch the Recording

Examples from
Holding Institutions Accountable

Center for Health Progress
YouTube video
El Centro
YouTube video
People’s Action Institute
YouTube video

Session Highlights

The “Ni Uno Más” campaign (El Centro) fights for equitable cancer care and access. Policy changes made at a local cancer center, including to their charity care policy, barred individuals without a social security number from applying. Patients needed to pay diagnostic treatment fees in full before they could start (pre-quotes of up to $50,000-$70,000). Ni Uno Más ultimately grabbed the attention of VPs at the cancer center, and has sparked an ongoing conversation regarding their policies and the impact they have on their community.
The “Care Not Courts” campaign (Center for Health Progress) called on the CEO of a non-profit health system (UCHealth) to stop suing patients for their unpaid medical debt. UCHealth has a substantial amount of power in Colorado, with over a quarter of the market share in the entire state. Although UCHealth has not yet been barred from suing their patients, a bill has passed through legislature requiring them to identify themselves on their bills and lawsuits rather than using a third party, which is a significant step in the right direction. Care Not Courts continues to push forward to hold these institutions accountable.
The “Care Over Cost” campaign (People’s Action Institute) urges insurers, like UnitedHealthcare, to end their practices of delaying and denying medically necessary or approved care for people who have insurance under their policies. It originated from people expressing that their healthcare was not helping them access care; but rather, was what was preventing them from obtaining it. Care Over Cost helps with people who have been denied care by their insurance company to go through the formal channels of appealing their denial. Paired with public pressure campaigns on the insurance companies themselves, these tactics encourage insurers to overturn their denials, while highlighting publicly that this is a problem that needs attention. Care Over Cost got a commitment from UnitedHealth for a follow-up meeting.
For advocates, organizers, funders, and everyone: it’s important that we pay attention to implementation of policy.
Systemic change takes time and investment in people and community; funding for that has to look different than traditional funding for traditional policy change without community.
Corporate accountability work is a way to engage people and directly fight the wrongdoing that is happening to them. In that process, we can build faith in that if we come together, we can make change.
In order to change the way that health care works, it will require our political systems to step up and do what’s right for their communities.


Erica Andrade, President/CEO of El Centro

Erica Andrade (she/her)

Erica Andrade was appointed President and CEO of El Centro on July 1, 2023. She was born in the Rio Grande Valley in south Texas and is the proud daughter of a strong, resilient immigrant mother from Guanajuato, Mexico.

Erica has worked at El Centro for the past 22 years, El Centro is a nonprofit organization with a strong 46-year history of serving the Latino community of the Kansas City, Kansas area. As a Spanish first organization we support our Latino community by reducing language barriers so they can access services they need, and deserve, to thrive. She graduated from the University of Kansas in 2001 with a BA in Latin American Studies and from University of Missouri in Kansas City with her MPA 2019.

Erica Andrade, President/CEO of El Centro

Rayna Hetlage (she/her)

Rayna Hetlage is a passionate community organizer and the Director of Political Strategy at the Center for Health Progress. With an MPH in Health Systems Management and Policy from the Colorado School of Public Health, she is dedicated to advocating for healthcare reform that focuses on the needs and experiences of communities of color.

Raised in Portland, Oregon, Rayna learned the importance of being unwavering in her willingness to speak truth to power in the pursuit of a better world. Inspired by Shirley Chisholm’s quote, “If they don’t give you a seat at the table, bring a folding chair,” Rayna is committed to ensuring that communities of color have a voice in shaping health care policies and decision-making processes. She strives to use her expertise to support community members in becoming leaders in the spaces where decisions are made.
As a self-proclaimed health policy nerd, Rayna’s work has primarily involved advancing legislation aimed at increasing access and affordability of health care, such as SB20-215: Health Insurance Affordability Enterprise, HB21-1232 Colorado Option, and HB22-1289 Cover All Coloradans. She currently serves as the Chair of the Health Insurance Affordability Enterprise, allocating over $200 million annually to make health care more affordable for Coloradans. She envisions a healthcare system shaped by communities, prioritizing people over profit.

Erica Andrade, President/CEO of El Centro

Aija Nemer-Aanerud (they/them)

Aija Nemer-Aanerud started organizing as a student leader with the People’s Action Institute affiliate The People’s Lobby in Chicago, Illinois. They went on to co-found and direct Student Action, People’s Action’s constituency development project that organized and developed the power of college students and young people and built powerful local chapters on campuses across the country, fighting for Free College for All. Aija has 12 years of organizing experience, and they currently work directing the Health Care for All campaign, working with member groups to develop winning strategies that advance our goal of winning tangible victories for the communities we represent.

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