Black Health is Not Negotiable

Our community has always been resilient. Our community has always had to be resilient. We’ve built networks of care when systems failed us. We’ve created healing spaces when we were shut out. And right now, as new federal legislation threatens to take away healthcare from thousands of our neighbors, we’re standing together once again.

In July, the federal government passed what they call the One Big Beautiful Bill Act. But for Black families in San Francisco and across the Bay Area, H.R. 1 is anything but beautiful.  While some provisions promise support for rural hospitals and tax relief, this law will cut over $1 trillion from health programs over the next decade – threatening to unravel critical safety-net programs like Medi-Cal (Medicaid) and CalFresh, placing millions at risk of losing coverage and care. Medicaid helps thousands of Black San Franciscans access doctors, medications, and the care we need to stay healthy and alive.

At Rafiki Coalition, we see every day what happens when our community loses access to healthcare. We also see the incredible strength that emerges when we support each other through crisis. This moment calls for both: honest talk about what’s coming, and clear action on how we’ll face it together.

What This Means for Our Families

Let’s be real about what we’re dealing with. When politicians in Washington cut Medicaid, it’s not just numbers on a budget. Here’s what we’re really talking about:

• Health Uncertainty

• • • A Medicaid recipient feeling “uncertain about the future of the services” as providers face the “worst-case scenario” with funding cuts

• More emergency room visits

• • • People who will be forced to wait and “only get care in the emergency room” for conditions like high blood pressure, diabetes, and asthma – as “preventable illnesses will become extreme emergencies”

• Special Needs Care

• • • A mother caring for her child with autism and ADHD who says “Medi-Cal is how I care for my son. Without it, I don’t know what we’d do” – facing an impossible choice

• Acute risk to Black pregnant women

• • • A pregnant Black woman needing prenatal care – facing higher risk in a community where Black women are already three times more likely to die from pregnancy complications.
    • Medicaid currently covers 51% of births to Black mothers in California. Congresswoman Lateefah Simon warns that 40,000 people in the East Bay alone could lose healthcare access

• Our Elders in Jeopardy

• • An elderly person on fixed income managing multiple chronic conditions – losing access to specialists and prescription drugs

As Shanell Williams, Rafiki’s Executive Director, puts it: “Medicaid is a lifeline for thousands of Black San Franciscans. These cuts represent an attack on Black health, Black families, and Black futures.”

How This Hurts All of San Francisco

When our communities lose healthcare access, the impact spreads throughout the city. 

• Emergency rooms overflow with people who can’t afford preventive care. 
• Mental health crises increase. 
• The entire healthcare system strains under pressure, while economic activity drops by billions and over a million jobs are lost statewide.

How Rafiki Is Here for You

Rafiki Coalition has served San Francisco’s Black and vulnerable communities since 1986. Here’s how we’re supporting you:

• Know Your Coverage
• Use Preventive Services: Access health screenings and wellness programs while available, including at the Umoja HAP
• Connect with Community: Join our programs and build relationships with neighbors
• Make Your Voice Heard: Contact your representatives about how these cuts affect your family 
• Support Community Health: Volunteer, donate, or spread the word about our services.

Standing Together

The challenges ahead are real, but so is our power to face them. For nearly four decades, Rafiki has been part of this community’s story of resilience, healing, and hope. The federal government may try to balance their budget on the backs of our community, but they can’t break the bonds we’ve built with each other.

Black health is not negotiable.

Ready to take action? Visit rafikicoalition.org, call (415) 615-9945, or visit us at 601 Cesar Chavez Street. Together, we’ll keep our community healthy and strong.