Guarantee Access to Affordable Quality Healthcare and Critical Human Services

We start with a fundamental principle. Any healthcare reform should provide the choice and control Americans want, the affordability they need, and the quality they deserve.

Mayors recognize that a strong federal, state, and local partnership is necessary to ensure that everyone has the services they deserve to live healthy and productive lives. Mayors also share a responsibility for the health, social welfare, and well-being of our communities, which includes ensuring access for all to affordable health care and comprehensive human services; robust and coordinated quality of life systems of care; walkable/bikeable neighborhoods; easy access to public transit and open space; safe and affordable housing; protection from emerging public health threats; and access to healthy, nutritious foods.

The facts are clear. The Affordable Care Act (ACA) decreased the number of uninsured, expanded health care coverage, and ended barriers to treatment for millions of residents in our cities. Additionally, ACA reduced medical gaps in coverage to ensure that essential health services like emergency, rehabilitative, pediatric, maternal and newborn care, lab, prevention and wellness, and mental health and substance use disorder benefits are protected.

Because these services and many others are of critical importance to the people we serve, mayors call on the President and Congress to:

  • Strengthen local and federal partnerships by investing in public health and prevention programs, and support research, evaluation, and tracking of key health measures. The more we know, the healthier our populations will be, and the more healthcare dollars we can save.
  • Ensure that any future health care proposal reduces long-term growth of healthcare costs for individuals, businesses, and government; protects families from bankruptcy or debt-driven by health care costs; guarantees choice of doctors and health plans, and provides individual control over healthcare decisions.
  • Invest in prevention and wellness; improve patient safety, quality, affordability of care; assure affordable, quality health coverage for all Americans; include comprehensive mental health and substance use disorder treatment options; maintain coverage when someone changes or loses a job; and continue to reduce barriers to coverage for people with pre-existing medical conditions.
  • Explore options to get additional funding directly to local government through reduced federal bureaucracy, changes in eligibility requirements of existing programs and/or create dedicated funding for local governments to address mental health and substance use disorders in our communities – to help more people find recovery and save lives.
  • Expand support for child-care and early childhood development.
  • Combat the growing youth vaping epidemic by supporting federal, state and local
    anti-tobacco initiatives.
  • Evaluate pricing for prescription drugs based on their effectiveness and treatment outcomes; enact measures to prevent companies from using price gouging to increase profits; requiring drug advertisers to inform viewers of the cost of their medications, and include clear enforcement mechanisms to protect the American consumer.

While obesity and diet-related chronic disease also remain a growing epidemic, they are largely preventable.

Today, more than one in three children and adolescents, as well as two-thirds of adults, are overweight or obese. Healthy food and food insecurity have been established as important considerations for local governments as they are fundamentally linked to issues such as chronic health problems, economic inequity, environmental sustainability and economic development.

Federal nutrition and emergency assistance programs offer a vital safety net, while other important public-private programs are increasing access to healthy foods, stimulating new economic activity, creating links between cities and rural communities, and ensuring environmental stewardship.

Thus, mayors call on the President and Congress to:

  • Craft a comprehensive national food policy that feeds the hungry, supports small farmers in urban and rural areas, and promotes access to healthy and affordable food for all residents in urban, suburban and rural communities. This includes strengthening incentives and infrastructure for local food production and distribution as well as environmentally sustainable farming practices. It also includes providing better access to fresh foods, investment in programs providing healthy food, expansion of programs that help communities invest in retail markets or food-based businesses, increased access to farmers’ markets, and expansion of farm-to-cafeteria programs that bring the freshest locally-grown food into school lunch programs, hospitals,
    and other institutions.
  • Reauthorize the Child Nutrition Act, WIC and Older Americans Act, so that every American knows he or she will always be protected.
  • Strengthen the food safety-net by maintaining current benefit levels for the Supplemental Nutrition Assistance Program (SNAP).
  • Support and strengthen local and regional food system infrastructure to ensure access to healthy and affordable food.


Focused on: Infrastructure, Innovation, & Inclusion