Rep. Jan Schakowsky headshotU.S. Rep. Jan Schakowsky has been representing Illinois’ 9th congressional district since 1998. During her time in Congress, Schakowsky, a Democrat, has been a leading advocate on a number of public health issues, including affordable care for seniors and widening access to reproductive and women’s health services. She was also a key supporter of the nation’s new health reform law, the Patient Protection and Affordable Care Act. Previous to holding elected office in both the U.S. House of Representatives and the Illinois State Assembly, Schakowsky worked as a community organizer and consumer advocate, taking on issues ranging from energy reform to food product labeling. In 2011, she was honored as APHA’s Distinguished Legislator of the Year for her work on behalf of public health.  

Q: APHA recently honored you as its Distinguished Legislator of the Year. What inspires you to be such an outspoken advocate on behalf of public health?

 Before I was ever elected to public office, my goal as an activist and organizer was to contribute to the efforts of bringing affordable, quality health care to all Americans. All of my biographies note that my top priority is achieving the goal of universal health coverage. I had (and still have) the privilege of working with people like Dr. Quentin Young, a past president of APHA and my personal physician before he retired, and Dr. Paul Farmer, of Partners in Health, in promoting the simple notion that affordable, quality health care is a human right, not a privilege at home and around the world.

A week does not go by in my district office that we don’t hear about a health care tragedy: a family bankrupted by medical bills; a women with breast cancer unable to get insurance; a senior who can’t afford her prescription drugs; or a young man with a disability sidelined because he can’t afford the services needed to be a productive member of our community. I simply can’t reconcile these circumstances being so prevalent in the richest country in the history of the world.

At the same time, I have visited the several community- and school-based health centers in my district and have seen affordable, quality primary and preventive care being delivered in an easy-to-access, dignified and friendly neighborhood setting. I have seen the impact of public health initiatives that address the contributors to poor health: inadequate housing and nutrition, poor environmental quality, violence and poverty.

Q; You were — and continue to be — a big proponent of the Affordable Care Act. What provisions of the law were you particularly passionate about and why?

One of the most rewarding days of my life was that day — March 23, 2010 — when the Affordable Care Act passed the House of Representatives. I was not the only member with tears in her eyes. With passage of this historic law, health care became a right for most Americans (sadly, not for undocumented immigrants.) Being a woman will no longer be a pre-existing condition, and having a pre-existing health condition will not exclude anyone from coverage or require higher payments.

As a member of the House Energy and Commerce Committee’s Subcommittee on Health, I had the privilege of playing a significant part in its enactment. I personally had a hand in provisions to end the practice of insurance companies rescinding the coverage of policyholders just at the moment when they need it most — when they get sick. This is a particular problem in Illinois. I worked successfully to include a provision to improve long-term care quality and staffing, and one to require health insurance companies to disclose and publicly justify premium increases. I helped get a public option included in the House-passed bill, but it was removed in the Senate. And I was part of a small group, including House Speaker Nancy Pelosi, that worked to preserve reproductive health care services for women.

Q: As co-chair of the Congressional Task Force on Seniors, how worried are you that attempts to significantly cut the Medicare program will come to fruition? Also, how is the task force working to strengthen Medicare so that it can sustain into the future?

As co-chair of the Seniors Task Force, I am very concerned that some in Congress are using the deficit as an excuse to dismantle Medicare. (Last year’s) House-passed Republican budget plan would eliminate Medicare and replace it with inadequate voucher payments to private insurance companies. The nonpartisan Congressional Budget Office estimates it would double out-of-pocket costs by 2030. The Republican budget would also convert Medicaid into a block grant and cut funding by 35 percent in 2022 and 49 percent in 2030, threatening access to critical long-term care services. Fortunately, the public strongly supports Medicare and Medicaid and opposes cuts — that is true across ideological, age, geographic and party lines.

While Medicare has done a remarkable job providing guaranteed benefits for older Americans and people with disabilities, it can be strengthened and improved. The Affordable Care Act takes many of those steps — eliminating excessive payments to private Medicare plans, fighting fraud and abuse, and improving health care delivery. It also focuses on prevention and wellness. Mt. Sinai hospital in Chicago is showing that “pre-primary health” — reaching into the community to prevent chronic diseases like asthma and diabetes — not only improves health outcomes, but lowers costs.

We can do more. I support proposals to lower prescription drug costs by requiring that Medicare negotiate for discounts (similar to Veterans Affairs), create a Medicare-administered drug plan to compete with private plans, and encourage the use of generic drugs.

Q: You’re a strong supporter of women’s health, speaking out against proposed funding cuts to reproductive health services and applauding policies that widen access to critical women’s health services. Why is this issue so important to you and do you predict continuing battles over women’s health funding?

As a leader in the Congressional Pro-Choice Caucus, I support access to the full range of reproductive health services, including access to safe abortion. I steadfastly oppose any effort to eliminate Title X funding to the more than 4,400 clinics in the United States, including Planned Parenthood clinics, that rely on that funding to serve approximately 5 million young and low-income women and men each year. Title X clinics provide preventive care, including life-saving cancer screenings, routine gynecological examinations, contraceptive services, immunizations, and testing and treatment for sexually transmitted infections. Title X clinics are critical to achieving the goal of improving quality health care in this country, including efforts to improve women’s health, lower the rate of unintended pregnancies and decrease infant mortality.

I believe that access to contraceptives and reproductive health care is a basic right. Access to effective contraception not only reduces unintended pregnancies; it is critical to improving women’s overall health and economic well-being. I fought for and will continue to fight for the women’s preventive health service guidelines, which ensure insurance coverage of preventive services, including contraception, for women with no cost-sharing requirements. It is no secret that substantial public health benefits and cost savings emerge when preventive services are accessible and affordable.  

Q: It’s sometimes hard to believe that our individual voices can make a difference within the halls of Congress. What do you say to Americans who feel disheartened by today’s political environment and what advice do you have for people who want to get more involved in advocacy?

I share with President Obama the credential of being a former community organizer. I began my activism as a young housewife, working with a handful of others to get freshness dates on food sold in the grocery store. For five years, I served as the director of the Illinois State Council of Senior Citizens, which focused mainly on health care issues such as affordable prescription drugs and protecting Medicare.

I still believe that people power can trump the money when it comes to influencing policy decisions, but that power needs to be organized. Working through organizations like APHA, public health advocates can magnify their impact. And APHA, working in coalition with like-minded organizations, can be even more effective.

We face enormous challenges, but we are winning. We need to enlist more and more people because the stakes are so high — from the future of Medicare to the environment of our planet and the legacy we leave to future generations.