From Coverage to Change: Designing Policy that Reflects the Lives of Black Men

🧭 From Coverage to Change: Designing Policy that Reflects the Lives of Black Men

Insurance is the floor—not the ceiling. It’s time to craft health policy that affirms, protects, and invests in Black men.

From Coverage to Change: Designing Policy that Reflects the Lives of Black Men on Capitol Hill

Insurance is the floor—not the ceiling. It’s time to craft health policy that affirms, protects, and invests in Black men.

By Dr. Okey K. Enyia | Where Purpose Meets Policy

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The ACA was a breakthrough.
It expanded Medicaid, launched health insurance marketplaces, and banned discrimination based on pre-existing conditions.

But for many Black men, especially non-Hispanic Black men, the law's reach stopped short of meaningful transformation.

Because coverage alone doesn’t change lives—policy alignment does.

To truly improve outcomes, health policy must not only account for how Black men live, but also affirm who Black men are: caregivers, change agents, innovators, fathers, and freedom-builders.

This final post in the series charts a vision that does exactly that.

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🔍 From Policy Inclusion to Policy Reflection

Health policy is often made about Black men—but rarely with us, and even less often for us.

According to my research and that of scholars like Gilbert, Griffith, Bruce, Hammond, and others:

• Black men are still the least likely to have a usual source of care—even when insured

• Black men face cumulative, overlapping barriers to care, including cost, bias, systemic racism, incarceration, and economic instability

• Despite their exclusion from policy design, Black men are hyper-visible in systems of surveillance (e.g., criminal justice), and invisible in systems of support (e.g., healthcare)

That’s not coincidence. That’s policy neglect.

We don’t just need “targeted outreach.”
We need structural realignment.

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📌 What Reflective Policy Looks Like

If we want health equity for Black men, we need policy that does more than distribute access—we need policy that reflects the lived realities of Black men.

That means designing policy through the lenses of:

🏥 Structural Access

• Ensure Medicaid expansion in every state

• Fund trusted, community-based health centers where Black men already gather (e.g., barbershops, churches, schools)

• Provide wraparound services like transportation, housing, and job placement—because care doesn’t happen in a vacuum

🧠 Mental Health Equity

• Invest in Black-led mental health models that normalize therapy, healing circles, and culturally grounded treatment

• Expand telehealth and peer navigation for trauma-responsive care

• Mandate training in racial trauma and masculinity-informed care across public programs

💼 Economic Stability

• Embed workforce development and job security policies into Medicaid and ACA reforms

• Expand access to entrepreneurial support for Black male-led businesses in health and tech

• Address the policy overlap between healthcare, housing, and the justice system

🎓 Representation and Research

• Dramatically increase Black male participation in medical, dental, public health, and AI/ML research

• Require all federally funded research to disaggregate data by race AND gender

• Include Black men in all stages of policy creation—from problem-framing to evaluation

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🗣️ “The policies that shape our lives must start reflecting the lives we actually live.”
— Dr. Okey K. Enyia

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🧭 A Framework Grounded in Dignity

The future of equitable healthcare isn’t race-neutral. It’s race-conscious, gender-conscious, and justice-driven.

The John Henry Health Equity Playbook proposes a roadmap grounded in three investment pillars:

1. Health Equity – Preventive care, behavioral health, chronic disease management

2. Economic Stability – Job access, small business capital, homeownership

3. Civic Empowerment – Voter protection, fatherhood support, and public accountability

When health policy reflects the realities, strengths, and aspirations of Black men, we move beyond survival—we build systems of thriving.

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🔁 From Coverage to Change—Now What?

Black men don’t need more pamphlets.
We need platforms, partnerships, and power.

Here’s how we close this ACA series—and open a new era of possibility:

✅ Recognize Black men as policy architects, not just data points
✅ Design care systems that respect and reflect our lives
✅ Fund the brilliance already in motion across our communities
✅ Embed equity into every policy—not as a footnote, but as a foundation

Because we are not waiting to be saved.
We are building, leading, and reimagining what’s possible.

And when we invest in Black men, everyone benefits.

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Thank you for following this ACA mini-series.
If this content resonated, please share, subscribe, and reach out to explore partnerships or policy collaborations. The next phase of this work will include the public launch of the John Henry Health Equity Playbook—and we want you in the room.

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Dr. Okey K. Enyia
Founder & CEO, Enyia Strategies
Chair, Men’s Health & Wellness Committee, Million Men Vote
Deputy Surgeon General, Alpha Phi Alpha Fraternity, Inc.