Despite historic gains made by the Affordable Care Act (ACA) in reducing health disparities, significant disparities remain. Recent news coverage on staggeringly high black maternal mortality – three to four times the rate of white mothers – is only one of countless examples of the effects of institutionalized racism on the health of communities of color. As one stark example, babies born to middle-class black mothers with a professional degree are more likely to die before the age of one than are babies born to low-income white mothers without a high school education.
The Trump administration’s ongoing attacks on health care access will deepen disparities. Mixed status immigrant families are making fewer doctors’ appointments and dropping out of important public programs like the federal supplemental nutrition program for Women, Infants, and Children (or WIC), and Medicaid due to fear around tougher immigration enforcement and potential changes to rules around “Public Charge.” LGBTQ individuals and people of color worry that they will be further ostracized and denied care due to the HHS’ proposed religious refusals rule as well as expected changes to HHS’ Health Care Rights Law. Moreover, individuals living with chronic medical conditions – such as HIV/AIDS and Hepatitis C – may be denied access to live-saving drugs as the Trump administration scales back the federal role in ensuring robust coverage of essential health benefits in Qualified Health Plans on the marketplace.
In contrast to Trump’s efforts to sabotage and undermine health programs, congressional members, advocates, and community members joined together to advance a future in which individuals do not suffer harmful health outcomes because of who they are, the color of their skin, or where they live. Today, Representative Barbara Lee (D-Calif.) introduced the Health Equity and Accountability Act (HEAA) of 2018, an important piece of legislation that provides a comprehensive plan to achieve health equity. This introduction, coupled with Senator Mazie K. Hirono (D-Hawaii) and Rep. Lee’s Dear Colleague Letter in support of HEAA, provides an important demonstration of the commitment of the Congressional Tri-Caucus – comprised of the Congressional Black Caucus (CBC), Congressional Hispanic Caucus (CHC), and Congressional Asian Pacific American Caucus (CAPAC) – to eliminate health disparities and create a just, high quality health care system that is rooted in fairness and justice. More than 300 groups also signed a letter supporting introduction. (See the National Health Law Program’s statement about the measure.)
HEAA includes 10 “titles” aimed at eliminating racial and ethnic disparities in health care access and outcomes. Specifically, HEAA addresses the intersection of health inequities with race, ethnicity, immigration status, age, disability, sex, gender orientation, gender identity and expression, language, and socio-economic status. The titles address:
1. Data Collection and Reporting
2. Culturally and Linguistically Appropriate Health Care
3. Health Workforce Diversity
4. Improvement of Health Care Services
5. Improving Health Outcomes for Women, Children, and Families
6. Mental Health
7. Addressing High Impact Minority Diseases
8. Health Information Technology
9. Accountability and Evaluation
10. Addressing Social Determinants and Improving Environmental Justice
The bill seeks to eliminate existing barriers to affordable health insurance coverage, promote investments in innovative health delivery methods and technologies, and advance research and data collection about diverse communities. It also aims to ensure that a full range of culturally and linguistically appropriate health care and public health services is available and accessible in every community. Finally, it incorporates strategies to address various disease-specific, mental and behavioral health issues facing minority communities.
HEAA has garnered wide-reaching support by health equity advocates, scholars and researchers, provider groups and associations, other professional groups, and organizations representing communities of color. In addition, various provisions of prior versions of HEAA were successfully included in the Affordable Care Act.
As Asian American and Pacific Islander Heritage Month comes to an end and Pride events upcoming, we are reminded that the fight for health equity requires unwavering commitment and hard work. We must continue to protect and improve health care for all each day of the year. Take the first step today and tell your Congressional members that you support HEAA. For more information on this bill and how you can get involved, click here.