“Of all the forms of inequality, injustice in health is the most shocking and inhumane.” Dr. Martin Luther King, Jr.
As COVID-19 sweeps the nation, African-American coronavirus death rates are alarmingly disproportionate with their representation in the population. Across the U.S., Black Americans are dying of COVID-19 at a rate of more than twice their population share. Collectively, they represent 13% of the population in states releasing data, but have suffered 28% of deaths.
Health care disparities in people of color
The higher rates of infection and death are directly linked to decades of unresolved health care disparities in communities of color. The term health care disparity refers to differences in health outcomes that are closely linked with social, economic, and environmental disadvantage.
Those disadvantages include decades of discrimination that force people of color into substandard housing with limited access to green spaces and healthy food options leading to chronic health conditions such as asthma, diabetes, and heart disease; fewer economic opportunities that cause them to be overly-represented in service industry jobs; and limited access to health care.
Know Your Rights
For these reasons, accessing health care and understanding your legal rights are more important than ever. A starting point to learning about health insurance options is the health care marketplace, https://www.healthcare.gov/ Here, you can get accurate information about the Affordable Care Act (ACA) or Obamacare and about Medicaid in your state.
Open enrollment in the ACA
Each year, there is an open enrollment period during which consumers can use the website to learn whether they are eligible for and enroll in marketplace insurance and a tax subsidy to help to pay insurance premiums. However, for a qualifying life event, the ACA extends a 60-day special enrollment period outside of open enrollment period to sign up for insurance plans and subsidies. Losing a job and losing the healthcare that was provided by an employer is a qualifying life event that gives you a special enrollment period.
State Medicaid agency found on ACA marketplace
On https://www.healthcare.gov/ individuals with low incomes can also find their state Medicaid agency to begin the process of applying for Medicaid. Medicaid applications can be filed at any time throughout the year. Medicaid eligibility criteria and coverage varies from state to state. In some states, Medicaid has been expanded to cover all adults below a certain income level. However, in all states, Medicaid provides coverage for some low-income people, families and children, pregnant women, the elderly, and people with disabilities.
State Medicaid agencies have requested flexibility from the federal government so that they can alter state Medicaid programs to respond to the COVID-19 national and state emergency. For a more detailed discussion about Medicaid emergency authority and due process rights, see Medicaid Emergency Authorities and Due Process During the COVID-19 Pandemic. https://healthlaw.org/medicaid-due-process-and-covid-19-part-i/
Constitutional due process rights
Medicaid applicants and recipients should still be aware of and exercise their constitutional due process rights even during these emergency circumstances. For instance, if a state agency denies a Medicaid application or terminates or reduces Medicaid benefits, an applicant or beneficiary must be given notice of that change. The notice must describe the adverse action that was taken, describe why it was taken, and explain how that decision can be appealed or challenged.
Due process also requires that applicants/beneficiaries get a hearing or an opportunity to challenge the agency decision before a neutral decision-maker. Prior to that hearing, beneficiaries and their representatives have the right to examine all documents and records that the agency used to reach the adverse decision.
Finding an advocate to represent Medicaid beneficiaries in a Medicaid appeal
Legal Services Corporations provides a starting point for Medicaid beneficiaries to find an advocate to represent them in a Medicaid appeal. Medicaid advocates should reach out to providers and community based organizations that serve Medicaid beneficiaries in order to monitor due process issues as they arise.