Tuesday, November 17, 2009
The major bills now pending before Congress include a number of key provisions that could either directly or indirectly have an impact on reducing health disparities affecting racial and ethnic minorities. Racial and ethnic minorities represent only one-third of the total U.S. population, but they comprise more than 50 percent of the nation?s uninsured.
A new Kaiser Family Foundation issue brief examines some of the key provisions of health reform legislation that are likely to have a significant impact on people of color and also highlights the specific provisions of the proposed legislation that focus on health disparities. These provisions include:
The Medicaid expansions. The pending legislation would expand Medicaid eligibility to all individuals with incomes up to either 150 percent or 133 percent of federal poverty level, These changes are projected to provide coverage to between 11 million and 15 million people, with a disproportionate share of people of color because they are a large share of the low-income uninsured population.
Health Exchange. Each of the proposals allow uninsured people who do not qualify for Medicaid coverage to purchase insurance through a newly created health exchange, with premium credits and cost-sharing subsidies available people with incomes up to 400 percent of the federal poverty level. This will help millions of additional uninsured moderate-income Americans, including people of color, to afford health care.
Specific Disparities Provisions. Each of the proposals contain provisions specific to health disparities. In the House bill, much of the focus is on providing language services to individuals with limited English proficiency, while the Senate bills include provisions to improve the collection of race, ethnicity, primary language, geographic area, and disability data. The House bill also would reauthorize the Indian Health Care Improvement Act.
Workforce Development. With many low-income individuals, rural residents, and people of color living in medically underserved areas, these populations could benefit from provisions in some of the bills aimed at increasing the primary care providers in the workforce and increasing the number of providers in medically underserved areas.
Community Health Centers. Community health centers fill a critical need for communities of color, as half of the patients who receive care at a community health center are people of color. Each health reform proposal includes increased funding for community health centers.
The brief, Health Reform and Communities of Color: How might it Affect Racial and Ethnic Health Disparities?, is available online.
In addition, the Foundation has issued a second brief, The Role of Health Coverage for Communities of Color, which examines variations in health coverage by race and ethnicity and explores the role coverage plays in improving access to health care services for communities of color. It is also available online