Addressing persistent racial, ethnic, and other health and health care disparities is necessary to reduce unnecessary health costs in the United States, but the changes being considered to repeal the Patient Protection and Affordable Care Act (ACA) (P.L. 111-148) would increase those disparities. In Public Witness Day testimony before the House Committee on Appropriations Subcommittee on Labor, Health and Human Services, Education, and Related Agencies, Samantha Artiga, director of the Henry J. Kaiser Family Foundation’s Disparities Policy Project commented on existing disparities and the importance of eliminating them.
Many groups in the United States face significant disparities in health, access to and use of health care services, and health outcomes. The disparities occur across many dimensions, including race, ethnicity, income level, language, location, and sexual orientation. According to Artiga, these disparities are longstanding and persistent, and these disparities limit overall improvements in the health of the nation. Under the ACA, HHS made organizational changes to measure and monitor disparities (see New data will help identify, eliminate disparities in patient experience, care, April 20, 2016), and to prioritize and coordinate efforts to reduce disparities (see CMS plan seeks to reduce disparities in Medicare, September 9, 2015). The agency also developed its first action plan to eliminate racial and ethnic disparities. Many of the initiatives taken are discretionary programs including increased funding for community health centers and increasing the number of providers in underserved areas.
Artiga noted that the nationwide increase in health insurance under the ACA through both the expansion of Medicaid and the health insurance marketplace played a central role in narrowing disparities in recent years, and pointed to research showing that access and use of health care and health outcomes will increase over the long-term based on the ACA’s coverage gains. However, in states that chose not to expand Medicaid under the ACA, disparities in coverage have widened, rather than narrowed. She said that the following are key for reducing disparities:
- maintaining gains in health insurance;
- support for public health and prevention;
- health care workforce support; and
- delivery systems that meet the needs of diverse populations.
Despite narrowing of disparities in many areas of the country, disparities still exist (see Racial and ethnic health disparities persist across Medicare beneficiaries, March 11, 2016), and must be narrowed as the population of the United States grows more diverse and health care expenses continue to increase, according to Artiga.
Companies: Henry J. Kaiser Family Foundation
Legislation: CongressionalHearings NewsFeed AccessNews AgencyNews GeneralNews HealthInsuranceExchangeNews MedicaidExpansionNews PreventiveCareNews QualityNews
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