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Bringing Fairness Back to Our Health System Having an insurance card often makes the difference between whether or not one has access to health care. The Affordable Care Act will make major strides toward ensuring that the vast majority of Americans have access to affordable health insurance, and millions Latinos are expected to benefit. But the job isn’t finished yet. Particularly in the Latino community, there are those who will be left out of health care reform and others who, even with health coverage, do not have access to high-quality health care or services. In fact, the Agency for Healthcare Research and Quality (AHRQ) has provided ample evidence that Hispanics are more likely than other Americans to be sicker, die younger, and suffer needless medical conditions because of inferior medical care and services. Every year since AHRQ has issued the National Health Care Disparities Report, gaps between Hispanics and Whites have widened. In 2010, the dire situation continued, with Latinos receiving lower-quality care in 60% of core measures and having worse access in 83% of core measures.1 The good news is that the commitment to fix our health care system did not stop with the Affordable Care Act. With the support of lead sponsor Representative Barbara Lee (D–CA), the Congressional Tri-Caucus has introduced the “Health Equity and Accountability Act of 2011 (HEAA)” (H.R. 2954). Along with hundreds of civil rights organizations, consumer advocates, and health provider networks, NCLR strongly supports this comprehensive bill, which has two major points of action. First, “HEAA” builds on reform by eliminating unfair restrictions to health coverage in the new health care system. Second, it promotes greater health equity by investing in solutions that narrow gaps by addressing the root causes of poor health outcomes in racial/ethnic and other communities. The “Health Equity and Accountability Act” promotes health equity and builds on reform for Latino and immigrant families by: Reducing obstacles to insurance for legal and undocumented immigrants by removing the federal five-year bar from Medicaid, CHIP, and Medicare and by removing barriers to unsubsidized purchase of private health insurance in Exchanges for all Americans Promoting workforce diversity and training by fully funding programs that will expand the health professions and emphasize culturally and linguistically appropriate training Improving the collection of data on a number of disparities by looking at race, ethnicity, primary language, sex, gender identity and sexual orientation, and disability. The bill also assesses how to advance data collection in vulnerable immigrant families Supporting community-based strategies that address social, economic, and environmental factors, known as social determinants of health, which contribute to health disparities in communities of color Strengthening health information technology initiatives in communities of color and other medically underserved areas to improve quality of care Promoting research and initiatives that address health conditions disproportionately affecting Latinos and other communities of color, such as HIV/AIDS and diabetes Expanding health care access and quality for rural areas, many of which are home to migrant or farmworker communities, by creating demonstration grants and establishing initiatives such as the Rural Community Hospital program and Rural Health Centers The changes proposed by “HEAA” are essential to our health care system because: Health inequity is expensive. America’s pocketbook cannot afford to keep health disparities in place. Research shows that inequities in health care for communities of color led, over three years, to direct medical costs of more than $230 billion and indirect expenditures of $1.24 billion.2 Allowing health disparities to worsen is like throwing money out of the bank. We should be making it easier for people to get health care coverage, not harder. We know that people who go without health insurance end up suffering over time— enduring preventable illness, losing productivity in their work and communities, and even falling victim to premature death. We should be doing everything in our power to remove barriers to health insurance: getting rid of restrictions that keep immigrants from paying for full-priced insurance and removing the arbitrary wait times that stand in the way of coverage for legal immigrants. Your health is more than an insurance card. H.R. 2954 recognizes that achieving health equity is more than getting a doctor’s note. We must address community infrastructure, poverty, and other social, economic, and environmental factors outside of health coverage that have a negative impact on health outcomes for communities of color. “HEAA” takes us down this road by looking at how we build up prevention and community programs to stop disparities where they start. To find out more about health care reform and to see what NCLR has been doing to improve health care for Latinos, go to www.nclr.org/healthcareforall and www.nclr.org/HCRBasics. For more information, contact members of the Health Policy Project: Jennifer Ng’andu, Deputy Director, at (202) 776-1762 or firstname.lastname@example.org Kara Ryan, Senior Research Analyst, at (202) 776-1703 or email@example.com Sergio Eduardo Muñoz, Senior Policy Analyst, at (202) 776-1562 or firstname.lastname@example.org 1 The Agency for Healthcare Research and Quality (AHRQ), 2010 National Healthcare Disparities Report (Washington, DC: AHRQ, 2010). 2 Thomas A. LaViest, PhD, et al., The Economic Burden of Health Inequalities in the United States (Washington, DC: Joint Center for Political and Economic Studies, 2009).
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