By Donna Christensen & Jason Resendez, on May 18, 2020
No one in this country should be surprised that COVID-19 is having a disproportionately deadly effect on communities of color in the United States. The coronavirus joins a litany of health inequities that plague low-income communities and people of color, underscoring the vital importance of health care access during pandemics and beyond. However, the virus comes in the midst of efforts by some state and federal officials to roll back access to Medicaid, a social safety net program that is vital to families in times of crisis like the one we find ourselves in. Coronavirus has made clear that Medicaid expansion must be a priority to our nation’s long-term planning and preparedness efforts to fight future threats.
Diabetes, HIV/AIDS, asthma, obesity, and Alzheimer’s occur at higher rates in people of color when compared to whites. These underlying conditions are exactly what put people at a higher risk for infection, severe illness and death from COVID-19.
Communities of color are more likely to live in poverty and to live in areas with high pollution and with substandard educational systems and housing. These social determinants, exacerbated by structural racism and limited access to the health care system, place these communities in the crosshairs of the current pandemic. Not only are communities of color facing the brunt of COVID-19 and other health disparities, they are doing so without health care coverage. In fact, the U.S. uninsured rate has reached a four year high.
The question now before us is: what are we going to do about it? From Detroit to New Orleans, Blacks and Latinos are facing higher rates of infection and death from COVID-19, and the Navajo Nation has lost more lives to the deadly virus than 13 states combined.
As advocates call for better data reporting on the racial and ethnic impacts of COVID-19 and for better testing in hard hit communities, improved access to health care must be part of the long-term solution. The virus is magnifying the long-standing disparities among racial and ethnic groups in America and is intensifying the urgent need for Medicaid expansion.
If we want to build resilience against the coronavirus – and the next pandemic – we will need a healthier population overall, which means an insured population.
Yet, today about 21.8 percent of American Indian/Alaskan Native, 17.8 percent of Latinos and 9.7 percent of blacks are uninsured, versus just 5.4 percent of whites. Those numbers have steadily increased under President Donald Trump, after years of decline in the wake of the Affordable Care Act.
Medicaid provides critical access to care for millions of low-income Americans and expanding it will have a greater effect on communities of color. With more coverage, the chronic conditions that disproportionately affect these communities can be detected and treated, making these individuals less vulnerable to future pandemics.
Since the ACA passed, 35 states and Washington, D.C., have opted for expansion, and more are doing so since the declaration of a national emergency.
However, some states are undermining these efforts by introducing disastrous proposals that could weaken our nation’s preparedness in the face of future health threats.
Oklahoma Gov. Kevin Sitt, for example, rolled out a dangerous Medicaid block grant proposal in the midst of the pandemic that would impose work requirements for some beneficiaries. With the economy in shambles and unemployment rates at record highs, this plan is out of touch with reality. Even before the pandemic and economic downturn, studies showed that implementing Medicaid work requirements in Arkansas and New Hampshire resulted in higher uninsured rates, yet no gains in employment rates. Instead, people who were already working and those with disabilities and serious health conditions lost coverage due to onerous red tape. This could prove dangerous for a state that already has the second highest uninsured rate in the country.
If Gov. Sitt’s proposal is approved, it could be a blueprint for other states to experiment with Medicaid – and sacrifice the overall health and wellbeing of Medicaid recipients – in order to find cost savings in state budgets. To make things worse, President Trump has called for cuts to the Medicaid program in his 2021 budget.
The coronavirus crisis has laid bare the inequities in our health care system that have made us vulnerable to pandemics, including gaps in insurance coverage for large swaths of our population. This must be remedied immediately with an expansion of Medicaid, not a retreat. It will help protect the groups most susceptible to the coronavirus, provide improved access to testing and treatment, and lead to better health outcomes for communities of color. Above all, Medicaid expansion will build a healthier and more resilient population that is better able to fight the next pandemic.