Ambitious push to address racial disparities in US health care

Noam N. Levey, Tribune News Service

As President-elect Joe Biden prepares to tackle the devastating COVID-19 pandemic killing thousands of Americans a day, he has given his health team another, equally challenging task: rooting out entrenched racial inequalities in American health care.

Led by California Attorney General Xavier Becerra, tapped by Biden to lead the Department of Health and Human Services, Biden’s health care team is aiming for an ambitious agenda to reshape a system that still leaves millions of Black and Latino Americans with weaker insurance protections, less access to care and poorer outcomes.

The effort will face an early and critical test as the administration seeks to blunt the calamitous effect the pandemic is having on minority communities.

“COVID unmasked how serious many of these issues are,” Becerra said in an interview with the Los Angeles Times. “The camouflage that may have hidden some of these disparities has been ripped away. ... There is no excuse not to take them on.”

Becerra, if confirmed by the Senate, will be the first Latino to hold the nation’s highest health care post.

The challenge Becerra and others on the Biden team face is immense. The coronavirus outbreak has devastated Black and Latino communities, spreading not only disease and death, but also severe economic hardship.

Black Americans, for example, account for more than a third of COVID-19 deaths in the US, though they represent only about 12% of the population, according to a study of selected states and cities with data on COVID-19 deaths.

Black and Latino Americans are also more likely to have lost a job or seen their income reduced during the pandemic than White Americans, a recent nationwide poll by the nonprofit Kaiser Family Foundation found. At home, Latino and Black parents are also facing a tougher time caring for their children amid the outbreak, the study revealed.

“This is a crisis that has fallen disproportionately on communities of colour,” said Leon Rodriguez, who headed the Office of Civil Rights at the Health and Human Services Department under President Barack Obama. “That’s been an important reminder that bad health outcomes still disproportionately hit communities of colour.”

These disparities received scant mention from President Donald Trump. Biden, by contrast, has made remedying inequality central to his planned pandemic response.

“For Blacks, Latino and Native Americans, who are nearly three times as likely to die from (the virus), COVID-19 is a mass causality,” the president-elect said earlier this month as he introduced Becerra and other members of his healthcare team in Wilmington, Delaware.

In addition to tapping the former Los Angeles congressman and son of immigrants to lead HHS, Biden also set up a COVID-19 “equity task force,” to be headed by Dr. Marcella Nunez-Smith, a primary care physician and founding director of the Equity Research and Innovation Center at the Yale School of Medicine.

Biden isn’t the first president with a health care agenda aimed at racial inequality. Half a century ago, President Lyndon Johnson’s push to enact Medicare and Medicaid helped usher in the desegregation of hospitals across the South and brought health protections to millions of previously uninsured Black and Latino Americans. More recently, the Affordable Care Act that Obama signed in 2010 fuelled historic gains in insurance coverage and access to medical care for those communities.

The share of Black Americans without health insurance dropped by nearly half following enactment of the law, for example, falling from almost 25% to less than 14%, according to data assembled by the nonprofit Commonwealth Fund.

Even so, Obama rarely spoke publicly about these racial disparities. That makes Biden’s decision to highlight their persistence more notable, said Samantha Artiga, who directs the Disparities Policy Project at the Kaiser Family Foundation.