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Thursday, June 2, 2016

Record Low Uninsured Rates, New Anti-Discrimination Rule: May Health Equity Update

Things have been pretty busy in the health equity world since last month’s blog. In addition to celebrating Asian American and Pacific Islander Heritage Month, we received news that uninsured rates are the lowest ever (woo-hoo!), Medi-Cal coverage for undocumented children in California became a reality, the long-awaited health anti-discrimination rule was published, as was the rule on Medicaid managed care.

More people insured than ever

Earlier in the month, HHS reported that the national uninsured rate has never been lower.  Dropping to 9.1 percent, this new data on the uninsured rate represents the first time we’ve hit single digit territory, and further proof that the Affordable Care Act is working. 

Highlights of the new data from HHS include:

  • Uninsured gaps between minority non-elderly adults and whites are narrowing
  • Hispanics experienced the greatest decrease in the percentage of people without health insurance between 2013 and 2015, dropping to 27 percent
  • Asian Americans have actually surpassed whites on coverage, with the data showing that more whites are uninsured than are Asian Americans

California Medicaid coverage for undocumented children becomes a reality

As we’ve reported, last year California’s broad-based #HealthforAll campaign pushed its elected leaders to authorize Medi-Cal coverage for all low-income children, regardless of immigration status. On May 16, this historic policy became a reality, as the California Health and Human Services Department began the process of enrolling these children. While advocates continue to work to extend Medi-Cal coverage to all low-income adults, this is a historic step on the path toward #HealthforAll

HHS issues rule on discrimination in health care

The U.S. Department of Health and Human Services (HHS) published the final regulations implementing the Section 1557 civil rights provision of the Affordable Care Act. Advocates have been working with HHS for some time to finalize this long-awaited rule, which is widely considered to be a monumental stride forward not just for health equity, but also for civil rights.

The rule builds on existing civil rights protections under Title VI of the Civil Rights Act of 1964, clarifying that discrimination on the basis of race, color, origin, sex, or disability in the provision of health coverage and health care is forbidden, including discrimination against LGBTQ people

Now that the rule is out, it is important that consumers and advocates take advantage of the complaint mechanism to enforce it, through the Office of Civil Rights (OCR) at HHS. 

Final rule on Medicaid managed care released

In May, CMS released another long-awaited rule. The rule, which hadn’t been updated in over a decade, guides the operation of Medicaid managed care. This far-reaching rule advances delivery system reform, strengthens consumer protections, and promotes accountability. For example, plans will be required to publicly post a quality star-rating for their plans, allowing potential and current enrollees to choose a plan based on quality.

This new rule has significant implications for communities of color, who make up more than half of Medicaid beneficiaries overall and more than 75 percent of all Medicaid enrollees in managed care. We hope that health equity advocates will be able to leverage this rule to improve the access to and quality of care for people with Medicaid coverage.   

Top Health Equity Reads and Resources

Health Equity Spotlight: The Asian and Pacific Islander American Health Forum (APIAHF), supported by the Robert Wood Johnson Foundation, recently published Public-Private Partnerships for Data Equity report, which highlights promising approaches for addressing the underutilization of national health data and improving the quality of data collection, analysis, reporting, and dissemination in Asian Pacific Islander communities.  It also includes policy recommendations to support adoption of public-private partnerships

New Push for Health Coverage for the Justice-Involved Population, Elizabeth Hagan, Families USA

New CMS Requirements Make it Harder to Qualify for a “Permanent Move” SEP, Elizabeth Hagan and Kara Nester, Families USA

Health Advocate: Medicaid Managed Care Final Regulations Released, Sarah Somers, National Health Law Program

How to Build a More Diverse and Inclusive Nursing Workforce, Lucia Alfano, Robert Wood Johnson Foundation

Aunt Bertha: A Social Services Search Tool for Camden, A free, user-friendly social services search tool for Camden County by the Camden Coalition and Aunt Bertha

Achieving Health Equity: How Academic Medicine is Addressing the Social Determinants of Health, Association of American Medical Colleges

Rural Children at Risk for Worse Health Outcomes, Higher Health Care Costs, Alon Peltz, et al. University of Alabama at Birmingham

Health Care’s Hard Realities on the Reservation: A Photo Essay, Misha Friedman, Kaiser Health News and National Public Radio

A Closer Look at the Race Gaps Highlighted in Obama’s Howard University Commencement Address, Allegra Pociniki and Richard V. Reeves, Brookings Institution