The COVID-19 pandemic exacerbated underlying disparities in health and health care, emphasizing the importance of addressing them. The federal government has made promoting health equity a priority as part of the pandemic response and recovery effort. In response to federal action, the CAP has developed policies addressing Medicaid expansion, Medicaid funding for US Territories, and social determinants of health (SDOH). Watch a 2022 webinar where CAP leaders discussed recent work on health equity issues. The CAP is exploring positions and policy development on standardized public health data, diversifying the health care workforce, diversifying clinical trials, and promoting independence in medicolegal death investigations.
CAP Health Equity Policies
Medicaid Expansion - Strengthening Medicaid is a vital part of ensuring increased health care coverage, especially for low-income people. Expansion efforts should focus on increasing ease of access to Medicaid coverage, simplifying and expanding enrollment, and ensuring adequate physician payment rates that will provide comprehensive patient access to specialty care.
Medicaid Funding for U.S. Territories - U.S. territories must be allowed to participate in the Medicaid program on the same terms as states. Differences in Medicaid financing, including a statutory cap and match rate, have contributed to broader fiscal and health system challenges for the territories.
Social Determinants of Health – Recognizing and addressing the role of social determinants of health (SDOH) is an essential part of combating health care disparities and inequities among patients. The CAP believes that the collection, access, distribution, and utilization of SDOH data can help to reduce health disparities among patients and improve medical decision-making, health outcomes for patients, and public health. As experts of diagnostic testing and stewards of laboratory data, pathologists are uniquely positioned to both identify and develop plans to mitigate health disparities in their communities.
Diversity in Clinical Trials - Pathologists provide essential diagnostic expertise that is necessary for guiding treatment decisions and improving patient health outcomes by evaluating and determining the effects of targeted therapies on diverse populations. The CAP believes addressing barriers to entry for underrepresented diverse populations in clinical trials will improve clinical research, patient safety, and ensure high-quality care in disease diagnosis and management. The CAP encourages Congress and pertinent federal relevant regulatory agencies to take action to promote diversity in clinical trials.
Independence in Medicolegal Death Investigations of Physicians Providing Forensic Medical Services - Protecting physicians providing forensic medical services (e.g., pathologists and non-pathologist physicians acting as medical examiners or coroners, i.e., “forensic physicians”) from undue influence is necessary to ensure the independence of medicolegal death investigations, to safeguard medical integrity, and to preserve public trust and confidence. The CAP supports robust protections to ensure physicians providing forensic medical services are not pressured or coerced to modify or reach specific conclusions in medicolegal death investigations.
Health Equity and Accountability Act
Rep. Robin Kelly (D-Ill) reintroduced The Health Equity and Accountability Act (HEAA) in the U.S. House on April 26, 2022. Since 2003, HEAA has been introduced by the Congressional Tri-Caucus, comprised of the Congressional Asian Pacific American Caucus, the Congressional Black Caucus, and the Congressional Hispanic Caucus. Rep. Robin Kelly (D-Ill) is leading the legislation this year in her capacity as CBC’s Health Braintrust Chair.
CAP-Backed Provisions of HEAA
Expanding Medicaid Coverage
- Permanently increases the Affordable Care Act’s premium subsidies as passed in the American Rescue Plan Act
- Addresses the Medicaid gap by creating a federal program like Medicaid that is operated by the CMS and provides the same benefits
- Treats the U.S. territories like states for purposes of Medicaid
Addressing the Social Determinants of Health
- Includes the Social Determinants Accelerator Act
- Establishes a council to increase coordination between health and social service program
- Requires the CDC to address social determinants of health by creating a program to improve health equity by coordinating activities across the organization
- Awards grants to eligible organizations to aid in these efforts
Standardizing Public Health Data
- Instructs the Data Council of the HHS to make recommendations on how to implement enhanced data collection and analysis while minimizing cost and administrative burdens of data collection on patients and providers
- Awards grants for data collection and reporting improvements
- Includes education on the importance of data collection and reporting to combat health disparities
- Develops educational programs on how to collect and report disaggregated data in a culturally and linguistically appropriate manner
- Establishes grants for minority-serving institutions to analyze racial and ethnic data on disparities in health care with the intent to monitor and report progress on reducing disparities
- Creates the Commission on Ensuring Data for Health Equity to provide guidance that improves the collection, analysis, and use of demographic data in responding to public health emergencies.
- Launches a national task force on workforce diversity.
- Funds the expansion of existing workforce diversity programs, implements new workforce diversity programs, or evaluates these programs concerning mental health care professions.
- Includes grant funding to expand research on the link between the diversity of the health workforce and the quality of health care.
- Funds for loan repayments of up to $50,000 a year for underrepresented minority individuals in medical school and other health programs.
Letters and Press Releases
- Senate Clinical Trials Letter – June 8, 2022
- Rep. Robin Kelly Introduces the Health Equity and Accountability Act – April 26, 2022
- Statement on Supporting Gender-Neutral Blood Donation – April 1, 2022
- Reconciliation Package Response Letter – September 17, 2021