HHS Sec'y Burwell: Break the barriers to health coverage
The Alliance for a Just Society, with funding from the Kellogg Foundation, has done research in 10 states concerning barriers to coverage and care under the Affordable Care Act facing people of color and other communities with a history of access challenges.
Based on this research, we have formulated a series of policy recommendations that we will be releasing in a national report in April. An Executive Summary of the report is available (click here for PDF).
The specific recommendations concerning barriers to access have been incorporated in a sign on letter to HHS Secretary Burwell that we are asking organizations to endorse. You can read and sign the letter via (this link).
If you have questions please contact William Daley at firstname.lastname@example.org.
Please feel free to circulate this notice to your lists!
The Honorable Sylvia Mathews Burwell
U.S. Department of Health and Human Services
200 Independence Avenue, SW
Washington, DC 20201
Re: Principles for action to break barriers to health coverage, expand access to care, and reduce race-based disparities
Dear Secretary Burwell:
Across the country, the health care landscape is in a period of rapid change. As states across the country push forward with expansions in health coverage and strategies that increase access to care and improve health outcomes for their residents, national leaders face a fundamental decision: will we advance policies that give our residents the best health care possible, or will we leave our residents with a second-class health care system that lags behind other countries?
While the ongoing debate over Medicaid expansion is the most obvious health care issue this country faces, it isn’t the only area where leaders have important opportunities to improve health care for residents. There are critical decisions to be made across three core areas: safeguarding access to health insurance, moving consumers from coverage to care, and building an infrastructure to promote preventive health care.
We urge you to support the following principles and strategies in these three areas as you consider options to improve health care for residents of the United States:
Safeguarding Access to Health Insurance
Don’t leave money on the table.It’s time to move beyond ideological debates and accept federal funds to expand health coverage through Medicaid. This remains the most immediate and highest-impact opportunity to expand coverage for uninsured residents.
Seek to streamline enrollment in health coverage programs. Automatically enroll in Medicaid people who already receive need-based benefits like SNAP (food stamps) or WIC, and eliminate waiting lists, ensuring that decisions are made on ACA marketplace and Medicaid applications within two weeks.
Improve language access in the enrollment process. Establish a right to enroll in the applicant’s primary language and require plans to notify applicants of their right to language services.
Make shopping for coverage easier and more transparent. Require insurers to simplify descriptions of plans, benefits, cost-sharing, and provider networks.
Moving Consumers from Coverage to Care
Expand the role of navigators to help people move from coverage to care. Enlist navigators to teach new enrollees how to use their coverage and to recruit enrollees to participate in marketplace-sponsored evening and weekend clinics focusing on health education and mobile health services.
Establish strong network adequacy standards and ensure provider access in marketplace plans and Medicaid. Require marketplace plan networks to meet a responsible patient-to-provider ratio, and ensure that enrollees are able to make primary care appointments within 10 business days. Set reasonable geographic access standards to limit the distance and time it takes for enrollees to reach primary care providers and specialists. In Medicaid, states can improve patients’ access to doctors by ensuring reimbursement at Medicare levels.
Hold insurers accountable for helping reduce racial disparities in access to care. Enforce ACA statutory provisions that require insurers to act to reduce racial disparities and continually monitor implementation of insurers’ disparity-reduction plans and programs.
Ensure free translation and interpretation services in the care setting. Publicize the availability of these services in all languages spoken by enrollees and ensure interpreter competence by using a reliable interpreter credentialing or licensing system.
Enforce access to preventive care and incentivize take-up. Ensure that all health plans cover the full scope of preventive services (yearly check-ups, immunizations, screenings, well-woman preventive care including contraception and reproductive health services) at no out-of-pocket cost. Patients should have the opportunity for a free physical exam and appropriate screening within 60 days of enrollment, and plans in which few enrollees receive these services should face penalties.
Measure results. Require plans to track health outcomes, disaggregated by race, ethnicity, primary language, gender, disability, and sexual orientation.
Building an Infrastructure to Promote Preventive Health Care
Strengthen community-based health care infrastructure, especially in low-income communities and communities of color. Support essential community providers, including community clinics, individual physicians, and small community practices, that serve low-income communities and communities of color. Reduce reliance on institutionalized care by prioritizing home- and community-based services in the state Medicaid plan. Expand school-based health centers with attention to medically under-served communities.
Incentivize health improvement approaches that address underlying social determinants of health. Offer incentives to health plans that adopt a broad view of health benefits and tackle underlying social determinants of health. Expand medical-legal partnerships as an avenue toward the broad array of issues that lead to poor health in low-income communities (e.g., mold in housing).
Invest in care coordination and population-based health promotion strategies. Direct Medicaid resource to care coordination and community support for high-risk individuals with chronic disease, and develop integrated care models for joint Medicare and Medicaid beneficiaries (“dual eligibles”). Use Medicaid waivers to leverage federal funds to facilitate population-based promotion of public health in addition to individual service-based care.Move toward delivering health care through accountable care organizations, which provide population-based health care that includes social services.
By adopting these principles and strategies, America can be a leader in breaking barriers to health coverage, expanding access to care, and reducing racial disparities in health. We urge you to champion these principles and strategies as you work to advance the promise of quality, affordable health care for everyone in the U.S.
Asian-American Community Service Council - OH
Christian Community Baptist Church - New Orleans, LA
Evening Star Missionary Baptist Church
Florida Chinese Federation
Galilee Baptist Church - LA
House of Faith - New Orleans, LA
Jesus is the Way Church of Hartford
Jobs & Self-Development Center - New Orleans
Language and Cultural Awareness Services of Northern Michigan
Second Rose of Sharon Missionary Baptist Church - LA
Southwest Detroit Immigrant and Refugee Center
Strike Debt Helena
Tabernacle of Prayer - New Orleans, LA
United Chinese Association of Florida
United Steel Workers 11-443
210 endorsements (list in formation)