Equity has been a cornerstone of the Biden administration since day one. On his first day in office, President Joe Biden signed an executive order (EO) to advance racial equity across the federal government in many areas – including health.
Policies to promote health equity are crucial to addressing health disparities, which affect populations with a lower socioeconomic status, rural communities, people with cognitive and physical disabilities, and communities of color. For example, African Americans and Hispanic Americans are less likely to have health insurance coverage and more likely to have chronic health conditions than non-Hispanic whites.
As the nation wraps up celebrating its second Juneteenth – a holiday paramount to the cause of racial equity – what steps has Congress and the administration taken since the president’s inauguration to advance health equity?
Health Equity and COVID-19
The EO called for the creation of the administration’s COVID-19 Health Equity Task Force, whose mission was to ensure that elements of the COVID-19 response, including the mass vaccination campaign, prioritized equity. The task force ultimately played a pivotal role in the administration’s response to COVID-19 by addressing barriers to vaccinations like the need to take time off work and lack of transportation to vaccination centers. This ultimately led to the administration to advocate for paid leave to allow people to get vaccinated and reimburse their transportation costs to vaccination sites.
Released in November 2022, the task force’s final report coalesced around several key actions: investing in local community-based efforts, putting more resources into collecting data on health-related concerns by race and ethnicity, and increasing representation of people of color in the health care system. The task force also recommended that the White House create a “permanent health equity structure” to coordinate health equity efforts across the executive branch, although the administration has yet to address this.
American Rescue Plan Act of 2021
Enacted in March 2021, the American Rescue Plan Act did much more than providing COVID-19 aid – it also made key investments in health equity by closing gaps in access to medical care, investing in community health, and addressing social determinants of health. Funding provided by the law has since gone on to bolster initiatives like a $90 million investment to support data driven approaches to reducing health disparities.
Health Equity Strategy at CMS
The Centers for Medicare and Medicaid Services (CMS) adopted an action plan on health equity in April 2022, which the agency outlined as a continuation of the administration’s drive to improve health equity. Some of the goals laid out in the plan include increased outreach to individuals about the Affordable Care Act (ACA) marketplaces, promoting culturally and linguistically appropriate services, and gathering more data factors like ethnicity, language, income, and sexual orientation.
One of the ways the action plan has manifested is through the CMS Innovation Center (CMMI), which added “advancing health equity” as one of its five strategic objectives in 2022 .
Legislation on Deck
Since the American Rescue Plan became law, lawmakers have been working on several bills aimed at improving health equity. Examples include:
- The Advancing Maternal Health Equity under Medicaid Act (H.R. 6612) – Provides a 90% federal matching rate for Medicaid maternal health care expenditures that exceed 2021 levels.
- The Rural Health Equity Act (S. 3149) – Establishes the Office of Rural Health within the Centers for Disease Control and Prevention (CDC) to serve as the primary point of contact within the CDC on rural health matters and coordinate public health research on issues affecting rural populations.
- The Pursuing Equity in Mental Health Act (S. 1795/H.R. 1475) – Directs the federal government to award grants to establish inter-professional behavioral health care teams in areas with a high proportion of racial and ethnic minority groups.
What could happen next? Although the window of opportunity for Congress to advance any sort of health equity legislation before the midterm elections is rapidly closing, the administration has yet to carry out many of the recommendations listed in the COVID-19 Health Equity Task Force’s report. This means there are still plenty of opportunities for the Biden administration to make strides on health equity over the next two years.