The Shaky Future of Health Care for All

With President Obama, historic gains were made in confronting racial differences in health care, but the GOP is threatening to roll them back. Here's a look at what's at stake.

 

 

"Health care coverage and clinical prevention screenings are important, but they're not the root causes of health inequities. When you look across the gamut of diseases that people of color disproportionately suffer from, at their root are inequitable neighborhood conditions," Smedley told The Root, echoing the problems of abundant fast-food retailers, environmental injustice and a lack of access to outdoor recreational facilities in many low-income neighborhoods of color. He proposes that federal agencies, such as the Environmental Protection Agency and the Department of Housing and Urban Development, collaborate to make neighborhoods healthier.

Christensen concurs with this community-based strategy -- in fact, it was one of the CBC's original recommendations. "We wanted to have 'health-empowerment zones' that would be designated because of their health disparities, and they would get help developing a plan with support from any federal agency, depending on their challenges," she says. "We did get something called Community Transformation Grants (pdf) for local organizations, which starts to get at that, but it's not fully what we wanted."

Protecting Health Care Gains

At the same time that advocates push for more to be done, House Republicans are vowing to use their majority to roll back the Affordable Care Act. On Tuesday, House Budget Committee Chairman Paul Ryan (R-Wis.) released a GOP budget (pdf) that repeals the Affordable Care Act, slashes $1 trillion from Medicare over the next 10 years and eliminates Medicaid, retooling it as a state-administered block grant. "This threatens everything we're trying to do," says Christensen. "I just don't understand it. This is not the kind of thing that you do if you care at all about the health of poor people."

Even though a repeal of the Affordable Care Act, which would require passage by the Senate and approval by the president, is unlikely, Christensen cautioned that legislative gains to narrow racial differences in health care are nonetheless vulnerable. "People just don't take health disparities seriously," she says, explaining that it wasn't until Democrats gained a majority in both houses of Congress in 2007 that the CBC's Health Equity and Accountability Act was even given a hearing. "When the Republicans are the majority, you cannot get support for these kinds of things."

In the meantime, the CBC is planning its defense strategy. The caucus will continue to push its own alternative budget, which provides full funding for the Affordable Care Act, and it has assembled a National Health Equity Commission to monitor the law's implementation. "The commission was founded specifically to protect the minority provisions and to ensure that they are implemented as robustly as possible," says Christensen. "So yes, we're prepared to push back."

Cynthia Gordy is the Washington reporter for The Root.

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