April 2006

In this Issue:

New Resources

• Families USA Conference Call: Reflections on, and Implications of, the NEJM Study
• Bridgeport Child Advocacy Coalition: The Price of Prescription Drugs: It Matters Where You Live
• American Journal of Public Health: Complementary and Alternative Medical Therapy Use among Chinese and Vietnamese American

Activities in the Field

Policy Updates  
   
     Medicare
     Medicaid and the Deficit Reduction Act

Reflections From the Field

Upcoming Events

New Resources

Conference Call: Reflections on, and Implications of, the NEJM Study: Did you miss this call? The audio playback is now available. This call focused on a study in the March 2006 New England Journal of Medicine that suggested that the quality of health care in this country is mediocre—but relatively equal—for all, with African Americans and Latinos receiving slightly better care. This conclusion contradicts numerous other studies that have documented disparities between minorities and whites. On the call, advocates heard directly from Steven Asch, lead author of the article, about the study’s objectives, findings, and limitations. Also joining us was Brian Smedley, study director for the landmark Institute of Medicine report Unequal Treatment and now research director for The Opportunity Agenda. This call also explored how advocates can counter messages that question the existence of racial and ethnic disparities in health care.

The Bridgeport Child Advocacy Coalition in Connecticut recently released The Price of Prescription Drugs: It Matters Where You Live, which found that the prices of prescription drugs varied widely within its local area. During spring 2005, the organization worked with local high school students and surveyed pharmacies in Bridgeport, Fairfield, Stratford, and Trumbull and analyzed the cost of 13 common prescription medicines. The study found wide variation—up to $225 per month—in prices for a “market basket” of 13 drugs at pharmacies in Bridgeport and its suburbs.

Complementary and Alternative Medical Therapy Use among Chinese and Vietnamese Americans: Many studies have proven that Asian Americans are less satisfied with their health care than white Americans. A number of factors contribute to this dissatisfaction, including, but not limited to, access to health care and language barriers. A new study in the April 2006 issue of the American Journal of Public Health explores how patient-clinician communication, particularly about traditional Asian procedures, can open the lines of communication and lead to better health care. The authors of the study concluded that physicians can optimize their patients' care by being aware of "how belief systems differ and how these differences influence health care practices." Click here to learn more about this study.

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Activities in the Field

La Fe Health Policy and Advocacy Center is a new initiative focused on improving health care access and service delivery for the Mexican American community in Texas and the Southwest. The mission of this organization is to advance the decision-making of Mexican Americans as health care consumers, to boost their interest in health care issues that are important to them, and to increase their involvement in health policy and health system change. The center will take on several core activities, such as conducting policy analysis, health leadership and constituency development, as well as consumer health education and advocacy, and legislative education and policy development. Also, in an effort to identify issues of importance to Latinos in the Southwest, it will focus on gathering information through stories shared in platicas (discussions), focus groups, and research.

The center’s strategic objectives include:

• conducting health policy analysis and advocacy;
• expanding health insurance coverage to all Mexican Americans;
• promoting the Mexican American social and cultural experience, linguistic and literacy characteristics, self-reliance, and resilience as strengths that can contribute to improved health and well-being;
• demonstrating improved Mexican American health care choices/decision making (access and quality) using culturally competent social and business marketing approaches;
• raising awareness of the inequalities in health resources and care, and engaging Mexican American and other supportive networks of social, education, health, business, and faith-based organizations to improve the capacity and quality of health care; and
• promoting and developing activist health leadership, at all levels from the grassroots on up, that in turn will contribute to the growth of a constituency that addresses the health policy issues that are important to Latinos.

For more information on La Fe Health Policy and Advocacy Center, please contact Juan Flores, Executive Director, at jflores@lafepolicycenter.org.

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Policy Updates

Medicare

Following the rocky and confusing rollout of the Medicare prescription drug benefit in January, insurers were required to provide a 90-day “transitional” supply of drugs to enrollees—even if those drugs would not normally be covered by the plan. This allowed people in Medicare to keep taking the prescriptions they depended on during their transition to Medicare Part D.

However, this three-month transition period ended on March 31, 2006. Now, many Medicare enrollees who show up at the pharmacy could be denied their prescriptions. This is a particular problem for the more than 2 million low-income racial and ethnic minorities in Medicare who were automatically assigned to drug plans without any regard to which prescription medications they take. What’s more, most of these individuals were not given the information and help necessary to choose an appropriate plan that meets their needs.

Another problem with Medicare looms on the horizon: The deadline for enrolling in a prescription drug plan is May 15—less than a month away. Most eligible individuals who have not enrolled in a plan by that time will face what could be substantial financial penalties if they choose to enroll after the deadline. This could pose particular problems for minority populations, who are less likely to have the tools to research drug plans online and who are more likely to live in underserved areas that have received limited outreach about the benefit. On April 13, 2006, members of the Congressional Black Caucus (CBC), Congressional Hispanic Caucus (CHC), and Congressional Asian Pacific American Caucus (CAPAC) wrote a letter to President Bush urging him to extend the enrollment deadline for the Medicare prescription drug benefit program from May 15, 2006, to the end of the year. 

For more information about the end of transitional benefits and what Medicare enrollees can do to make sure they receive the drugs they need, read April Fools for Medicare Part D Beneficiaries? Transitional Benefits End April 1 from Families USA.

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Medicaid and the Deficit Reduction Act

Beginning July 1, 2006, millions of U.S. citizens enrolled in Medicaid will have to provide documentation to prove their citizenship status. This is an unprecedented change that could result in many eligible citizens being denied access to the health care services to which they are entitled. This new requirement is one of several damaging changes to the Medicaid program caused by the so-called Deficit Reduction Act of 2005. It will especially hurt African Americans, who are disproportionately less likely to have the documentation necessary to prove their citizenship.

At the legislative level, both Senator Akaka (D-HI) and Congresswoman Christensen (D-VI) have introduced legislation that would repeal the provision. In addition, legal advocates across the country are examining potential litigation strategies aimed at challenging the validity of the new law. Advocates have been working on several fronts to ameliorate the harm that will be caused by this new requirement. At the state level, advocates have been working hard to ease the burden imposed by the requirement by talking to state Medicaid officials and educating beneficiaries before the law takes effect.

If you or your organization want to get more involved in combating the harmful changes caused by the Deficit Reduction Act, read our Medicaid Alerts or contact us at minorityhealth@familiesusa.org for more information.

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Reflections from the Field

It’s the Politics behind the Policy
Britt Weinstock
 
Health policy issues, ranging from racial and ethnic health disparities, Medicare Part D, uninsurance, SCHIP, the Ryan White CARE Act, and Medicaid, are among the most pressing and politically charged issues our country is grappling with. As the senior health policy advisor to the Congressional Black Caucus Health Braintrust in the Office of Congresswoman Donna Christensen (D-VI), I am afforded a unique perspective on politics and the making of health policy. As such, I have seen the critically important role that health care advocates can and often do play in the health policymaking process. 
 
If ever there was a time for the health care advocacy community to further leverage its size and effectiveness as a unified voice around a unified health policy agenda, it is now. Despite numerous legislative efforts aimed at expanding access to health care and improving health care quality, the U.S. health care system is in a precarious and vulnerable position. Uninsurance rates are unacceptably high. The Ryan White CARE Act, which supports systems of care for people with HIV/AIDS who do not have adequate access to health care and related services, is drastically underfunded and has yet to be reauthorized. And critically important public health programs such as Medicaid and SCHIP are experiencing significant budgetary and programmatic cuts. In addition, extensive racial and ethnic health disparities, which leave people of color in poorer health with less access to care and more likely to suffer and prematurely die from preventable causes, remain under-addressed and—in some areas of health care—are actually getting worse.
 
In light of the grave health and health care challenges confronting all Americans, health advocates must take their place in the policymaking process and work together to improve health care for all communities.

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Upcoming Events

• The Congressional Black Caucus Health Braintrust’s Spring Health Braintrust: New Voices, New Strategies: Reframing the Minority Health Debate will take place on April 26-27, 2006. For more information, send an e-mail to britt.weinstock@mail.house.gov.
• The National Health Policy Training Alliance for Communities of Color, along with the National Association for Hispanic Journalists, is hosting a day-and-a-half long health policy journalism training.This training will take place on May 10-11, 2006, in Los Angeles, CA. 
• The National Committee for Quality Assurance has announced a call for applications to publicly recognize health plans that have developed, designed, or implemented innovative practices geared toward improving the provision of culturally and linguistically appropriate services and reducing health disparities. For more information on the 2006 Innovations in Multi-Cultural Health Care Award, please click here.  
• El Pueblo: Foro Latino is a statewide conference for Latino advocates, service providers, policy makers, community members, and youth in North Carolina, that will take place on May 20-21, 2006, in Greensboro, NC. For more information, visit the group’s Web site.
• Health Care for All is hosting a Health Disparities Policy Conference on June 13, 2006. This conference, which will take place in Shrewsbury, MA, will examine the latest local, state, and national disparities data and determine how to use it for policy change. To learn more about the conference, click here.
• The National Alliance on Mental Illness is hosting a summit in Washington, DC called Eliminating Disparities: Multicultural Strategic Summit. This event, which will take place from June 28-July 2, 2006, will focus on disparities in the mental health field and will bring together leaders from around the country.
  
  

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