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Spring 2011 Vol. 3, No. 3
Opportunities for Addressing Health Disparities in the Affordable Care Act
Many U.S. racial and ethnic minorities, rural and poor populations experience difficulties accessing quality health care. They face a number of social, economic and environmental barriers, including a lack of community providers, inability to pay for services, or cultural or language obstacles. As a result, they are less likely to receive preventive care and are more likely to suffer from serious illnesses and poor health. These health disparities have long troubled policymakers and public health officials who have tried to improve the availability and quality of care that racial and ethnic minorities and other underserved populations receive.
The Affordable Care Act (ACA), signed in March 2010, contains provisions intended to improve the availability and affordability of health insurance, establish new consumer protections, and provide better oversight of the health care system.
Provisions in the ACA with the potential to reduce health disparities include the following:
- Section 4302 may help to better identify challenges faced by underserved minority communities by expanding existing standards for collecting demographic information to include race, ethnicity, gender, primary language and disabilities. This information can be used in research and in designing targeted programs to improve access and the quality of health care services.
- In addition to better data collection, Sections 5401 and 5402 increase funding to the Centers of Excellence and for scholarships to support recruitment and training of minorities who are interested in health careers.
- Section 6301 creates the Patient-Centered Outcomes Research Institute to conduct comparative research on the most effective practices to reduce disparities in health care delivery and health outcomes.
- Section 3011 creates a National Strategy for Quality Improvement, which was released on March 21, 2011, to improve overall quality of health care services; support the entire population’s health by addressing behavioral, social and environmental determinants of health in communities; and reduce health care costs.
- Finally, Section 10334 transfers the Office of Minority Health (OMH) to the Office of the Secretary of Health and Human Services, which the deputy assistant secretary for minority health will lead, while reporting directly to the secretary. Offices of Minority Health were also created within the Centers for Disease Control and Prevention, the Health Resources and Services Administration, the Substance Abuse and Mental Health Services Administration, the Agency for Healthcare Research and Quality, the Food and Drug Administration, and the Centers for Medicare & Medicaid Services.
The ACA’s focus on training minority health professionals, improving data collection and targeting research on minority health issues, has the potential to significantly reduce health disparities long faced by U.S. racial and ethnic minorities.
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Upcoming Events and NCSL Resources
Legislative Summit, August 8-11, 2011, in San Antonio, TX. Come learn about key state issues, and help develop NCSL's advocacy positions before Congress and the administration. The work of NCSL Standing Committees has saved states billions of dollars over the years as they work to fight unfunded federal mandates.
NCSL has launched the first-of-its-kind database tracking state actions on major provisions in the Affordable Care Act. The database contains 2011 legislation, including pending, failed and enacted bills and resolutions.
Technical Assistance
NCSL can provide testimony to legislatures on chronic disease prevention; health promotion; preventing injuries and violence; reducing health disparities; access to health care; community health centers; and other health policy topics. Contact Alise Garcia at Health-info@ncsl.org.
NCSL Resources
Health Disparities Overview
Health Disparities Legislation Tracking Page
Health Reform Implementation Page
Health Disparities Resources:
The Office of Minority Health (OMH)
The National Institute on Minority Health and Health Disparities (NIMHD)
National Strategy for Quality Improvement
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In the News
On March 30, 2011, the Robert Wood Johnson Foundation released the 2011 County Health Rankings that provide information about the overall health of nearly every county in all 50 states. Included with the release is a county health calculator that shows the effect that education and income have on health and wellness.
With the release of the 2011 County Health Rankings, the Robert Wood Johnson Foundation announced its new community grants program, Mobilizing Action Toward Community Health (MATCH). Communities applying for the grants are being asked to address social and economic factors, such as education and employment that can influence health.
The Health Impact Project, a collaboration of the Robert Wood Johnson Foundation and The Pew Charitable Trusts, is accepting brief proposals through June 1, 2011 for grants to conduct health impact assessments (HIA). The assessments will help policymakers and community members identify and address potential health implications of proposed policies and projects in a broad range of sectors, such as agriculture, energy, transportation and development.
Building on the Affordable Care Act's Prevention and Public Health Fund investment of $500 million last year, the Department of Health and Human Services announced a new $750 million investment in prevention and public health. These new dollars will help prevent tobacco use, obesity, heart disease, stroke, cancer and increase immunizations. Fact sheets provide details about how the initial $500 million was allocated to each state.
The Department of Health and Human Services announced $100 million in grants through 2015 for states to provide financial incentives to Medicaid enrollees to adopt healthy behaviors.
The General Services Administration (GSA), in partnership with the Department of Health and Human Services (HHS), released "Health and Sustainability Guidelines for Federal Concessions and Vending Operations." The guidelines follow the 2010 Dietary Guidelines for Americans and encourage the availability of, among other things, foods free of trans fat, seasonal vegetables and fruits, and foods with limited sodium. They apply to all food service and concession operations and vending machines managed by HHS and GSA.
On April 1, 2011, Food and Drug Administration (FDA) released two proposed regulations related to calorie labeling for vending machines and menus in chain restaurants with 20 or more locations. The FDA is soliciting comments on the menu labeling proposed rule until June 6 and comments on the proposed vending machine rule are open until July 5. The FDA news release includes instructions on submitting comments.
Trust for America’s Health and the Robert Wood Johnson Foundation released a report, Investing in America’s Health: A State-By-State Look At Public Health Funding And Key Health Facts. The report looks at public health funding and key health facts in states around the country.
The National Institutes of Health announced a new strategic plan to guide diabetes-related research. The plan identifies research opportunities with the greatest potential to benefit the millions of Americans who are living with or at risk for diabetes and its complications.
Public Health Project Partner News
NCSL collaborates with the Centers for Disease Control and Prevention and other national organizations—including the National Governors Association, the Association of State and Territorial Health Officials and the Society for Public Health Education—on public health projects. Recent resources available from partner organizations on public health topics include the following.
CDC Releases New Guide for Food Procurement
The newly released guide," Improving the Food Environment through Nutrition Standards: A Guide for Government Procurement," gives states and localities ideas for developing, adopting, implementing, and evaluating a food procurement policy to promote health.
ASTHO "Salt and Your State Webinar"
The second webinar of "Salt and Your State" series provides an overview on how nutrition, including sodium reduction, can be improved through procurement policies that require foods to meet nutritional standards. This includes new information about HHS guidelines on procurement and how to develop and implement procurement standards at the state and local level. To view Salt and Your State enter your name and then click "view recording."
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