On June 17, 2020, the Health Subcommittee of the United States House of Representatives’ Committee on Energy and Commerce held a hearing on “Health Care Inequality: Confronting Racial and Ethnic Disparities in COVID-19 and the Health Care System.” Throughout the hearing, there was a bipartisan show of support for finding solutions to end racial disparities in health care, highlighted by the disproportionate impact of COVID-19 on minorities.
Witnesses included: Rhea Boyd, MD, MPH, Pediatrician and Child Health Advocate at the Palo Alto Medical Foundation; Oliver T. Brooks, MD, President of the National Medical Association; and Avik S. A. Roy, President of the Foundation for Research on Equal Opportunity.
Opening Statements
In his opening statement, E&C Committee Chairman Frank Pallone referenced the long-term health inequity that we are seeing today, stating that it is rooted in social determinants that tend to be driven by structural discrimination and institutionalized racism. He noted that the result of those trends is that people of color are more likely to have underlying health conditions, a harder time gaining access to care, and when they are able to get health care, are more likely to face bias, discrimination, and poor health outcomes.
E&C Committee Ranking Member Greg Walden spoke about some of the steps the Trump Administration has taken to ensure more vulnerable populations have access to COVID testing, care, and other critical resources. He stated his belief that safely reopening the economy, maintaining social distancing, and focusing resources in areas where they are needed most, will help minority communities.
Discussion
During the hearing, there was bipartisan criticism surrounding the lack of collection of racial and ethnic COVID-19 data and that the announcement that such collection will begin on August 1 was “too little too late.” Dr. Boyd noted, though, that despite the lack of data on racial disparities, there is a bunch of information that can be acted on – including clusters in correctional facilities and nursing homes. Dr. Brooks also discussed that since there is no set standard for collecting data about COVID-19 and since racial minorities are more likely to receive fragmented care, the data that will be collected may not be complete, or it may be lost between providers.
The witnesses also opined that there are steps that could have been taken earlier in the pandemic that may have lessened the disproportionate impact on minorities. Dr. Brooks mentioned more aggressive initial testing in communities of color, increased access to health care and personal protective equipment (PPE) for those practicing in communities of color, and increased access to telehealth could have been helpful. Mr. Roy suggested that a more aggressive testing of workers and patients in nursing homes initially should have been done, and Dr. Boyd called for greater testing in outpatient settings and universal access to PPE for essential workers.
Dr. Brooks also noted that increased telehealth is only helpful if the patients have the technology to participate. He called for solutions that increase broadband access so that access to healthcare in minority and rural areas may be better solved by telehealth. Dr. Roy also mentioned that testing sites need to be more accessible, as many minority communities do not have a site and many in those communities often do not have the resources to travel or time to wait to be tested.
New Working Group Formed
During the hearing, Chairwoman Anna Eshoo announced the creation of the Energy and Commerce Racial Disparities Working Group, led by Representatives Robin Kelly and Yvette Clark. E&C Committee Ranking Member Greg Walden requested bipartisan participation in the working group.