2023: A Milestone Year for Health Equity

2023: A Milestone Year for Health Equity

As 2023 comes to a close, it’s worth reflecting on some of the remarkable strides in health equity that have shaped the year.

On Capitol Hill, the most racially diverse Congress in history advanced legislation to rein in drug supply chain middlemen called “pharmacy benefit managers.” These massive conglomerates push the price of medications upward in order to reap larger profits — behavior that disproportionately harms minority communities. Black and Hispanic Americans, for instance, are significantly more likely than white Americans to forgo taking their prescriptions due to cost.

Thankfully, a bipartisan group of lawmakers led by Rep. Lisa Blunt Rochester (D-De.) introduced a bill that decouples PBM compensation from a drug’s price. Passing the bill would go a long way to ensure that all Americans — especially those of color — can afford their medicines.

The unscrupulous practices of PBMs aren’t the only example of corporate greed in our healthcare system. Hospitals are currently abusing the 340B drug discount program, which was intended to save low-income Americans money on prescription drugs.

The government enacted 340B to give hospitals that serve low-income communities deep discounts on prescription medicines, with the expectation that those savings would get passed down to patients.

Unfortunately, that hasn’t happened. Instead, hospitals often bill insurers for a drug’s list price — which is usually many times more than what hospitals actually pay for the medicine — and pocket the difference. Patients, in turn, are forced to shoulder out-of-pocket costs based on that artificially inflated price.

The good news is that a combination of grassroots advocacy and investigative reporting raised 340B’s profile this year. In the new year, lawmakers must prioritize reforming this broken federal program.

Health equity gains have also been substantial for pregnant mothers. The Centers for Medicare & Medicaid Services renewed efforts to reduce maternal morbidity and mortality — which disproportionately affect women of color — among Medicaid beneficiaries. CMS also plans to embrace new technologies like telehealth to treat women living with postpartum depression. These efforts will likely make enormous strides towards improving maternal health outcomes.

To be sure, there’s still more to be done to bolster equity throughout our healthcare system. Lawmakers can start by reforming the way PBMs are compensated and placing some much-needed guardrails on the 340B program. As the new year approaches, let’s hope that this year’s advances have laid the groundwork for further progress.