Prioritizing Health Equity in the State of Union

Prioritizing Health Equity in the State of Union

February 25, 2022

On March 1, President Biden will outline his administration’s accomplishments and policy priorities during his first State of the Union address since taking office last year.[1]

We hope that one of those priorities will be promoting health equity. Here are just a few reforms we urge President Biden to address in the State of the Union.

Ensuring Access to Mental Health Services

Americans of color face disproportionate barriers to treatment for many mental health conditions.[2] [3] The Covid-19 pandemic has shed light on and exacerbated these existing inequities.[4] To ensure that communities of color have access to the mental health resources they need, we must divert funding into mental health reform efforts.[5]

Addressing Healthcare Diversity

The Biden administration should continue working to create a healthcare system that reflects the population it serves. This starts with the doctor workforce. In too many specialties, doctors of color are dramatically underrepresented. For instance, while Black Americans make up around 14% of the U.S. population, they account for just 5% of all physicians.[6] [7]

Promoting diversity also extends to the development of new treatments. According to the FDA, “people from racial and ethnic minority and other diverse groups are underrepresented in clinical research.”[8] Diversifying clinical trial populations will ensure that new treatments meet the needs of all Americans.[9]

Reducing Out-of-Pocket Healthcare Costs

Historically marginalized groups are more likely to have trouble paying for their prescription drugs.[10] [11] To reduce the costs patients of color face at the pharmacy counter, we must hold each sector of the healthcare system accountable.[12] That starts with requiring greater transparency from pharmacy benefit managers.

These industry middlemen are hired by insurance companies to negotiate discounts with manufacturers on prescription drugs. But since PBMs are largely unregulated, they rarely pass these savings along to patients at the pharmacy counter. Increasing government oversight of PBMs will lead to lower out-of-pocket costs for patients.[13]

Supporting Medicare & Medicaid

Patients of color are more likely to be uninsured than their white counterparts.[14] Expanding Medicare and Medicaid — and strengthening existing coverage for the Americans of color who disproportionately rely on these programs[15][16] — will help to reduce uninsured rates among the country’s most vulnerable populations.

It’s also imperative that Medicare and Medicaid enrollees have access to the medications they need. That’s why Medicare’s recent decision not to cover an entire class of FDA-approved Alzheimer’s drugs is particularly concerning.[17] For the sake of America’s marginalized communities, who suffer higher rates of chronic diseases like Alzheimer’s, we urge the Biden administration to support access to lifesaving medications in the government’s health programs.

Understanding Social Determinants of Health

A patient’s health is defined by much more than their physical wellness. Social determinants of health — including education, income, community stability, environmental safety, and climate — contribute to existing health disparities.[18]

While the Build Back Better Act — which addressed many of these factors — may be stalled in Congress, President Biden still has an opportunity to improve health equity by making social determinants of health a national priority.[19] Doing so will require action on initiatives like climate change, child care, and affordable housing.

Removing Barriers for Americans with Disabilities

Certain groups — including Black Americans and American Indians — are more likely than their white peers to have a disability.[20] By advancing legislation focused on improving the health and safety of Americans with disabilities, the Biden administration can help to break down the barriers to health facing patients of color. One example is the Air Carrier Access Amendments Act of 2021, which would improve air travel safety for those living with disabilities.[21]

Though this isn’t an exhaustive list, these reforms will improve the health of the nation’s patients of color and create a more equitable healthcare system. We urge the Biden administration to make them a priority during his State of the Union address — and in the years ahead.