GOP lawmakers, health care officials raise concerns with proposed health disparities bill at house panel hearing

Jun 26 2008

Republican legislators and representatives of several minority health advocacy groups on Tuesday at a House Energy and Commerce Health Subcommittee hearing raised concerns over several measures within a proposed bill (HR 3014) intended to reduce racial and ethnic disparities in the U.S. health care system, CQ HealthBeat reports.

The bill -- sponsored by subcommittee member Hilda Solis (D-Calif.) -- would require federal agencies to maximize efforts of data collection and reporting on race and develop grants for groups serving minority communities to evaluate the data, according to a fact sheet released by Solis' office. More than 100 Democratic officials and two Republicans -- Ileana Ros-Lehtinen (Fla.) and Luis Fortuno (P.R.) -- have co-sponsored the bill, according to CQ HealthBeat.

Energy and Commerce Committee ranking member Joe Barton (R-Texas) said that the bill's emphasis on race and ethnicity might overshadow the issue of income and its effect on the quality of care. Barton said, "Data certainly show that some diseases seem to follow racial lines, but they also show that it's how rich or poor you are that makes the much greater difference in health outcomes." According to CQ HealthBeat, Democrats and many witnesses disagreed with Barton. Risa Lavizzo-Mourey, president and CEO of the Robert Wood Johnson Foundation, said, "Even after controlling for income and education levels, disparities continue to exist."

Deeana Jang, policy director for the Asian and Pacific Islander American Health Forum, suggested that additional research into racial and ethnic differences is required. Jang said, "Asian-American and Pacific Islander communities are not homogenous, but lack of data on specific minority sub-groups mask the disparities that exist."

Role of HHS

Barton and Health Subcommittee ranking member Nathan Deal (R-Ga.) expressed concern that some of the bill's provisions would be duplicative by creating divisions that address minority health issues within each agency at HHS. Meanwhile, John Ruffin -- director of the National Center on Minority Health and Health Disparities at NIH, who offered support for a provision in the bill to increase funding for health education initiatives for minority residents -- said, "The infrastructure that we have established has to be strengthened ... and sustained." According to CQ HealthBeat, existing programs at NIH include a loan repayment program for health care professionals who obtain certifications to conduct research on minority health care issues.

Undocumented Immigrants

James Edwards of the Hudson Institute, a witness at the hearing, raised issue with language in the bill, which states that "undocumented residents who are lawfully residing in the United States" would qualify for Medicaid benefits. Edwards said, "That description is curious ... since every legal immigrant and nonimmigrant visa holder is either issued documents by the federal government or required to possess a valid visa with an entry stamp." He said the bill's "flimsy description of who qualifies for Medicaid adds yet another incentive to enter or remain in the country illegally."

In a statement issued after the hearing, Solis said, "Our intent is to expand health coverage to legally residing pregnant women and children, and if this bill moves, we can easily amend the bill with a technical correction." Solis did not disclose future plans for the bill but said, "What's important is to start the foundation for what's to come in the next session" (Cooley, CQ HealthBeat, 6/24).