[Congressional Record Volume 163, Number 72 (Thursday, April 27, 2017)]
[Extensions of Remarks]
[Pages E552-E553]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




              COMMEMORATING NATIONAL MINORITY HEALTH MONTH

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                          HON. DANNY K. DAVIS

                              of illinois

                    in the house of representatives

                        Thursday, April 27, 2017

  Mr. DANNY K. DAVIS of Illinois. Mr. Speaker, I am here to recognize 
the month of April as National Minority Health Month. The Affordable 
Care Act is a transformative piece of legislation that has helped 
millions of uninsured people to acquire affordable health insurance who 
otherwise would not have access to quality patient-centered care. This 
legislation was not just relegated to help the poor and the needy but 
also the 177 million employer sponsored insured employees with 
additional health benefits that never existed before the Affordable 
Care Act. For instance, ACA prohibited insurance companies from 
discriminating individuals with pre-existing conditions, and imposing 
lifetime cost caps on patients. Under ACA, parents can keep their 
children on their insurance plan up to the age of 26. Also, insurance 
companies are required to spend 80 percent of all premium dollars 
toward direct medical expenses and 20 percent toward insurance 
companies' administrative costs. Otherwise, they must reimburse the 
customer some of their money back. Currently, ACA has allowed more than 
20 million U.S. residents to have health insurance coverage, which has 
improved the racial and ethnic disparities among minority population.
  The purpose of the Affordable Care Act consisted of five basic goals:
  1. Expand health insurance coverage for nearly 50 million uninsured 
people in the United States, which consist of 44 percent Whites, 32 
percent Latinos, 16 percent African Americans, 6 percent Asians, 2 
percent Native Americans and 0.4 percent Native Hawaiian and other 
Pacific Islanders.
  2. Reduce health care costs by establishing marketplaces called 
exchanges where federal and state-based marketplaces will have a single 
process to determine whether someone is eligible for tax credits to 
reduce the cost of premiums, in the form of cost sharing, Medicaid, or 
Children's Health Insurance Program. ACA requires a minimum standard of 
essential health benefits to include ambulatory patient services, 
prescription drugs, emergency services, rehabilitative and facilitative 
services, hospitalization, laboratory services, maternity and newborn 
care, preventive and wellness services and chronic disease management, 
mental health and substance use disorder services (including behavioral 
health treatment), and pediatric services (including oral and vision 
care). Whereas before, ACA's essential benefits did not exist, thus 
leaving the prospective patients without quality access to care.
  3. Reduce health care fraud and abuse
  4. Improve health care quality through several initiatives: (1) a 
national quality strategy; increased reliance on value-based 
purchasing; expansion of meaningful use of electronic health records 
(EHRs); better care coordination; development of quality measures for 
Medicaid and Medicare; and measures of quality in the marketplace.
  5. Improve population health that includes reducing racial and ethnic 
disparities among the minority population. One aspect of the ACA 
helping people of color to reduce disparities is by requiring health 
plans to cover certain preventative services such as blood pressure and 
cholesterol screening, mammograms and Pap smears, and vaccinations, 
with no cost-sharing. The ACA increased funding for community health 
centers, which provide quality primary and comprehensive services to 
underserved communities. They served approximately 25 million people in 
rural and urban centers where more than half of the patients were 
members of various ethnic and minority groups.
  We need more doctors and allied health professionals to assist a 
healthcare system that for decades was not adequately addressing health 
disparities among millions of racial and ethnic minority Americans. 
Many of our minorities are disproportionately more likely to suffer 
deleterious health disparities just because they are low-income wage 
earners, poorer in health and suffer worse health outcomes, and are 
more likely to die prematurely and often from preventable causes 
compared to their White counterparts. Some of the examples of these 
health disparities include the following:
  The infant mortality rate for African Americans and American Indian/
Alaska Natives are more than two times higher than that for whites;
  African Americans with heart disease are three times more likely to 
be operated on by ``high risk'' surgeons than their White counterparts 
with heart disease;
  Hispanic/Latina women have the highest incidence rate for cancers of 
the cervix; 1.6 times higher than that for white women, with a cervical 
cancer death rate that is 1.4 times higher than for white women;
  Puerto Ricans have an asthma prevalence rate over 2.2 times higher 
than non-Hispanic whites and over 1.8 times higher than non-Hispanic 
blacks;
  Together, African Americans and Hispanics account for 28 percent of 
the total U.S. population, yet account for 62 percent of all new HIV 
infections;
  American Indian/Alaska Natives have diabetes rates that are nearly 3 
times higher than the overall rate; and
  Of the more than one million people infected with chronic Hepatitis B 
in the United States, half are Asian-Americans and Pacific Islanders.
  In addition to the unacceptable costs of human suffering and 
premature death, there are significant economic repercussions of 
allowing health disparities to persist. A 2010 study from the Health 
Policy Institute at the Joint Center for Political and Economic Studies 
found that the total costs of health disparities were $1.24 trillion 
over a three-year period. This same report found that eliminating 
racial and ethnic health disparities would have reduced direct medical 
care expenditures by $229.4 billion over the same three-year period.
  Many analysts over the past several years have reported that 
investments through the Affordable Care Act and the American Recovery 
and Reinvestment Act of 2009 have helped double the number of 
clinicians in the National Health Service Corps by providing 
scholarships and loan repayments to medical students and primary care 
physicians and other healthcare professionals as incentives for them to 
practice in underserved communities. The ACA helped bridge some of the 
gap in workforce diversity to include dentists and other primary oral 
health care providers.
  Increasing the proportion of African-American dentists is critical 
because studies show that they are more likely to serve in underserved 
communities than their white cohort. In 2010, underrepresented minority 
(URM) Black or African American, Hispanic/Latino of any race, American 
Indian or Alaska Native, and Native Hawaiian or Other Pacific Islander-
students composed 13 percent of the overall applicant pool for dental 
school programs. For the 639 URM applicants who enrolled in 2010, the 
enrollment rate increased only by 1 percent since 2009. A statistic 
that shows that progress is needed. Dental schools today are graduating 
300 Black dentists out of 5,000 each year. Today, 5 percent of dentists 
are African-American. Black dentists treat nearly 62

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percent of Black patients; White dentists only treat 10.5 percent; 
Hispanics treat 9.8 percent; and Asian dentists only treat 11.5 percent 
Black patients. The Affordable Care Act helps ensure that dental visits 
and oral and dental health care become a routine part of everyone's 
health care regimen.

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