[Congressional Record Volume 163, Number 112 (Thursday, June 29, 2017)]
[Extensions of Remarks]
[Page E922]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




        HOW TRUMPCARE WILL EXACERBATE THE TRANSPORTATION BARRIER

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                          HON. TERRI A. SEWELL

                               of alabama

                    in the house of representatives

                        Thursday, June 29, 2017

  Ms. SEWELL of Alabama. Mr. Speaker, America is a global leader in 
health care innovation and discovery. Thanks to the Affordable Care 
Act, we've made great progress in making sure more Americans have 
access to health insurance in recent years. We must recognize that much 
work remains to ensure all Americans have practical access to health 
services. Financial and structural barriers continue to exist for 
countless Americans, particularly those in rural and under resourced 
communities where distance to a hospital is long and the concentration 
of health professionals is sparse.
   Health care access presents a problem for people in rural areas 
where distance is a taxing obstacle. People in suburban and urban 
settings, while they may live closer to a doctor or hospital, can still 
have trouble with transportation. Often, households share one vehicle 
between many family members if they own one at all. Low-income 
neighborhoods are often subject to unreliable public transportation. 
Birmingham is the only city in my district with a public transportation 
system but it faces many challenges that the city is trying to rectify. 
For the disabled, obese, or chronically ill, the lack of reliable 
transportation options lead to missed appointments and overall lower 
health outcomes.
   Patients miss doctor's appointments simply because they do not have 
transportation to get there. Without transportation access, patients 
may wait for a medical emergency just to be able to see a doctor. In 
rural parts of Alabama, the problem is worse among minorities. 
Throughout the nation, 55 percent of African American and 60 percent of 
Hispanic survey respondents reported that transportation was a major 
barrier to medical treatment, compared to 38 percent of white 
respondents.
   Eligibility requirements vary, but each state has a ``non-emergency 
medical transport'' benefit for people with Medicaid. It covers a 
certain number of rides for medical care per month. Some states 
contract with local companies to provide rides for citizens who 
otherwise would have no way to receive regular medical attention. These 
are just some of the benefits millions of beneficiaries will have no 
access to if Trumpcare becomes law.
   The Affordable Care Act's expansion of Medicaid and reforms to the 
individual insurance market has helped to lower the uninsured rate for 
African Americans. Between 2013 and 2016, the uninsured rate for 
African Americans declined from 18.9 percent to 11.7 percent. However, 
African Americans still have higher uninsured rates than whites (7.5 
percent) and Asian Americans (6.3 percent). Repealing the ACA and 
cutting Medicaid programs reverses the progress America has made to 
make healthcare more accessible and affordable in recent years.
   One's access to quality health care should not depend on where they 
live, what their race is, or how much money they have. This country 
should uphold the values it claims to have and ensure that healthcare 
is not a preferential benefit, but a human right for every citizen.

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