[Congressional Record Volume 166, Number 178 (Monday, October 19, 2020)]
[Senate]
[Pages S6331-S6332]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Ms. HIRONO (for herself, Mrs. Gillibrand, Mr. Merkley, Ms. 
        Duckworth, Mr. Blumenthal, Mr. Sanders, Mr. Booker, Mr. Cardin, 
        and Mr. Kaine):
  S. 4819. A bill to improve the health of minority individuals, and 
for other purposes; to the Committee on Finance.
  Ms. HIRONO. Mr. President, there is no shortage of examples showing 
how our Nation systemically fails communities of color and other 
minorities, but the events of 2020--namely COVID-19 and the killings of 
Black Americans--have brought heightened attention and urgency to 
addressing inequities and disparities throughout our nation. 
Tragically, these inequities and disparities pervade our health care 
system, resulting in poor health outcomes and barriers to care for far 
too many communities.
  Mr. President, I believe that healthcare is a right--not a 
privilege--and that this right should extend to everyone in our Nation. 
Yet, this is not the case. Our Nation falls short in ensuring that 
right to everyone regardless of race, ethnicity, gender, sexual 
orientation, socioeconomic status, immigration status, or any other 
factor, which is why I am reintroducing the Health Equity and 
Accountability Act (HEAA). This bill is a comprehensive blueprint of 
bold policy solutions that address a wide spectrum of health equity 
concerns.
  Despite progress made through the Affordable Care Act, health care 
access remains a problem in the U.S., with minority communities 
disproportionately facing barriers to coverage. HEAA expands access to 
health care for many communities in need including immigrant 
communities, rural communities, and of particular importance to my 
state, citizens of the Freely Associated States who are living in our 
country under the Compacts of Free Association.
  We know that diversity in our health care workforce can improve 
health outcomes, and yet racial and ethnic minorities remain 
underrepresented in our health professions. HEAA seeks to address the 
lack of diversity in our health workforce through loan repayment 
programs and health professions fellowships. The bill would also help 
providers better serve a diverse patient population with culturally and 
linguistically appropriate health care services through investments 
like cultural competency education and expanded language access 
services to assist the over 12 percent of Hawaii residents and about 8 
percent of people nationwide with limited English proficiency.
  Women, children, and adolescents often face additional barriers and 
disparities in accessing information, health education, health 
services, and coverage. HEAA aims to dismantle those barriers and 
address a range of infant, maternal, sexual, and reproductive health 
needs, particularly for

[[Page S6332]]

marginalized and underserved communities. For example, HEAA would 
invest in sexual health education for underserved, minority, and LGBTQ 
youth and link them to services related to positive health behaviors. 
The bill also seeks to address our country's tragically high maternal 
mortality rate, particularly for Black women, who have a maternal 
mortality rate three to five times that of White women. HEAA would 
expand services to pregnant and postpartum women, develop maternal 
health initiatives in rural areas, and establish a program to address 
implicit biases and cultural competency in providers.
  HEAA doesn't stop there. The legislation would also expand and 
promote mental and behavioral health services for minority communities, 
increase Federal resources for diseases that disproportionately affect 
minorities--such as heart disease and diabetes in Native Hawaiians--and 
improve data collection and reporting so we can more completely 
recognize and address health disparities. In Hawaii, these investments 
through HEAA will help combat diseases like viral hepatitis, which 
disproportionately affects Asian Americans, Native Hawaiian, and 
Pacific Islander communities, and better understand the health 
disparities faced by Asian Americans, Native Hawaiians, and Pacific 
Islanders through disaggregated data collection.
  Finally, HEAA addresses the ``social determinants of health''--non-
medical factors like the environment, housing, education, and economic 
stability that ultimately affect individual and community health. HEAA 
would require non-health federal agencies like Department of Housing 
and Urban Development, Department of Transportation, Department of 
Agriculture, and Environmental Protection Agency to work together to 
improve the social determinants of health.
  Achieving health equity is achievable and to do it we must make bold, 
substantial investments in transforming our health and health care 
systems. I thank my colleagues for joining me in introducing the bill, 
and encourage others to join us as we work to level the playing field 
and empower everyone in our nation to achieve their full health 
potential.

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