Obama Official Admits Health Care Law 'Targeting' Racial Inequality

FARAI CHIDEYA, HOST, "TELL ME MORE": Exactly one year ago today President Barack Obama signed new health care legislation; the Affordable Care Act will roll out changes over the course of 2010 to 2014. Some of these changes include letting young adults stay on their parents health insurance plans until they're twenty six years old. Insurance companies won't be able to void your benefits if you make a mistake on your application, and what's called the "donut hole" will be closed. Formerly, after you and your plan spent a pre determined amount of money for your covered drugs, you'd have to pay for the rest out of pocket. We wanted to learn more about how the law is affecting our lives one year later, how much change have people seen? With us now we have Dr. Garth Graham he is the assistant secretary for minority health at the US department of Health and Human Services. He joins us from his office. Thank you for being here.

Dr. GARTH GRAHAM (Assistant Secretary for Minority Health, Department of Health and Human Services): Thank you for having me.

FC: According to the US government about 1 in 3 Hispanics and American Indians are uninsured, by comparison 1 in 5 African Americans are uninsured and that drops to 1 in 8 for White Americans. Those are very significant differences and so has the affordable care act help to lessen those disparities, if so, how?

GG: Sure, so the Affordable Care Act is exactly targeting those disparities and others, so certainly the institute of medicine and other organizations, non political organizations, have identified health insurance and health insurance coverage as a key factor for the health of minority populations so those statistics that you just explained in terms of the differences in insurance coverage in minority communities compared to others also play out in terms of differences in health outcomes, certainly higher rates of diabetes, hypertension, deaths from caner, etc. Many of that due to lack of insurance, so the Affordable Care Act is directly moving forward with providing health insurance and health insurance coverage and access to care for a number of individuals and certainly those from minority backgrounds. So things that we've done to date, we've put in place the pre existing health insurance plan that has been providing insurance coverage for individuals who have pre existing health conditions and a number of health components across the board and many of those things will also come into full effect in 2014 so you're exactly right that those health disparities and insurance coverage exist, and that they're challenges that are certainly not acceptable and things that the Affordable Care Act and our department is working on.

FC: In comes another factor, 4 out of 10 low income Americans no matter what race or ethnicity don't have health insurance, 94% of upper income Americans are insured, is there any way this new law is changing the game?

GG: Sure, so one of the things the new law is working with states to do is to help strengthen Medicaid and certainly have Medicaid to be able to cover a lot of folks who are working poor, one of the challenges with some of the statistics you gave earlier, which are very true, is that even some folks have insurance coverage, but if they're gonna get sick they don't have health insurance coverage that will really take care of them once they get sick, so what we're doing is that we're shoring up Medicaid, working to make making sure that Medicaid can cover more of the working poor and more people who work but need health insurance access, and also making sure that we make health insurance really just accessible for all individuals across the board regardless of their income status so you're very right that socioeconomic status and income is a key factor in all of this and we're going to make sure that we take care of everybody.

FC: And Dr. Graham we actually have a couple of questions that are coming from people who we've been in conversation with, doctors across the country. First I'm going to play a question from one of our regulars Dr. David Ellington; he's a former board member for the American Academy of Family Physicians.

Dr. DAVID ELLINGTON (Former Board Member, American Academy of Family Physicians): Dr. Graham do you believe that both the President and his team and the democrats and republicans in congress can come together to #1 persevere to work this thing through to a successful conclusion and at the same time compromise with each other enough with new and different strategies to improve the bill?

F.C.: Dr. Graham?

GG: That's an excellent question. Certainly we know that we want to continue making progress and I think between our administration and folks on the hill there is efforts to certainly make sure that we continue to make progress. I believe that we will continue to move forwards with the implementation of the Affordable Care Act so that hopefully as Dr. Ellington asked in so eloquently a way we'll be able to get folks to continue to work together so that we can continue to make progress.

FC: We've also got a question from Dr. Carolyn Barley Britton; she's a neurologist in New York and past President of the National Medical Association

BB: All of us know this is a time of budget constraints for many states and many states are already opposed to the implementation of health care reform, what can occur that will change the dynamic, or build support statewide, and is there a plan?

FC: And what about that?

GG: First let me say that Dr. Britton is somebody who through her work at the National Medical Association and other work has been working to fight health disparities for some time so I want to recognize her leadership. We've been working with states to help states implement many of the provisions in the Affordable Care Act but certainly make state health care systems continue to work effectively. So a number of ways in which we've been working with states with potential cost savings is changing benefits, so allowing states, states can generally change optional benefits or limit their amount, duration or scope through an amendment through their state plans so, certainly allowing states some flexibility. Working with states to manage the care of high cost enrollees more effectively is another strategy, as well as working with states to purchase drugs more efficiently, and continue to assure program integrity. So there are a number of different strategies that we're doing to work with states so that they will have some flexibility but will be able to, like I said before, maintain their program integrity.