By Hazel Trice Edney
Black and Latino communities throughout the United States have disproportionately suffered the most devastating impacts of the coronavirus, including a higher rate in deaths, underscoring inequities in the nation’s health care system and the broader society.
In New York state, for example, African-Americans make up 14 percent of the population, but have experienced 26 percent of all deaths. In Virginia, 49 percent of coronavirus cases come from the Hispanic and Latino community, which makes up 10 percent of the population.
The disparities reflect a number of factors. But experts point to one factor in particular: the relatively high costs of medical care for COVID-19 at a time when Blacks and Hispanics are less likely to have health insurance than Whites are.
Indeed, as pointed out by the Kaiser Family Foundation, the persistent gap in insurance coverage in minority communities is at the start of a chain of events that produces worse health outcomes. Some 36 percent of nonelderly Latinos and 22 percent of African Americans are uninsured.
Uninsured adults are twice as likely to forego doctor visits, which often means that developing or worsening health conditions go undetected and untreated. In fact, Gallup released a poll earlier this year that found that 14 percent of American adults said they would avoid seeking healthcare for early symptoms of coronavirus infection for themselves or a family member because they could not afford to pay for the care.
How lower rates of insurance coverage among Black and Latino Americans contributed to disparities seen during the pandemic should be atop the list of questions posed to major insurance companies by the House Committee on Energy and Commerce, which recently launched an investigation into insurance companies’ policies and practices amid COVID-19.
Demanding clear plans to remediate these critically important coverage issues must be a non-negotiable first step in holding health insurers accountable.
In recent years, health insurers have been shrinking physician networks – the number of in-network doctors available to patients in a given geographical area – in an apparent attempt to cut costs and pad their bottom line. A number of states have seen drastic reductions in coverage networks, including Texas, New Jersey, Massachusetts and Georgia.
For communities of color, shrinking coverage networks compound the problem of medical indigency, which continues to be a systemic failing. Even in the wake of Obamacare, 30 million people remain uninsured, with half of them being people of color.
The concern of Black leaders over the harmful practices and policies of health insurers surfaced earlier this year. They spoke out forcefully against an attempt by industry lobbyists to press Congress to approve legislation that would have enabled companies to pass on costs to medical providers and patients instead of requiring insurers to pay their fair share.
During a primary campaign stop in South Carolina, Reverend Al Sharpton issued a clarion call for Congress to reject those industry efforts and craft legislation that protects the underinsured and those without insurance. And in a follow-up piece explaining the reason for his visit to the state, Sharpton wrote, “African American access to high-quality health care in particular is a pressing issue this election – if not a full-blown crisis.” That was before the pandemic struck.
In the months since, insurers have engaged in other tactics to sure up profits at the expense of doctors and patients, from strong-arming doctors to accept lower reimbursement rates to restricting the types of COVID-related procedures that would be covered.
Those aggressive measures have paid off: one of the nation’s largest health insurers, United Healthcare, recently posted its most profitable quarter in the company’s history.
On Capitol Hill, lawmakers are rightfully trying to respond. In fact, those historic profits at a time when so many other industries are struggling to stay afloat are what prompted lawmakers to open an investigation.
It is unclear how Congress will press the insurance companies to address the persistent racial disparities in coverage that preceded the crisis and appeared to play a role in making the pandemic particularly deadly for Black and Latino Americans. But at a time when there’s an urgent national conversation on social and racial justice sweeping the country, lawmakers have a responsibility to hold their feet to the fire.