12 Actionable Next Steps for Business Leaders from our webinar on “Racism, Inequality and the US Healthcare System”
By Marla Becker
On Friday Juneteenth, our Co-founder and CEO Gil Addo moderated a live 75min webinar featuring an esteemed panel of Black Healthcare Leaders – Julian Harris, MD, Partner at Deerfield Management Company, Toyin Ajayi MD, Chief Health Officer and Co-founder at Cityblock Health and Errol L Pierre, Senior Vice President at Healthfirst – on Racism, Inequality, and the US Healthcare System in partnership with The Healthcare Club and NYC Health Business Leaders.
In an outstanding turnout, nearly 1200 people registered to learn more about how Covid-19 has exacerbated health and economic disparities for communities of color and what business leaders can do amidst the current unrest to help move our country forward. We are heartened by the level of engagement in this meaningful conversation and would like to share actionable next steps coming out of our conversation in hopes of enacting change.
- Educate Yourself by reading The Best of Enemies that Julian Harris recommended and The Economic Benefits of Reducing Racial Health Disparities. You can also check out the wealth of resources available here on “How to be Anti-racist.”
- Ensure Pay Equity among all employees to end the perpetual cycle of pay gaps between gender and marginalized groups who are less likely to counter offers.
- Hire a Chief Diversity Officer who will report to the CEO so they have sufficient influence and don’t merely take the role of “event planner” or “statistician.”
- Diversify Your Organization to improve performance. If the organization you work for doesn’t look like America, ask yourself why not and learn what you can do about it.
- Diversify your board, C-suite, executive team, managers and analysts
- Don’t recruit from your networks if they are not diverse
- Develop a diverse pipeline for roles across each function
- Invest in organizations that have African American and women leadership
- Ask D&I Experts to help you diversify your workplace and ensure that work is properly compensated for and not relegated to “the side of the desk.”
- Measure What Matters so corporate leaders are held accountable for outcomes that promote equity and ensure stakeholders are aligned with your goals.
- Create Safe Spaces for people to share their stories so you can determine what is acceptable behavior and part of company DNA and what will not be tolerated anymore.
- Counter Microaggressions in the workplace by teaching employees how to navigate, identify and proactively rule out microaggressions when they see them.
- Have the Hard Conversations with people who you know who harbor resentment towards blacks or marginalized communities because, over time, people can change.
- Support Medicaid Expansion to help close the coverage gap for uninsured poor adults in certain states that have chosen not to expand Medicaid under the ACA.
- Invest in Police Reform that re-trains and diversifies law enforcement officers to establish trust within the communities they serve.
- Share the Work by engaging other members of the white community to take on this responsibility because these are not just “black problems.”
“Injustice anywhere is a threat to justice everywhere” – Martin Luther King, Jr.
“If you have come here to help me, you are wasting your time. But if you have come because your liberation is bound up with mine, then let us work together.” – Lilla Watson
Dr. Ajayi says “even though its a challenging time, there is joy in doing the hard work with people who are passionate around a shared mission of building an anti-racist company.” We are grateful to have a professional community that is willing to do the work with us so that together we can create a more just society for everyone.
More info here: https://blog.rubiconmd.com/12-actionable-next-steps
COVID-19 is widening gaps in health equity. Here are some ways organizations are trying to address it
The COVID-19 pandemic is hitting low-income, underserved populations particularly hard, experts say.
Many people who have been furloughed or lost their jobs are struggling to pay for basic needs, increasing the risk for food insecurity and homelessness in some neighborhoods in hard-hit areas like New York and New Jersey.
And in communities of color across the country, COVID-19 has exposed existing inequalities, causing an already unleveled playing field to tip over.
Case in point: Newark, New Jersey is a predominantly African American community.
Even so, the disparately high numbers of COVID patients coming into Newark Beth Israel Medical Center who are African American—about 95%—have been stark, said Dr. Frederick Waldron.
“The numbers have been overwhelming,” Waldron said. “What is different is the acuity. Most of the patients now are very very sick. The ER is almost saturated with COVID patients, some of them intubated.”
At play in that community, he said, is the fact African American patients are more likely to have co-morbidities. They have also tended to have poorer access to testing relative to the rest of the population.
“They make up a greater percentage of those providing essential services which require them to go to work. They may not have the money to buy large stores of food that is sometimes required,” Waldron said. “For many, there is an issue of where they live: Sometimes there is overcrowding and they are not able to maintain that six feet that’s generally required.”
In Chicago, African Americans make up 30% of the population but, as of late April, 77% of COVID-19 deaths were residents in black and brown communities, according to Darlene Hightower, vice president of community health equity at Rush University Medical Center.
“Many people were surprised by the racial disparities. But for me and my team, it’s not surprising at all. We see these disparities all the time, and this is sounding the alarm even more for the need for the work that we’re doing,” she said. Hightower and her team focus on providing access to quality healthcare for underserved populations and also work to address “upstream” social factors that impact health such as jobs and education.
RELATED: How a new wave of technology startups is tackling social determinants of health challenges
Getting food on the table is the biggest issue facing disadvantaged populations, said Errol Pierre, senior vice president, state programs at Healthfirst, a New York City-based insurer with a large Medicaid population.
New York City is a “tale of two cities,” Pierre said, as affluent residents have the option to work from home or leave the city. With many social service organizations shutting down during the pandemic, disadvantaged residents are struggling without a safety net.
“Disposable income has dried up so people can’t purchase food. In some lower-income communities and communities of color, there are long lines at the grocery stores or the stores are out of things. One-third of the food pantries in the city have closed down,” he said.
Not-for-profit insurer Healthfirst serves 1.4 million members in New York City and Long Island, with about 1 million Medicaid members. During COVID, there has been an unprecedented demand for financial assistance, he said.
On a typical day, about 400 New Yorkers will request Medicaid assistance through Healthfirst and that has spiked to 900 applications a day amid COVID-19, Pierre said.
Reaching the most vulnerable populations
Many hospitals are addressing these issues through programs in place before the pandemic began. At Newark Beth Israel Medical Center, which is part of the RWJBarnabas Health, providers screen individual patients for social determinants of health to identify which need additional support.
Those support programs offer help, for example, ensuring the patient has access to prescribed medications if they might have trouble accessing those drugs on their own, said Waldron.
One big challenge is connecting patients with available resources as some services have closed down while new ones have popped up. Startups like NowPow, UniteUs, and CityBlock Health were already working to bridge those gaps before COVID and their technology platforms are proving to be valuable now.
RELATED: How NYC Health + Hospitals is teaming with a startup to tackle food and housing insecurities
At Healthfirst, care managers use NowPow’s community referral and analytics platform to find resources, in real-time, based on members’ zip codes to meet their specific needs.
Healthfirst also accelerated the roll out its member-facing mobile app in April and is integrating NowPow’s referral tool into its app, Pierre said.
“That means members don’t have to come to us, we’re not the middle man, so they can just leverage the NowPow tool directly themselves,” Pierre said.
These apps are helping New Yorkers in need every day, he said. As one example, a Healthfirst member in Long Island lost his job, then tested positive for COVID. Quarantined at home with his family, he can’t leave his house to buy groceries.
“He is now able to use NowPow to filter down and find places that provide food and offer home delivery,” Pierre said.
During the COVID-19 pandemic, people need immediate resources, and NowPow’s digital social services network is providing a “single source of truth” for COVID resources in Chicago neighborhoods, Hightower said.
“Nobody has the time right now to gather all that information to know what’s out there and what’s available. NowPow provides that information in real-time and that has been crucial. It enables community-based organizations to better serve their clients,” she said, noting that Rush has been working with the startup for two years.
NowPow also just launched the first in a series of interactive maps to show how the COVID-19 outbreak is affecting community resource availability in the United States. The first maps focus on food resources in three of the nation’s hardest-hit areas: New York City, Long Island, and Chicago. The map helps healthcare organizations to track geographies at-risk relative to available resources, the company said.
RELATED: Kaiser Permanente building infrastructure to ‘connect the dots’ for social determinants
During the pandemic, the need to address social determinants of health has only grown more critical, experts say. The current health crisis is likely exacerbating the social factors that impact health, such as joblessness, lack of education, and racial inequities, and this could have a major long-term impact on community health.
Health systems that are taking steps now to identify immediate unmet social needs in their patients will be in a better position to use data to address social determinants of health going forward, experts say.
“My hope is that this becomes an opportunity to look at the systemic barriers that exist in the communities,” said Hightower. “We have programs that are providing food to people for now, but we need to look at why that person needed food in the first place.”
“With light being shined on COVID, and the disparities that have been exposed, there is an opportunity to change the conversation,” Hightower said.
New York’s Medical Community Unites for COVID-19 Response
Written by Daphne Liu
As worldwide concerns surrounding the COVID-19 pandemic heightens, the medical community in New York has actively united to pave a path toward healing, and has shown their support for Tzu Chi’s fundraising campaign, “Providing Relief During the New Coronavirus Outbreak.” Healthfirst, the Coalition of Asian-American IPA (CAIPA), and the Chinese American Dental Association (CADA) donated nearly $90,000 to Tzu Chi New York to facilitate the purchase of vital medical supplies to be delivered directly to medical institutions in the affected areas.
Healthfirst, a well-known not-for-profit health insurer for New Yorkers, held a fundraising campaign within the company which encouraged colleagues to donate spontaneously. The company later matched the donation to a total of $21,948. Errol Pierre, the Senior Vice President of Healthfirst, said that he has been collaborating with Tzu Chi New York for quite some time, even visiting Tzu Chi in Taiwan once. He is therefore familiar with how Tzu Chi can effectively mobilize volunteers to help the people most in need.
Tzu Chi volunteers around the world directly help people in need. I can’t think of a better group than Tzu Chi which can help us send medical supplies to severely affected areas. Errol Pierre, Senior Vice President of Healthfirst
The Chinese American Dental Association (CADA) also donated $17,500. The generous donation was made with the help of Dr. Kenneth Liao, the Deputy Chief Executive Director of Tzu Chi’s Northeast Region. Dr. Henry Chiu, Executive Committee Member of CADA, expressed that everyone on Earth shares the same destiny — what transpired in Wuhan, China, will affect everyone to some extent. And indeed, implementing effective preventative measures and inspiring unity in addressing the pandemic are paramount.
The Coalition of Asian-American IPA (CAIPA) is a group of Asian-American physicians in New York who have been fundraising since the beginning of the new coronavirus in January. Several doctors in the association are from Hubei and Wuhan, China, and many of the medical professionals on the frontlines in the affected areas were their classmates and colleagues. They are extremely cognizant of the plight of those in the areas most severely impacted by the virus, and therefore, launched fundraising campaigns within the association which accumulated $130,000 in relief funds — and the number of donations only continues to rise. George Liu, the President of the association, and Peggy Shen, the association’s CEO, donated $50,000 to Tzu Chi on behalf of CAIPA.
Freeman Su, Executive Director of Tzu Chi’s Northeast Region, thanked the three associations for their charitable contributions. Dr. Kenneth Liao, the Deputy Chief Executive Director of Tzu Chi’s Northeast Region, additionally presented a video to the guests detailing the process of how the medical supplies are collected globally and delivered to the affected areas. Tzu Chi USA delivered three bulk shipments of medical supplies in February, which included nearly 10,000 masks, 521 safety goggles, 600 N95 respirators, and 90 sets of medical protective overalls.
The donations from the medical industry in New York represents the love of the New Yorkers. They are paying close attention to and understanding the importance of the COVID-19 outbreak, we thank everyone for believing in Tzu Chi for always helping those in need.Freeman Su, Executive Director of Tzu Chi Northeast Region
Before the event ended, Dr. Yushia Lin, an infectious disease physician at the Maimonides Medical Center, reminded everyone that the best preventive action is to one’s wash hands frequently for 20-30 seconds, and use soap every time you wash your hands — especially after using the restroom, before eating, after blowing your nose, coughing, or sneezing. If you cannot wash with soap, use hand sanitizer, and remember to cough and sneeze into a tissue, not your hands. Also, it is highly recommended to start breaking some bad habits, such as the constant touching of the eyes, nose, and mouth.
While monitoring the growing pandemic, physicians and clinics in New York’s Chinese community have begun to pay close attention to the latest data released by the Center for Disease Control. Dr. George Liu, president of CAIPA said that at this time the New York City authorities have applied for 1,200 beds from Bellevue Hospital Center to prepare for COVID-19 patients. George Liu further suggested that before the testing reagents are made readily available, persons with symptoms similar to COVID-19 should not take the risk of going directly to a clinic — rather, contact your family doctor first for testing information and the correct screening procedures.
The COVID-19 outbreak in New York is escalating. The city government has begun to establish screening, prevention procedures and residents should not panic. If symptoms similar to the new coronavirus occur, please contact a family doctor first to inquire about the correct treatment and testing procedures.” George Liu, President of the Coalition of Asian-American IPA (CAIPA)
Tzu Chi’s New York Branch additionally implemented preventive procedures for containing the spread of the pandemic, which emphasizes regularly disinfecting surfaces. Individuals visiting the branch will also use hand sanitizer before signing in, and gatherings have been reduced. At 1:30 PM every day, prayer is held at the branch office, and as Tzu Chi volunteers continue to care for local communities, residents are called upon to be cautious, fundraise, and cooperate with the government officials’ preventive actions.
Study: Give millennials reasons to stay on Long Island
By: Adina Genn
Long Islanders between the ages of 20 and 44 continue to leave Nassau County, largely because they find the region’s housing, along with student debt, and often challenging public transportation is burdensome.
This is according to “The is Nassau: The Deal for The Next Generation,”a report released by County Comptroller Jack Schnirman this week.
The report shows that Nassau has seen a 9.3 percent decline in residents in this age bracket since 2000. The report was released at a public forum at Molloy College on Tuesday.
The panel discussion included County Leg. Josh Lafazan, Molloy Professor Errol Pierre, Association for a Better Long Island Executive Director Kyle Strober, Jillian’s Circus Founder Jillian Weston and Director of Policy Planning and Strategic Initiatives for the Comptroller’s Office Marv McMoore Jr.
“For prior generations, the deal of living of Nassau County became an affordable option for young families with a quality of life based upon our schools, services, beaches, parks and access to New York City,” Schnirman said in a statement.
“Working together, policymakers must recommit to making this deal work for the next generation of Nassau County residents,” he added.
The Office of the Nassau County Comptroller’s Policy & Research Unit developed the report, with assistance from the office’s summer college interns.
According to the report, those ages 25-to-34 on Long Island, are increasingly living with their parents. And 44 percent of Long Islanders between the ages of 25 and 34 live at home, while nationally, this figure is 16 percent.
“Long Island is facing a potential demographic catastrophe, which will turn into economic crisis if corrective action isn’t taken soon,” Strober said in a statement.
“One important step in addressing this threat would be reducing the red tape that currently challenges economic development projects, and coupling that action with a recognition that transit-oriented rental housing needs to be approved to serve this unmet need,” he added.
The report revealed that Long Island’s median rental price of $1,760 would take 53 percent of an average millennial’s monthly salary. As a result, young people opt to reside with their parents or move to lower cost regions. Nassau County lost 22 percent of its affordable housing stock and the price per acre of property has increased 28 percent during the past decade. The report also notes that transportation options, particularly for north-south communities are lacking in many areas.
“If we had more public transportation, if we didn’t have to use our cars as much, of course that would contribute to a more eco-friendly Long Island, which is something that I think a lot of millennials and the next generation are very passionate about,” Weston said in a statement.
“So we’re trying to figure out how to get less cars on the road, have a little less stress, maybe help some people that can’t get to work any other way, I think it’s a win for everybody,” she added.
Student debt plays a big role in the ability to afford housing on Long Island. According to the report, the average student debt balance for Long Islanders is $33,900. That burden is furthered by the fact that 9.5 percent of Long Islanders with student loan debt are more than 90 days late on payments.
Although unemployment is at record lows, 34 percent of college graduates are underemployed, according to the comptroller’s office. While jobs in the gig economy have provided more flexible employment opportunities, lack of health care or long-term career trajectories hamper the ability to build a strong financial base. Building up professional resources for the next generation could help them get started on careers that allow them to stay in this region.
“Young people often feel that asking questions or asking for help is a sign of weakness, because you’re admitting that you don’t know something,” Lafazan said. “I think it’s the surest sign of strength and humility because, you’re admitting that you need to know something, because you don’t have that life experience.”
The report outlines a number of areas for policy development that could help provide the next generation of Long Islanders with the support needed to prevent them from leaving the region completely.
Potential policy options, according to the report, include efforts to reduce the burden of student loan debt and increase financial aid. In addition, updating zoning codes to allow for more transit-oriented development, specifically around LIRR stations, would also benefit millennials. Expanding public transportation options that connect the north and south shores was also included as an option, as was increasing access to affordable childcare options, such as expanded pre-k.
More here:
ACA: Last Day of Open Enrollment!
Errol sat down with Arise News to discuss the future of Healthcare Reform as the 2018 Open Enrollment Period for the Affordable Care Act comes to a close.
The Open Enrollment Period ran from November 1st through December 15th, 2017, however, some states like New York and California extended their Open Enrollment Period to January 31st, 2018.
Stars Under 40 strut their stuff at awards event
Brooklyn’s young professionals stepped into the spotlight on Thursday, June 22 as Schneps Communications and Star Network honored over 40 of the borough’s best and brightest at the 2017 “Stars Under 40” Awards and Networking Event.
Honored for exemplifying leadership skills, not only in their chosen fields, but in their communities as well, over 40 stars – all under the age of 40 – filled the Grand Prospect Hall (263 Prospect Avenue) with their smiles, compassion and professionalism.
“Star Network is pleased to acknowledge the many extraordinary achievements of the men and women we are honoring,” said Co-Owner of Schneps Communications and Star Network Victoria Schneps. “These fabulous people have been so successful because they have a passion for what they do. It is my privilege to recognize them.”
The night’s honorees, along with six very special “Rising Stars,” (three high school students, two middle school students and one elementary school student) were given the chance to mingle with one another during a VIP reception and cocktail hour, and later receive awards and citations for their hard work and dedication.
This year’s “Rising Stars” included five-year old second-grader Ariana Jalia, 11-year-old master chef Steven Esses, I.S. 187 student Preston Ferraiuolo, Stefano Ientile, a rising senior at Xaverian High School, Kristina Scarfo, a rising senior at Fontbonne Hall Academy and Rookie of the Year – Sheryl Chen, a recent graduate of Staten Island Technical High School who will attend the Wharton School of Business at the University of Pennsylvania this fall.
Also honored as a “Rising Star” was Bay Ridge resident and I.S. 187 student Preston Ferraiuolo who, now just 13, founded his own volunteer group, the Bay Ridge Lemonade Coalition – an organization made up of middle school students working together to benefit the community – while also continuously lending his hands to volunteer efforts and initiatives across the ‘hood.
“I am so honored to be able to meet so many successful businesspeople that are doing a lot for other people,” said Ferraiuolo. “These honorees do so much good for the community, so this is an exciting opportunity to network and get even more involved.”
Three high school students were also lauded as “Rising Stars,” including Stefano Ientile, a junior at Xaverian High School who has participated in numerous statewide championships with his school’s speech and debate team, while also taking home first place in the Congressional Art Competition, and Kristina Scarfo, a rising senior at Fontbonne Hall Academy whose resume already includes outstanding scholastic achievement, participation in a research project at St. Joseph’s University and the title of an accomplished athlete.\
Sheryl Chen, a senior at Staten Island Technical High School, was also honored as a “Rising Star,” as well as the event’s “Rookie of the Year.” Chen is the founder and CEO of a female empowerment nonprofit, Girls Advocating Leadership & Strength (GALS). As a young female activist, she has already won awards for her volunteerism and has spoken at the United Nations, Columbia University, Princeton University and schools throughout inner cities to discuss the power of youth, the importance of kindness and topics like intersectional feminism, female self-esteem and advancing girls of color.
This year’s Stars Under 40 event also honored Brian Chin, vice president and branch manager of Northfield Bank in Bay Ridge, as the annual event’s first-ever Hall of Famer. Chin, who joined Northfield Bank in 2011, is responsible for developing new business in the Bay Ridge area and for managing the day-to-day operations of the branch – all of which he does while remaining active in Bay Ridge, where he also happily resides.
“It’s an honor and a privilege to be the first-ever Rising Star Hall of Famer,” Chin said. “It’s something that shows that hard work and perseverance really pays off.”
Just as exciting, he said, is the annual event itself.
“The Home Reporter is a great organization and so is Star Network,” Chin raved. “This is a really great opportunity to get out there and network with other wonderful people in this community.”
Stars Under 40 Honorees included Dara Adams, Dance Instructor, Brooklyn United Music & Arts Program; Dana Bentz, President & CEO, Dell’s Maraschino Cherries; Paul Caruso, Operations Manager, Auto Dent Collision; Richard Corredor, Owner/CEO, AB Surveillance Systems; La Quasia Crandell, Head of Flag Department; Brooklyn United Music & Arts Program; Joseph D’adonna, President, CityLine Abstract; Soraya Denis, Founder/Co-Founder, Dlo Pou Viv/Women Who Inspire Women; Jelanie DeShong, Director of Community Engagement, Lieutenant Governor Kathy Hochul; Angelica Diaz, Owner, Event Works; Erkan Emre, Founder/CEO, Kotti Berliner Döner Kebab; Nicole Esposito, Co-Owner, Bohemian Rose Hair Studio; Victoria Fernandez Wint, Program Operations Manager, Brooklyn Prospect Charter, School-Clinton Hill Middle; Jasmine Figueroa, Project Manager, Rodriguez, Gambino & LaPorta; Gregory Gatewood, Horn Instructor, Brooklyn United Music & Arts Program; Ari Harkov, Licensed Real Estate Broker, The Harkov Lewis Team, Halstead; Debbie Hootam, Assistant Vice President, Branch Manager, Investors Bank; Michael Joseph, Police Officer, 70th Pct.; Adam Kalish, Esq., The Law Firm of Adam Kalish P.C.; Kiki Lekkas, Co-Owner, Blue Door Restaurant; Igor Lazebnik, Business Development Officer, Flushing Bank; Joseph Leston, Senior Director of Marketing, CareConnect Insurance Company; Jane Lvovskiy, CPA, Managing Director, Supporting Strategies, Brooklyn & Staten Island; Marla Loughran, D.C., Chiropractor, Brooklyn Chiropractic Partners; Farah Louis, Deputy Chief of Staff, New York City Council; Andrew Luftig, Esq., Partner, Chaves & Perlowitz LLP; Richard Luthmann, Esq., Luthmann Law Firm, PLLC; Ayat Masoud, Esq., Assistant District Attorney, Kings County DA’s Office; Stacey Meekins, Horn Instructor, Brooklyn United Music & Arts Program; Ayumi Otaki, Senior Managing Director, Corcoran Group; Errol Pierre, Vice President of Medicaid and Commercial Markets, Healthfirst; David Ratner, Licensed Real Estate Agent, The Ratner Team, Warren Lewis Sotheby’s International Realty, Co-Founder of The Brooklyn Made Podcast/Blog; Craig Rosenman, Director of Acquisitions, The Daten Group; Samantha Ross, Event Coordinator/Community Liaison, New York City Councilmember Mark Treyger; Andrea Serie, Freelance Marketing Consultant; Rodney Smith Jr., Head of Percussion, Brooklyn United Music & Arts Program; Danny Soldano, Lic. Real Estate Associate Broker, Dorsa Group Realty; Tarin Sukkarieh, Co-Owner, Bohemian Rose Hair Studio; Melissa Tropnas, Events Coordinator, Extra Extra Creative; Teresa Vasquez, Community Manager, Balfour Beatty Communities/Licensed R.E. Broker; Shakiera Walker, Digital & Communications Manager, Delivering Good; Douglas Youla, Operations Manger, Luna Park; Simon Zabrovskiy, Vice President, Relationship Manager & Area Manager, Chase Bank.
“There’s this wonderful sort of value that I see in putting together ambitious, kind-hearted people who strive to make the community a better place,” said Emre, “and to be a part of that network is just an honor.”
That honor was also particularly touching for Serie, a sixth-generation Brooklynite, and her family.
“This is so exciting,” she said. “My family has been in Brooklyn for six generations – way before it became this trendy, travel destination. Through the good and the bad, we always stayed, and we made lives for ourselves, so this means a lot to my entire family for me to be recognized for my work within the borough.”
Furthermore, the Brooklyn United Music & Arts Program – which honorees Adams, Crandell, Gatewood, Meekins and Smith Jr. are a part of – was awarded for Excellence in Music & Performing Arts.
The night also featured exciting raffles – proceeds from which went to support the Make-A-Wish Foundation, which grants the wishes of children with life-threatening medical conditions to “enrich the human experience with hope, strength and joy.”
The event’s sponsors included Investors Bank, New York Community Bank, HealthFirst, Flushing Bank, National Grid, Chase, JetBlue, CEBU, Bohemian Rose Hair Studio, Malsons Jewelers, MedCast Plus, Broadway Stages, the Brooklyn Chamber of Commerce, The Daily News, Brownstoner, The Home Reporter and The Brooklyn Spectator.
More info here:
Republican Healthcare Reform Redo?
The Republican Party faced an inexplicable set back on Friday, March 24, 2016 when the Speaker of the House, Paul Ryan, informed the President that despite their best efforts, The American Healthcare Act (H.R. 1628) would not even be brought up for a vote.
Since then, President Donald Trump has said, “I don’t lose”, while speaking to the Financial Times on Sunday, April 2, 2017. He went on to promise that America will have reform whether it is exclusively with the Republicans or on a bipartisan basis.
Even last night, he told Kristen Welker of NBC News, that he was very serious about “reviving the push for healthcare reform”.
The American Healthcare Act was the probably the most important vote of the Republican agenda during Donald Trump’s young Presidency.
After winning the White House and having voting majorities in the House of Representatives and the Senate, Republicans can no longer be the party of “No”. In fact, with so many campaign promises, Republicans must become the party of “Grow”.
He promised to grow the economy by bringing jobs back from overseas and putting the coal miners back to work. He promised to grow the military by increasing Pentagon funding. He ran on growing border security through the building of a wall along America’s southern border. Lastly, and most importantly, he promised to grow the number of Americans that have access to high quality, affordable healthcare.
In fact, Thing Progress has counted 68 times that the President has promised to repeal and replace Obamacare.
“We are gonna win, win, win. We’re going to win at everything. And some of you are friends and you’re going to call, and your going to say, “Mr. President, please, we can’t win anymore like this, Mr. President, you’re driving us crazy, you’re winning too much..” – Donald Trump, 145th annual NRA convention – May 20, 2016.
CBO: 24M reasons to revisit Obamacare Repeal
The non-partisan Congressional Budget Office (CBO) “scored” the American Healthcare Act this yesterday. That means they have forecasted the impacts of the legislation to the Federal budget over the next 10 years.
For context, when Lyndon Johnson signed Medicare into law the CBO did not yet exist. Back then, all cost estimates and projections were delivered solely from White House. It was not until 1974, when a Republican President by the name of Richard Nixon signed the Congressional Budget and Impoundment Control Act into law, that the CBO was established. The aim of the CBO is to provide “objective, nonpartisan, and timely analysis that aids in the economic and budgetary decisions on a wide array of programs covered by the federal budget.
Here is the CBO report on the American Healthcare Act
American Healthcare Act: Fewer Enrolled = Huge Savings
The American Healthcare Act is projected to reduce federal deficits by $337 Billion by 2026.The reductions are a culmination of $1.2 trillion decrease in spending, partially offset by $883B reduction in revenues. But at what costs?
The largest impacts to the budget are those that impact insurance coverage. With 24M fewer Americans covered, Federal deficits are projected to decline by $935 billion over a 10 period.
What makes up the $935B in reductions?
Medicaid:
- Revenue: $880B in savings from undoing Medicaid expansion in future years and converting Medicaid to per capita caps with a ceiling on yearly price increases.
- Enrollment: 14 million people would lose their Medicaid coverage by 2026
Individual Market:
- Revenue: $673B in savings from removing the individual mandate and shrinking the funding available for financial assistance. However, the bill implements a new form of tax credits based on age which offsets the savings by $361B in costs.
- Enrollment: 9M people would lose their coverage by 2020, but that would begin to improve to shrinkage of only 2M people.
Employer Market:
- Revenue: Penalties for Employers and Individuals offsets savings by $209B
- Enrollment: 8M people would lose coverage from their employer coverage with the removal of the employer mandate.
Miscellaneous:
- Revenue: $33B in deficit savings from the following items:
- Funding to provide the states with funds to keep the insurance markets stable offset savings by $80B.
- Additional funding to Medicare offsets savings by $43B.
- Lastly, tax credits for COBRA and changes to tax revenue on compensation increase deficit savings by an additional $70B
- Enrollment: 24M people already do not have insurance under the ACA. This new law would increase that by an additional 28M people to equal 52M uninsured by 2026 based on CBO estimates; 16% of the population. Ironically, this was the uninsured rate prior to the ACA legislation.
The new healthcare law allows the following things:
- Health plans charging older individuals 5x more than younger/healthier ones.
- Health plans offering plans that cover less than 60% of someone’s average healthcare costs.
- Financial assistance to be based on age instead of income.
- Americans to no longer face penalties for forgoing health insurance and large employers no longer face penalties for not offering health insurance to their employees.
- The removal of people who gained Medicaid coverage from the ACA expansion after 2020.
Meet John & Jeff: A real life example
John – 21 year old than earns 26,500 per year
- Current Law: John can buy a plan that covers 87% of his healthcare costs (Gold Plan) for $5,100 per year ($425/month) on the Health Exchange. At 175% of the federal poverty level, he would receive $3,400/yr in financial assistance through subsidies ($283/month). John would owe the health plan $1,700/yr. ($141/month).
- New Law: John can buy a plan that only covers 65% of his healthcare costs (Bronze Plan) for a much lower price, $3,900 per year ($325/month) on the Health Exchange. His tax credit is now based on age, and at his age he would receive $2,450/yr in financial assistance ($204/month). John would owe the health plan $1,450/yr. ($120/month). He saves $252 a year for a plan that covers 22% less in his average healthcare costs (ie: higher deductibles). But he may have an HSA he can use to fund his deductibles to pay for healthcare costs with tax free money.
Jeff – 64 year old than earns 26,500 per year
- Current Law: Jeff can buy a plan that covers 87% of his healthcare costs (Gold Plan) for $15,300 per year (1,275/month) on the Health Exchange. It is more expensive because today health plans can charge 3x more for older individuals. However, at 175% of the federal poverty level, he would receive $13,600/yr in financial assistance through subsidies ($2,408/month). Jeff would owe the health plan the same amount as John, $1,700/yr. ($141/month) because subsidies are currently ased on income.
- New Law: Jeff can buy a plan that only covers 65% of his healthcare costs (Bronze Plan) for a much higher price, $19,500 per year (1,625/month) on the Health Exchange. It is even more expensive now because the new law permits health plans to charge older consumers 5x more than their younger consumers. However, his tax credit is now based on age, and he would only receive $4,900/yr in financial assistance ($408/month). John would owe the health plan $14,600/yr. ($1,216/month). Jeff would pay $12,900 more per year for a plan that covers 22% less in (ie: higher deductibles). But again, he may have an HSA he can use to fund his deductibles and pay for healthcare costs with tax free funds.
RINOCARE: Why the Republican Bill is “Repeal In Name Only”
President Donald Trump ran aggressively to repeal and replace the Affordable Care Act, which has come to popularly be referred to as “Obamacare”. In fact, on Donald Trump’s campaign website, his four page healthcare proposal proclaimed, “On day one of the Trump Administration, we will ask Congress to immediately deliver a full repeal of Obamacare. “
So the Republican led Energy & Commerce and Ways & Means committees have passed their respective healthcare reform bills down party lines last week. Their combined efforts have culminated into a legislation dubbed “The American Healthcare Act” and it is now viewable online at www.readthebill.gop.
As written, the current legislation is a far cry from the “full repeal” of the ACA promised by the administration. In fact, the Republican’s full strategy to implement a replacement actually uses many of the provisions passed by the previous administration.
Republicans might be able to erase Obama’s name from their new healthcare law, but the shadow of his influence still very much remains if the law is passed without any changes.
What influence? The Obama administration has successfully changed the conversation. In 2008, the debate was about the following:
- Will we cover pre-exisiting conditions?
- Will dependents up to age 26 be able to enroll on their parents plan?
- Will we eliminate lifetime caps and limits?
- Will we have a vehicle to enroll into healthcare plans nationally online?
- Will we provide financial assistance to low income individuals to purchase health coverage?
Nearly 10 years later, Republicans are guaranteeing all of these provisions at their town hall meetings and only discussing ways to make them more patient centric using market forces verse government control.
Effectively, on the road to healthcare reform, the American people are now witnessing a debate between Republicans about what color to paint the car, not whether or not if a car is the right form of transportation to get to universal access.
Thus, this legislation is RINOCARE: Repeal In Name Only.
Here are the 3 reasons why:
Reason 1: Republicans plan to use the language inside the ACA to deregulate the market.
Congressman Paul Ryan rolled out the details of the American Healthcare Act at a press conference last week. During that roll out he eluded to using the enormous power given to the Secretary of Health & Human Services to regulate the healthcare market. Those powers were established through the passing of the ACA. Rather than repealing those powers, the Republicans plan to use them in order to deregulate the market. Specifically, there are 1,442 sections or instances that give the Secretary discretion on how to administer the health care law.
Reason 2: There are many provisions that are either maintained or tweaked.
The framework of the ACA will stay in place even with the passing of this law.
Financial Assistance – The law switches financial assistance from income based to a fixed dollar amount based on age. Eligibility would be limited generally to individuals who do not have access to government health insurance programs or employer-sponsored coverage. Additionally, the law actually expands the income levels eligible for the financial assistance. Today, the ACA stops financial assistance at 400% of the federal poverty level (Roughly $45,000/per person). Under the Republican led legislation, the tax credits are eligible for Americans who earn up to $75,000/ per person and are adjusted by age:
- Under age 30: $2,000
- Between 30 and 39: $2,500
- Between 40 and 49: $3,000
- Between 50 and 59: $3,500
- Over age 60: $4,000
Individual Mandate – While the bill removes the individual and employer mandates, it actually implements a new rule in its place, that becomes a a stronger economic incentive to not only buy insurance but stay enrolled. Health plans can charge a 30% late-enrollment surcharge for consumers who have a gap in coverage that exceed 63 days. So while there is no longer a penalty for not having insurance, there is a surcharge for buying insurance two months after letting it lapse.
Patient Protections – This bill will still allow patients to purchase insurance with pre-existing conditions. The law bans lifetime limits and caps, and allow dependents to enroll on their parent’s plan up to age 26.
Market Protections – The Affordable Care Act needed to create a series of market protections to keep the Health Insurance plans in the market. Those protections included (1) risk adjustment, (2) reinsurance, and (3) risk corridors. All of these provisions provided funding and/or protections for health plans that enrolled sick patients by limiting their financial exposure. Coincidentally, under different names, those mechanisms appear to occur in this new legislation. Dubbed the “Patient and State Stability Fund”, federal funding set at $15 billion annually in 2018 and 2019 and $10 billion annually from 2020-2026 will be provided to states that can use these funds for a wide range of programs to lower patient costs and stabilize insurance markets. The law also calls for a “Default Federal Safeguard” that would allow CMS to use the funding to establish a reinsurance program with health plans in states that opted against the Medicaid expansion.
Reason 3: There is no BIG idea in this new legislation.
Congressman Ryan mentions this law is the first of three steps to replace the Affordable Care Act. The next two steps will be to use administrative action by the HHS Secretary to deregulate the market followed by passing individual bills to enhance the law (ie: buying insurance across state lines). However, at the macro level, this bill does not introduce anything that changes the way healthcare is delivered in the United States in any big way. The U.S. spends more than any other country in the world on healthcare and does not have the quality, lower morbidity levels, or the universal access to coverage to show for it. That is mainly driven by a system that rewards volume over value. The ACA introduced small pilot programs to try to change this dynamic (ie: Accountable Care Organizations). However, in the 6 years since the ACA has launched, it has not changed the way we finance healthcare demonstrably. If Republicans are serious about taking advantage of this opportunity to fix the healthcare market – this legislation or the ones to come from the Republican Party should be big and bold. It should change the way we deliver care. Here are some specific examples:
- Alter Federal funding to States for Medicaid based on state uninsured rates and nationally accepted quality metrics.
- Create a national benchmark for “true” essential health benefits tied to federal funds that only cover those minimum standards.
- Rather than penalties – provide tax incentives or earned income tax credits for not only buying health coverage but practicing healthy behaviors.
It is very disingenuous to refer to this law as “Repeal and Replace.” It is more of a “Revise & Rebuild” plan attempting to rename liberal programs with Republican ones under the guise of free-market principles. Additionally, the President’s Press Secretary compared the length of the Republican bill to the much longer ACA. One of the reasons the bill is so few pages is because it is built upon current healthcare law, much of which was passed under the ACA.
Lastly and ironically, a President that became a billionaire by putting his names on tall buildings has been reluctant to put his name on this so called Repeal and Replace legislation that will do away with the very thing that got him into the White House.