DC, Maryland Health Centers Win Millions from Obama Health Law Grants

By Talib I. Karim, Tech & Health Writer

DC-based Unity Health Care, a recipient of the Obama health center grants this week cut the ribbon for a $20 million health facility in Southeast, DC (Photo/courtesy Unity Health Care)

 

 

 

 

 

 

 

 

 

 

Recently, President Obama’s administration awarded grants of over $728 million for the renovation and construction of health centers around the country.  DC andMaryland centers snagged more than $15 million for projects designed to boost local government’s ability to care for low and mid-income patients while creating jobs in the process.

The funds were made possible by the Affordable Care Act, described as the President’s signature legislative achievement, currently being examined by the U.S. Supreme Court, which in weeks, is set to rule on whether the law should be upheld.

“We don’t have time to wait,” to determine how the Court will rule on the law said Cecilia Muñoz, Director of the Domestic Policy Council.  Instead, the President is moving ahead to ensure that the public enjoys all the many benefits of the landmark health reform law asserts Muñoz.

One significant benefit under health reform, carved out and championed by Congressional Black Caucus and progressives in Congress, was $11 billion for community health centers.  These facilities, located in urban and rural communities alike, are designed to offer comprehensive, culturally competent, health care services to communities and vulnerable populations that lack access to quality health care.  By definition, these centers are community-based and serve individuals and families experiencing homelessness, those living in public housing, immigrants and many others.

Over the next five years, the community health center provision of the Obama health law divides its funding up by setting aside $9.5 billion to build new or expand existing health centers, and $1.5 billion to help maintain and renovate current community health centers.

In addition to expanding health care access, the funding is also designed to create jobs, according to White House officials.  The numbers back up this claim.  The Obama Health and Human Services department reports that President’s health care law has funded as many as 190 construction and renovation projects and helped open up 67 new health center sites across the country to date.  Through 2014, the law aims to fund more than 485 new health center construction and renovation projects.  It’s predicted that in total, community health center funding will pave the way for 457,300 jobs by 2015.

When its all said and done, the $11 billion invested by the government is expected to generate $54 billion in economic activity, in two ways.  First, health centers employ people in the communities they serve, including entry-level workers taking people right off the unemployed rolls.  Second, health centers purchase goods and services from local businesses, which leads to even more job growth according to thinkprogress.org, a blog of the progressive Center for American Progress Action Fund.

An example of the direct impact of the funding on local communities can be seen in the efforts of Community of Hope, one of the six DC and Maryland non-profits winning health center grants.  Community of Hope got a half-million dollars through a grant targeting existing health centers seeking to address pressing facility and equipment needs.  With the money, the non-profit intends to invest in equipment and renovations for its newly acquired Family Health and Birth Center located at 801 17th Street, NE,  near the old Heckinger Mall said Kelly Sweeney McShane, the group’s executive director.  “We want to buy an ultrasound machine, phone system, and more exam tables,” states McShane.  “We also want to configure space [of the center] so we can see more patients…and give [patients] more privacy,” McShane adds.

And even though it’s a relatively small pool of money, McShane hopes to spend as much of it as possible with small, community based, and disadvantaged businesses.  “We’re currently taking bids for a general contractor for this project,” noted McShane.  With this and the larger multimillion 50,000 square foot facility planned for Ward 8, McShane says her group is committed to spending as much of 40% of the overall construction dollars with community-based businesses.

If the health law prevails, communities can expect another round of funding for local health centers in June.  According to the US Health Resources and Services Administration (HRSA), up to $150 million will be available to support approximately 220 new full-time service delivery site(s) for the provision of comprehensive primary and preventive health care services including oral and behavioral health services.  Groups interested in applying for health center grants can visit http://bphc.hrsa.gov/about/howtoapply/index.html.

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The writer can be reached attkarim@teclawgroup.com.

Supreme Court Weighs Health Reform Law: Poor, African Americans to be Most Impacted by Decision

(Photo/courtesy Supreme Court Collection)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 By Talib I. Karim

Contributing Health Writer

This week, the U.S. Supreme Court convened hearings to settle the question once and for all of whether the historic health reform law, the Patient Protection and Affordable Care Act, dubbed “Obamacare” by Republicans is constitutional. Supreme Court experts suggest that this case is the most significant before the Court in more than 50 years – rivaling Brown v. Board of Education – a landmark case that led to the end of legalized segregation.

Given the magnitude of the case, the Supreme Court had set aside six hours of arguments over a three day period which began on Monday, March 26 through Wednesday – more time given to any case since 1966. The justices have also postponed half of their normal monthly case load to clear way for the Court to issue a decision by as early as July. 

The case will have a significant impact on the upcoming election in November. If the Court strikes down the Affordable Care Act, it could be considered a win by Republicans who seek to unseat President Obama and take over both houses of Congress. However, if the Court allows the law to stand in whole, or in part, the president could declare his signature legislative achievement to date, a victory.

A recent report by Brown University Professor Michael Tesler makes the point what many, including former President Jimmy Carter, have long stated: much of the opposition to Obama’s initiatives like health reform has less to do with policy than with race. While Obama himself has attempted to set aside the racial dimensions of debates over health care and even the tragic killing of Trayvon Martin, Tesler’s study is clear.

“African-Americans were about 20 points more supportive of the Barack Obama [health] plan (with 80% support) than they were of the Bill Clinton plan,” said Tesler in an interview for a National Public Radio (NPR) program hosted by Michel Martin.  Yet, the divide is not simply an issue between African Americans and European Americans, Democrats and Republicans, suggests Tesler.  Instead, Tesler argues that health and other policies of President Obama are likely to be supported by people of all race who have liberal attitudes about race.

Four Separate Hearings

The reason behind the unprecedented three-day, 6 hours of oral arguments before the Supreme Court is rooted in the four separate issues being considered. Each issue is considered so unique, that the Supreme Court has afforded separate hearings for each. On Day One, lawyers were asked to debate whether the Supreme Court has the power to decide on the merits of the Affordable Care Act’s penalty for failure to get health insurance – considered a tax by some – since the fines and other sanctions don’t kick in until 2015. If the Court rules that the penalty for not getting health insurance is a tax then it could punt and put off the issue for three more years, after the presidential elections.

On Day Two, the Court requested arguments on whether the health law’s individual mandate itself is constitutional under the Commerce Clause, which allows the federal government to regulate interstate activity.

The final day of arguments focused on two questions, the first: whether the health reform law can stand even if the Court declares the individual mandate unconstitutional; the second whether the Affordable Care Act’s expansion of Medicaid to cover everyone under 133 percent of the federal poverty line [individuals with yearly earnings of about $14,000] by 2014 is too onerous.  The federal government argues that Medicaid is a voluntary grant program, thus states can opt-out if they object to the expanded coverage.

People of Color, Poor Caught in Middle

While health reform was being debated by lawyers before the Supreme Court, the nation’s top African-American physicians – members of the National Medical Association (NMA) – along with state legislators from across the country lobbied federal officials to ensure people of color are able to get their fair share of benefits.

NMA President, Dr. Cedric Bright, said people of color may likely feel the brunt of any decision. On the one hand, if the law stays intact, out of those unable or unwilling to get health insurance as mandated, Bright acknowledges that African Americans in particular may be those disproportionately required to pay the-lack-of-insurance fine [at least $695 per year by 2016]. Bright argues, that even this modest sum is a lot for “… folk with only a few dollars a month left over in their pockets.”  Bright said, “I believe an ounce of prevention is much better than a pound of cure.” He also said that the mandate is a small cost for benefits provided by health reform: billions to build community health centers, funding to address ethnic health disparities, and increased minority participation in clinical trials.

Another historic dimension of this case is the record number of legal filings [at least 170, including more than 120 "friend-of-the-court" or amicus briefs]. These briefs, or written legal arguments, are known to have great weight on the Court’s decisions, so much so that often justices quote directly from these submissions in writing their own decisions.

One such brief was filed by a coalition led by the NAACP Legal Defense Fund under the lead signature of John Payton, who was the group’s president until he died suddenly the week before the Supreme Court hearing.  In their brief, the legendary civil rights lawyer Payton and his colleagues write, “[U]ninsured persons experience significant hardship that has a profound cumulative impact on our nation….These burdens are disproportionately borne by racial and ethnic minorities, lower-income persons…For many individuals, being uninsured is not a choice, but rather is a consequence that is imposed on them due to circumstances largely beyond their control.

For the nation, and the tens of millions who benefit from the health reform law, eyes are likely to stay glued on the Supreme Court until its ruling this summer.

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The writer is a lawyer focused on health, business, and family law in the District of Columbia.  To contact the writer, email him at tkarim@teclawgroup.com.

Ending Food Deserts, Cure to DC Region’s Obesity Epedimic Say Experts

By Talib I. Karim, Esq.

Health Writer

Health advocates such as Dr. Maya Rockeymoore, PhD. suggest that understanding the connections between food deserts, what families eat at home, and obesity can reveal solutions to chronic illnesses. (courtesy/NOW)

In this season of festivities, the Washington region is awash in receptions, dinners, and other gatherings prominently featuring pork and other fatty meats, high cholesterol starches and alcohol of all varieties.

Health experts are concerned that this ritualistic feeding frenzy is a contributing factor to the increasing rates of obesity and diabetes, particularly amongst youth, African Americans, and Latinos in the nation’s capitol.

While the District’s adult obesity rate is just 21.7 percent (the country’s second lowest), when the overweight rate is combined with the rate of obesity, according to a report by the Trust for America’s Health and the Robert Wood Johnson Foundation, 54.8 percent of District residents fall within this pool.  This data also suggests that over a third of the District’s adults who are either African American or low income (earning less than $15,000 per year) are obese. Moreover, the report indicates that 1 in 5 children and adolescents in the District are obese, more than quadruple the rate two generations ago.

While the quantity of food consumed and physical exercise are major contributors to the rise of obesity in the nation’s capitol, some point to the absence of healthy food sources as a critical factor in the District’s poor health stats.

Experts such as Dr. Maya Rockeymoore, who directs Leadership for Healthy Communities, refers to the scarcity of quality foods, particularly in African American and Latino neighborhoods as “healthy food deserts.”  While a desert usually conjures up images of sand, blowing shrubs, and plains with no water, Rockeymoore and other health advocates correctly describe “food deserts” as places where fresh food (produce and meats) is difficult to obtain. However, in these same neighborhoods,fast food restaurants such as McDonald’s, Chinese carry-outs, and small convenience stores are abundant.  Rockeymoore contends these calorie-rich, but vitamin-deficient food sources in low income neighborhoods are particular contributors to the disproportionate health issues faced by residents of these communities.

A study by the U.S. Department of Agriculture found that more than 23 million Americans, including 6.5 million children, live in low-income urban and rural neighborhoods where the closest supermarket is more than one mile from their homes.

What causes food desertification?

While it would be nice to have healthy food options like Whole Foods, Wegmans, and Trader Joe’s in every neighborhood in the District, the fact of the matter is that “certain stores tend not to locate in area where they don’t believe there is adequate demand by their target customers to support them,” says Rockeymoore.

Perhaps not by coincidence, Rockeymoore’s husband, Congressman Elijah Cummings (D-MD) last year co-sponsored H.R. 4971, Greening Food Deserts Act, to encourage local agricultural production and increase the availability of fresh food in urban areas.

Such efforts by federal and local stakeholders to change the healthy food landscape can make a difference asserts Rockeymoore.

On the federal level, Rockeymoore points to the Healthy Food Financing Initiative a cornerstone of First Lady Michelle Obama’s Let’s Move! project.  In partnership with three key Departments: Treasury, USDA, and Health and Human Services, the initiative seeks to leverage public funds to support private efforts to bring healthy foods to underserved communities.  Thus far, at least one local non-profit, the Anacostia Economic Development Corporation, was awarded $800,000 to build a 20,000 square foot full-service grocery store in DC’s Ward 8.

Rockeymoore also highlights the work of the Healthy Corner Stores Network, a private coalition  dedicated to increasing the availability and sales of healthy, affordable foods through small-scale stores in underserved communities.  According to Rockeymoore, through this initiative, some DC area convenience stores have received funding to purchase refrigerators that allow them to carry and sale fresh fruits and vegetables to otherwise underserved.

The arts community also has a role to play according to Philadelphia-based  natural foods culinary consultant turned filmmaker, Joni Bishop.  Recently, Bishop produced “The Corner Store Kids,” a short documentary that reveals the connection between deplorable school lunches in inner cities and the relationship between students and the corner store.  Bishop’s next project called Get Schooled, is an initiative that seeks to inspire hip-hip artists to take charge of promoting healthy and clean eating, losing weight.

This is the type of effort that advocates like Rockeymoore believe is essential to address the healthy food deserts that permeate neighborhoods in the District, Maryland, and Virginia alike.

Rockeymoore predicts that even after the area’s new planned Walmart stores are constructed, there are still going to be a dearth of full-scale supermarkets.  Thus, she suggests innovative strategies for bringing fresh and healthy foods into food deserts such as community gardens, farmers’ markets, and mobile healthy food trucks and carts.

Perhaps this holistic approach to replacing food deserts with healthy food valleys, and making healthy eating fresh and cool, will be the right formula for ending obesity and other chronic diseases that plague African Americans and low income residents of the Washington region in the new year and beyond.

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NBA, Howard Law Journal Host Symposium Analyzing Health Reform

Congresswoman Donna M. Christensen U.S. Virgin Island

The Eighth Annual Wiley A. Branton/Howard Law Journal Symposium is sponsored by the Howard University School of Law, Sidley Austin LLP, Debevoise & Plimpton LLP, and the National Bar Association.

The working poor, the elderly, and the middle class are at the center of the healthcare debate, yet no one seems concerned about how the Health Care Affordability Act will impact these vulnerable communities.

“Can we afford it?” often dominates the discussion. “Can we afford to live without it?” some ask, while others advocate for the repeal of the new regulation.

These vulnerable communities need the protection of health care professionals, policymakers, and the courts. On November 4, 2011, the discussion will be at the forefront of the Eighth Annual Wiley A. Branton/Howard Law Journal Symposium, where more than a dozen experts will convene to give voice to these vulnerable communities.

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Friday, November 4, 2011

8:30am to 4:30pm
Howard University School of Law – Moot Court Room

Eighth Annual Wiley A. Branton/Howard Law Journal Symposium (228 kb)

 

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The keynote address will be delivered by:

Congresswoman Donna M. Christensen

 

U.S. Virgin Islands

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Other confirmed speakers are:

Vence L. Bonham, Jr. | National Institute of Health: National Human Genome Research Institute

Brietta R. Clark | Professor of Law at Loyola Law School in Los Angeles

Mary Crossley | Dean of University of Pittsburgh College of Law

Okianer Christian Dark | Associate Dean, Howard University School of Law

Lisa Ikemoto | Professor of Law at UC-Davis School of Law

Honorable Isiah Leggett | County Executive, Montgomery County, Maryland

Gwendolyn R. Majette | Assistant Professor of Law at Cleveland-Marshall School of Law

Dr. Perry Payne | Assistant Research Professor in the Department of Health Policy at George Washington University School of Public Health and Health Services and Adjunct Professor of Law at Howard University School of Law

Karen H. Rothenberg | Marjorie Cook Professor of Law at University of Maryland College of Law

Dr. Brian D. Smedley | Vice President and Director of the Health Policy Institute at the Joint Center for Political and Economic Studies

Dr. Stephen B. Thomas | Professor of Health Services Administration in the School of Public Health at University of Maryland and Director of University of Maryland Center for Health Equity

Sidney D. Watson | Professor of Law at St. Louis University School of Law

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PROGRAM

9:00 AM – Welcome Remarks

• Kurt L. Schmoke | Dean, Howard University School of Law
• Dr. Cliff L. Wood | Branton Family Representative
• Michael A. Nemeroff | Partner, Sidley Austin LLP
• Jack N.E. Pitts Jr. | Associate, Debevoise & Plimpton LLP
• Daryl D. Parks | President, National Bar Association
• Maryam F. Mujahid | Editor-in-Chief, Howard Law Journal

 

9:30 – Opening Presentation – The Current State of Health Care for Vulnerable Communities in America

• Dr. Stephen B. Thomas | Professor of Health Services Administration, School of Public Health, University of Maryland, and Director of the University of Maryland Center for Health Equity

10:00 – Panel 1: Do the Dollars Make Sense: Medicaid, Tax Exemptions, and More

• Mary Crossley | Dean, University of Pittsburgh College of Law
• Brietta R. Clark | Professor of Law, Loyola Law School in Los Angeles
• Dr. Perry W. Payne Jr. | Assistant Research Professor, Department of Health Policy, George Washington University School of Public Health and Health Services, and Adjunct Professor of Law, Howard University School of Law

11:00 – BREAK

11:15 – Panel 2: Reproductive Justice and Women’s Health Care

• Lisa Ikemoto | Professor of Law, University of California Davis School of Law
• Rachel Rebouché| Assistant Professor of Law, University of Florida Levin College of Law, and Associate Director of the Center for Children and Families

12:00 – LUNCHEON AND PRESENTATION OF THE WILEY A. BRANTON SCHOLAR AWARD • The Dining Hall

1:30 – Keynote Address

• Congresswoman Donna M. Christensen | United States Virgin Islands

2:15 – Panel 3: Falling Behind in the Race: Racial Disparities in Health Care

• Sidney D. Watson | Professor of Law, St. Louis University School of Law
• Gwendolyn Roberts Majette | Assistant Professor of Law, Cleveland-Marshall School of Law
• Vence L. Bonham Jr. | Senior Advisor to the Director on Societal Implications of Genomics at the National Institutes of Health, National Human Genome Research Institute
• Dr. Brian D. Smedley | Vice President and Director, Health Policy Institute, Joint Center for Political and Economic Studies

3:30 – Closing Presentation – The Impact of Health Care Reform on Local Governments

• Okianer Christian Dark | Associate Dean of Academic Affairs and Professor of Law, Howard University School of Law
• Honorable Isiah Leggett | County Executive, Montgomery County, Maryland

4:00 – Closing Remarks

• Aurelia Hepburn-Briscoe | Executive Solicitations & Submissions Editor, Howard Law Journal

All sessions will be held in the Moot Court Room unless otherwise indicated.

LIGHT RECEPTION TO FOLLOW
Moot Court Foyer

Health Power-Broker Series: Congressional Black Caucus Foundation Research Director Dr. Marjorie Innocent Promises that Annual Legislative Conference Will Arm Public with Truth about Health Reform

By Talib I. Karim, Esq.
Health & Law Reporter

Dr. Marjorie Innocent, Ph.D., Congressional Black Caucus’ Senior Director of Research and Programs says the CBC ALC is very rich in content and offers those interested in health care issues useful information, contacts, and other resources to advance their work. (Courtesy of Robert Wood Johnson)

This week’s Congressional Black Caucus Foundation Annual Legislative Conference or “CBCF ALC” will be the 20^th that I’ve attended/observed, and the 41st ever, the first being held in 1970, just months after my arrival, on earth that is.

It’s no coincidence that nearly 40 years to the date after the Congressional Black Caucus (CBC) itself was formed, one of its own members, Barack Obama, standing on the steps of the U.S. Capitol, would be sworn in to the nation’s highest public office.

It’s also no coincidence that two and a half years later, the ALC would focus on the center-piece of the Obama Administration’s legislative policy, health reform.

I recently discussed this year’s focus of health reform and jobs, with Dr. Marjorie Innocent, CBCF Director of Research and Programs.  A proud crisp-dressing woman of Haitian decent, raised inQueens,NY, Dr. Innocent has a B.A. in Political Science and a Ph.D. in Health Policy and Management from Columbia University and the Johns Hopkins Bloomberg School of Public Health, respectively.

Here’s what Dr. Innocent had to say:

Talib:  Dr. Innocent, first tell me, how did you get involved with championing health care issues for the CBCF?

Dr. Innocent: After finishing college, I noticed a connection between a person’s health and where they lived.  This sparked my curiosity which was quenched at Johns Hopkins where I focused on this issue as well as the benefits of school based health centers.  My work on these issues ultimately led me to the CBCF.

Talib: As people follow your lead and look to the health sector for employment opportunities, do you think it’s a good choice.

Dr. Innocent: I do.  In fact, the truth is that the Affordable Care Act provides opportunities for good paying jobs, not just for traditional health sciences professionals like doctors and nurses, but also for educators, IT specialists, and others.

Talib:  During my days as a Hill staffer helping to advance health reform, many in the CBC and Progressive Caucus argued that health care legislation was in fact a jobs bill.  So your point proves that fact.  Nonetheless, how are those seeking good paying health sector jobs helped by the President’s new $450 billion jobs stimulus package?

Dr. Innocent: While I’m still studying the President’s entire proposal, it’s clear that there are billions of dollars proposed for job training that can help the unemployed get the skills needed for them to reenter the workforce by landing the kind of good-paying jobs offered in the health sector.

Talib: With so many opportunities in the President’s health reform law, why is the public still confused?

Dr. Innocent: The CBCF is a non-partisan, non-profit organization.  Yet, it appears that certain forces might prefer to keep the public misinformed.  As a social policy think tank, it’s our role to give the public the truth, particularly the African American community.  And that’s what we’ve done with the Affordable Care Act.

Namely, we’ve published a report, Understanding Health Reform: A Community Guide for African Americans, specifically written for African Americans but designed to help all Americans understand the benefits available to them under the health reform law, as well as the law’s potential for bringing about health equity across racial/ethnic, gender, economic and geographic lines.

Talib: What are examples of some myths that your Community Guide helps to dispel?

Dr. Innocent:  First, we explain that the law does not mean that people will lose their health care or be forced to give up their family doctors, it does not impose limits on the services that people can receive, nor will it cause costs to sky rocket for businesses.  In fact, we explain that health reform is designed to give people access to care by using the latest in preventative care.  The law seeks to shift the nation’s focus from just treating people when they are sick to keeping people healthy, which will eliminate the gross burden on the nation’s limited resources.

Talib: Your Community Guide explains the many benefits of the Affordable Care Act in 50+ pages.  For our readers, what would you say is the most important opportunity for those representing underserved communities like African Americans?

Dr. Innocent: There’s really too many to quickly single out the best opportunity.  Yet, if I had to choose, I’d say the newly created National Institute on Minority Health and Health Disparities.

Talib: Right, the Institute was formerly aNationalCenter at the National Institutes of Health.  But what does this elevation mean in practical terms?

Dr. Innocent:   As a National Institute, it will have expanded research funding and will lead and evaluate NIH’s work on minority health and health disparities.  On a practical level, we now have a national resource tasked with helping health providers and organizations who have established relationships within our community to get the funding they need to better serve our community.  Some groups don’t get funding because they don’t know about the grants or cannot compete with larger applicants.  The National Institute is there to level the playing field.

The Institute can also play a pivotal role in tracking the efforts of the entire federal public health system to assess whether their efforts are effectively impacting the African American community.  If fully funded, and properly supported, over the next 15-20, we can see a dramatic change.

Talib: You’re talking about significant increases in mental and physical wellbeing, total health outcome improvements?

Dr. Innocent: Correct.

Talib: In closing, you all have several events planned next week specifically designed for those like our readers who are interested in advancing health outcomes on the local and national level.  Can you highlight them?

Dr. Innocent:   There are numerous events to attend.  I would say check out the full list to see what works for schedule.  For example, on Wednesday at 12:00, there is a Luncheon entitled “Healing Power:Community Health Centers, Prevention and Health Reform in Black Communities.”  The next day there are several other Health and Wellness events including a forum hosted by Congressman Conyers discussing what’s needed to defend and build on Healthcare Reform.  Friday also features health forums and braintrusts such as that organized by Congresswoman, Dr. Donna M. Christensen examining the Politics of Race & Health Equity.

Talib: And I’m sure we can also expect an earful on health reform from your keynote speaker for Saturday’s Phoenix Awards Dinner, President Obama. Clearly, with such probing and insightful content, the Washington Post, Huffington Post, and Wall Street Journal alike should have no problem finding hard news during the ALC to feature in the front pages of their publications.

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Medicare-Medicaid-Health Reform on Budget Cutting Block: Advocates, Docs Say Fight is On!

By Talib I. Karim, Esq., Health & Law Writer

August 16, 2011

Advocates for seniors, disabled, and the poor along with health providers are gearing up for a fight to convince Congress to protect Medicare, Medicaid, Health Reform (Photo Courtesy of AARP).

Through an 11th-hour deal, Congress recently avoided a potential “debt-magetton” — a predicted financial melt-down had the federal government defaulted on its debt by not raising its borrowing limit.

To be clear, the deal signed into law by the president on Aug. 2 contained no cuts to Medicare, Medicaid, and Social Security.  However, in exchange for the $900 billion debt-limit hike, $917 billion was axed in federal spending through capping discretionary budgets over the next 10 years.  This comes on the heels of $38 billion in federal cuts required by an earlier deal to avoid a government shutdown this spring.  While not directly affecting Medicare, Medicaid, and Social Security, these new cuts will no doubt impact health agencies responsible for critical components of social safety-net programs including the Department of Health and Human Services, the Food and Drug Administration, and the Health Resources and Services Administration (HRSA).

How Much Will it Hurt

 

The immediate cuts may be the least of worries for Medicare, Medicaid, and health reform advocates such as Dr. Cedric Bright, M.D. who leads the 30,000-member National Medical Association (NMA).  Dr. Bright is particularly focused on round two of the default-saving deal, which he fears could gut safety-net programs like Medicare and further stymie the landmark health reform law.

Under the deal-now-law, by year’s end, Congress is required to reduce the federal deficit by $1.5 trillion through one of two ways.

The first approach is via a newly formed Congressional bipartisan panel consisting of 12 members of both legislative chambers.  The special panel is charged with combing the entire federal budget to find savings and/or new revenues.  As far as cuts, even defense spending and guaranteed federal benefits (or “entitlements”) such as Medicare and Medicaid (long regarded as “sacred cows”) are on the chopping block.  Analysts with the law firm of Patton Boggs expect a Supercommittee deal to be painful for the nation’s health system.  “[Reductions] that would produce significant savings, including cuts to graduate medical education programs, home health providers, labs, rural hospitals, Medigap and Medicaid,” are likely targets for the budget-ax according to a Patton Boggs client update.

If this new committee cannot reach a consensus on at least $1.2 trillion in additional debt reductions by November 23 or if Congress does not approve a package recommended by this committee within 30 days later, a trigger automatically kicks in to guarantee the $1.2 trillion in federal deficit savings.  This mechanism, in the form of a federal sequestration process, would amount to across-the-board cuts in defense and non-defense spending over the next decade.  Included in these cuts would be a two-percent reduction in Medicare health provider payments.  Medicaid would not be affected by the trigger.

The president and some Congressional Democrats hope to avoid the cuts-by-trigger because the required deficit reductions would completely shield the wealthy from new taxes, which President Obama has spoken out against as he campaigns for re-election.

Similarly, Republicans don’t see the trigger as the ideal solution as it portends deep cuts to the military, the most significant since before the Bush presidency.  Sen. John McCain (R-AZ), the top Republican on the Senate Armed Services Committee described the possible military sequestration as “extraordinarily difficult.”

However amongst Progressives who generally opposed the deficit-deal, some such as Robert Creamer who writes for the blog Americans Against the Tea Party, suggest that the triggered cuts may be preferable to a supercommittee plan that could weaken  Medicare and similar programs.

Health Reform, Medicare Doctors in Bullseye of Budget Cutters

Either path to federal budget austerity threatens health care reforms created by the Obama Administration’s prized achievement, the Affordable Care Act.  Both deficit reduction approaches could zero-out funding for key health reform programs such as those supporting disease control efforts, initiatives to increase physicians of color, and aid for state health insurance exchanges.  At least two health reform programs have already been scrapped, a win for conservatives who have made the reforms their top legislative target.

Health providers are also caught in the cross hairs of both deficit reduction paths.  According to NMA’s Dr. Bright the anticipated reductions in health provider fees are “a double-edged sword” in light of the 29.5 percent Sustainable Growth Rate (SGR) formula’s cuts to Medicare physician payments set to kick in on January 1, 2012.  The NMA and others are working to include a full repeal of the SGR in the next budget deal, yet such a proposal would require $300 billion in offsets elsewhere.

The Fight for Medicare, Medicaid, Health Reform is On!

With the battle lines drawn between conservatives—set on dismantling Medicare and other safety-net programs and outright killing health reform initiatives—and care providers, progressives who see the nation’s growth and prosperity rooted in the health and well-being of its people, observers expect a huge fight in Washington over the next few months, with millions being spent to sway Congress in one direction or another.

And if the conservatives win, seniors and the nation as a whole will lose, “[because] doctors simply wont be able to afford to treat them…and the adage of cutting off our nose to spite our face could become a reality,”  says the NMA President Dr. Bright.

Profile of Health Industry Power-Broker: Dr. Cedric Bright, NMA President

By Talib I. Karim, Esq., Health & Law Reporter

Dr. Cedric Bright, MD, Assistant Dean for Admissions at University of North Carolina recently assumed the post as the 112^th President of the National Medical Association(NMA).  Dr. Bright spoke with me about the ongoing relevance of NMA and the group’s fight to protect Medicaid and Medicare, which he describes as “products” of the NMA.

The NMA has just wrapped up its annual convention in Washington, which I found quite informative.  From here, what are the top challenges facing the NMA today?

I would rank our challenges as follows: (1) the possibility of cuts to Medicare and Medicaid funding, (2) opposition to fully funding key provisions of the Affordable Care Act, the result of which would prevent those eligible for free health insurance from getting the care they need, particularly those who lose their jobs; and (3) cardiovascular disparity.

What’s cardiovascular disparity?

In 1999, the Institutes of Medicine reported that African Americans with similar health insurance as those from other ethnic groups received unequal health treatment.  One of the most egregious disparities identified was in the outcome of cardiovascular patients based solely upon their race.  Our goal is to decrease and eventually eliminate the gap of health outcomes between [European-American] and underrepresented [African American] populations.

In this environment of budget-tightening and consolidation, has there been any thought for a merger of NMA with other African American health professional organizations to expand your political and economic power?

We have explored such collaborations, but we’ve not yet been able to come to a mutually beneficial agreement.  However, many of our NMA local societies are mixed societies.

In my hometown, I’m a member of the Durham Academy of Medicine, Dentistry, and Pharmacy.  On the local level you see the value of combined economic and political power; it’s my hope to expand this collaboration on the national level.  For now, there’s nothing to stop us from collaborating with other African American health professionals to construct a common health agenda for our community.  That’s something that I would like to see during my presidency.

Some have asked whether African American organizations remain relevant in this era of the Nation’s first African American President, why should a young physician out of medical school join the NMA and is your organization still relevant?

Relevance is demonstrated in that we still have health disparity, which doesn’t dissipate based upon income.  You can have the same health insurance but different outcomes from your colleague who does not look like you.

In addition, the medial profession is still fraught with institutional barriers that impact the development of African American physicians.  Evidence of this is found in the number of professors in academic medicine, compared to the junior faculty (assistant professors and clinical assistants) who are unlikely to be promoted.  Let’s also look at health care professionals in administrative positions in hospitals, the number continues to hold stagnant and has not grown.

It’s a fact that 70% of successful Black physicians face a challenge in their careers that jeopardize their ability to practice their profession.  From frivolous law suits to sham peer reviews.

Third, look at our economic condition, which is connected to our health condition.  A recent PEW study showed that in 2004, net worth at of white families stood at $134,000, compared to $12,000 for African Americans.  By 2009, the average net worth of the white family dropped to $113,000 and the black family dropped to $5600, Latinos fared a bit better at $6300.  For every one dollar in net worth black household had $.05.

Even with a Black President we still are economically disadvantaged and your wealth is determinative of your health.  Your zip code can tell more about your life expectancy than your genes.

The NMA was founded in 1895, what accomplishments stand out most over its history?

By far, it’s our role in establishing Medicaid and Medicare 46 years ago.  The NMA lobbied LBJ [President Johnson] for these initiatives when other professional organizations lobbied vehemently against them.  We understood the value in taking care of our seniors and other vulnerable populations understanding the strength of a nation is only as strong as its weakest links.

What legacy do you intend to leave from your term as President?

I hope to leave a legacy of expanded collaborations between the NMA and other African American health organizations and to bridge gaps between the generations.  I gave a lecture to the Student National Medical Association.  I asked the students how many had to drink from a white-only water fountain.  My generation’s realization that we were different from our white colleagues served as the tie that bound us.  That’s not the tie that binds this new generation of physicians.

We have to build relationships with younger professionals so when they start to be affected by professional barriers they will view NMA as a source of advocates and champions.

Dr. Cedric Bright, serves as Assistant Dean for Admissions at University of North Carolina and also leads 30,000 African American physicians as the newly inducted President of the National Medical Association (courtesy)