May 19, 2020
To: Members of the Governor’s Minority Health Strike Force
From: The Center for Community Solutions
Subject: Short-term recommendations to reduce the spread of COVID-19 and the disparate impact on communities of color
We are all in this together. This is only true as long as the same opportunities for optimal health and wellbeing are shared among all Ohioans, essential health care services are provided to those most in need, and those provisions are not based on our individual race, ethnicity or income. The Center for Community Solutions improves health, social and economic conditions through nonpartisan research, policy analysis, communications and advocacy. This means all of our work advances diversity, racial equity and inclusion. We have laid out the recommendations below because they will have an immediate impact on reducing racial disparities as they relate to COVID-19.
- Per the recommendation of the National Governor’s Association, it is critical to support additional federal funding for Medicaid by increasing the Federal Medical Assistance Percentage (FMAP) to at least 12 percent and maintain that level until the national unemployment rate falls below 5 percent.[i] The maintenance-of-effort (MOE) provision in the Families First Coronavirus Response Act should also be maintained.
- Increasing Medicaid support will ensure all Ohioans retain access and it will also prepare for the anticipated increase in Medicaid enrollment due to the decline in the economy. Historically, Medicaid has muted economic downturns, lessening the loss in real gross domestic product by 15 to 17 percent during the five recessions between 1969 and 1999.[ii]
- Since 2014, there have been significant increases in health coverage rates among communities of color.[iii] We don’t want to see these coverage gains reversed.
- Support Medicaid reimbursement for all members of a birth support team, including midwives and doulas.[iv] Women of color experience higher rates of maternal mortality and morbidity, but we know that these outcomes can be mitigated by the support of culturally competent birth support staff.[v]
- It is especially important in the midst of a pandemic to have people who can support moms throughout their pregnancies, who understand the unique challenges faced by those who may be required to work on the front lines of various industries that have been open throughout the health emergency.
- Assure that race and ethnicity data is fully and accurately reported in all COVID-19 data, and in the longer term, work toward that same goal for all public health and Medicaid data reported by the state. This data is imperative to inform an overall strategy.
- Examine Medicaid testing and treatment data and look for differences in race, disability and geography to get a fuller picture of disease impact and disparity. This data would then be used to target strategies to reduce any disparities.
- Assure that serological testing to determine exposure is done through sampling of the Ohio population. Ensure that there are oversamples by race and ethnicity to assure estimates can be made disaggregated by race and ethnicity.
- Launch a statewide public education and awareness campaign to reach diverse populations so they know how to access treatments and benefits to keep their families healthy and safe.Thank you for your consideration. Please contact us via our Director of Public Policy, Tara Britton, with any questions, tbritton@communitysolutions.com.
[i] “Governors’ Letter Regarding COVID-19 Aid Request.” National Governors Association, April 21, 2020. https://www.nga.org/policy-communications/letters-nga/governors-letter-regarding-covid-19-aid-request/.
[ii] “Medicaid Could Help Economy Recover During Recession, Joint Center for Political and Economic Studies, Report Says.” Commonwealth Fund. Accessed April 17, 2020. https://www.commonwealthfund.org/publications/newsletter-article/medicaid-could-help-economy-recover-during-recession-joint-center.
[iii] https://www.kff.org/disparities-policy/issue-brief/changes-in-health-coverage-by-race-and-ethnicity-since-the-aca-2010-2018/
[iv] https://comsolutionst.wpengine.com/giving-birth-social-distancing-changes-everything/
[v] https://www.who.int/reproductivehealth/companion-during-labour-childbirth/en/
