Bill Overview
Title: Health Equity and Accountability Act of 2022
Description: This bill directs the Department of Health and Human Services (HHS) and others to undertake efforts to reduce health disparities. For example, the bill (1) requires more detailed reporting of demographic and health disparities data, including related to public health emergencies; (2) directs certain components of HHS to support health workforce diversity; and (3) increases access to culturally and linguistically appropriate health care. The bill also modifies eligibility and other requirements for Medicare, Medicaid, private health insurance, nutrition assistance, and other programs to reduce health disparities among vulnerable populations. The bill includes specific provisions with respect to noncitizens; maternal, infant, and child health; mental and behavioral health; specified conditions that disproportionately affect racial and ethnic minority groups, such as certain cancers, HIV/AIDS, kidney disease, and diabetes; investments in communities facing health and other inequities; and nondiscrimination in the provision of services in federally supported health programs. Additionally, the bill (1) revises health information technology programs to address health disparities, and (2) supports health impact assessments and other efforts pertaining to environmental justice and social determinants of health (i.e., nonmedical factors that influence health outcomes, such as income and educational attainment). The bill also requires various studies and reports on issues related to health care and health disparities, including a report by the Government Accountability Office on health workforce diversity.
Sponsors: Rep. Kelly, Robin L. [D-IL-2]
Target Audience
Population: People experiencing health disparities, especially in racial and ethnic minorities
Estimated Size: 100000000
- The bill targets health disparities, which tend to affect racial and ethnic minority groups disproportionately worldwide. This could involve extensive populations given the global incidence of inequality.
- By including noncitizens, it reflects potential impacts on global migration populations in addition to U.S.-based immigrants.
- Globally, conditions disproportionately affecting racial and ethnic minority groups include cancers, HIV/AIDS, kidney disease, and diabetes, which can affect millions globally.
- Investments in communities facing health and other inequities indicate a broad target, as these communities exist in every country.
Reasoning
- The policy is designed to reduce health disparities with a particular focus on racial and ethnic minority groups, maternal, infant, and child health, and chronic conditions that disproportionately affect these populations.
- Given the budget constraints, not all aspects of the policy will be implemented simultaneously or nationwide, so the impact may vary significantly based on geography and individual circumstances.
- The policy's effects will likely be seen in improved access to healthcare, better representation in health workforce diversity, and reduction in discriminatory practices within federally funded healthcare programs.
- A variety of scenarios should be presented to reflect individuals who are directly impacted by the policy and those who are marginally or not impacted to get a comprehensive picture of its implication across different demographics.
- Considering the diverse nature of the U.S., some individuals in rural areas or those not part of the minority groups might not perceive a direct impact from the policy.
Simulated Interviews
Community Health Worker (Los Angeles, CA)
Age: 42 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 20.0 years
Commonness: 15/20
Statement of Opinion:
- I hope the policy brings more healthcare access to Hispanic communities.
- Diversity in healthcare is crucial because we often lack representatives who understand our cultural needs.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 6 | 5 |
| Year 3 | 7 | 5 |
| Year 5 | 7 | 5 |
| Year 10 | 8 | 5 |
| Year 20 | 9 | 5 |
Retired (Houston, TX)
Age: 65 | Gender: male
Wellbeing Before Policy: 6
Duration of Impact: 20.0 years
Commonness: 12/20
Statement of Opinion:
- I've faced discrimination when trying to access healthcare services.
- Changes in Medicare could finally make healthcare easier and more affordable for multigenerational families.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 7 | 6 |
| Year 3 | 7 | 6 |
| Year 5 | 8 | 6 |
| Year 10 | 8 | 6 |
| Year 20 | 8 | 6 |
Primary School Teacher (Phoenix, AZ)
Age: 33 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 20.0 years
Commonness: 10/20
Statement of Opinion:
- I'm particularly concerned about maternal health and how it impacts our future generations.
- I'm hopeful for improved outcomes with culturally appropriate practices.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 8 | 6 |
| Year 3 | 8 | 6 |
| Year 5 | 8 | 6 |
| Year 10 | 8 | 6 |
| Year 20 | 8 | 6 |
Software Engineer (New York, NY)
Age: 29 | Gender: male
Wellbeing Before Policy: 8
Duration of Impact: 0.0 years
Commonness: 15/20
Statement of Opinion:
- I don’t think this policy will change much for people with private insurance.
- It's essential for resources to be directed towards underserved communities.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 8 | 8 |
| Year 2 | 8 | 8 |
| Year 3 | 8 | 8 |
| Year 5 | 8 | 8 |
| Year 10 | 8 | 8 |
| Year 20 | 8 | 8 |
Nurse (Atlanta, GA)
Age: 50 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 15.0 years
Commonness: 13/20
Statement of Opinion:
- This policy could really aid in resource allocation to underserved areas and improve health equity.
- We need more health programs that address chronic conditions like mine.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 6 |
| Year 2 | 7 | 6 |
| Year 3 | 7 | 6 |
| Year 5 | 7 | 6 |
| Year 10 | 8 | 6 |
| Year 20 | 8 | 6 |
Construction Worker (Chicago, IL)
Age: 58 | Gender: male
Wellbeing Before Policy: 5
Duration of Impact: 20.0 years
Commonness: 14/20
Statement of Opinion:
- I hope the changes to Medicaid will cover more of my medical expenses.
- It’s about time attention is brought to communities like mine.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 6 | 5 |
| Year 3 | 7 | 5 |
| Year 5 | 7 | 5 |
| Year 10 | 8 | 5 |
| Year 20 | 8 | 5 |
Retired Nurse (Miami, FL)
Age: 68 | Gender: female
Wellbeing Before Policy: 7
Duration of Impact: 20.0 years
Commonness: 11/20
Statement of Opinion:
- Breast cancer services need more proactive approaches in minority communities.
- The health care system should better recognize cultural differences.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 8 | 7 |
| Year 2 | 8 | 7 |
| Year 3 | 8 | 7 |
| Year 5 | 9 | 7 |
| Year 10 | 9 | 7 |
| Year 20 | 9 | 7 |
Unemployed (Detroit, MI)
Age: 45 | Gender: male
Wellbeing Before Policy: 4
Duration of Impact: 20.0 years
Commonness: 9/20
Statement of Opinion:
- Access to healthcare has always been difficult due to my immigration status.
- I am optimistic that changes will better recognize and serve people with chronic conditions.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 4 |
| Year 2 | 6 | 4 |
| Year 3 | 6 | 4 |
| Year 5 | 7 | 4 |
| Year 10 | 7 | 4 |
| Year 20 | 8 | 4 |
Environmental Scientist (Seattle, WA)
Age: 39 | Gender: female
Wellbeing Before Policy: 7
Duration of Impact: 10.0 years
Commonness: 7/20
Statement of Opinion:
- Environmental justice is key to improving health in communities across America.
- The policy has to address these systemic issues for true health equity.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 7 |
| Year 2 | 7 | 7 |
| Year 3 | 7 | 7 |
| Year 5 | 7 | 7 |
| Year 10 | 8 | 7 |
| Year 20 | 8 | 7 |
Medical Student (Boston, MA)
Age: 32 | Gender: male
Wellbeing Before Policy: 7
Duration of Impact: 15.0 years
Commonness: 10/20
Statement of Opinion:
- As a future doctor, workforce diversity is critical for better patient care.
- I hope this policy encourages more students like me to pursue medicine.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 7 |
| Year 2 | 7 | 7 |
| Year 3 | 8 | 7 |
| Year 5 | 8 | 7 |
| Year 10 | 9 | 7 |
| Year 20 | 9 | 7 |
Cost Estimates
Year 1: $1500000000 (Low: $1200000000, High: $1800000000)
Year 2: $1550000000 (Low: $1250000000, High: $1850000000)
Year 3: $1600000000 (Low: $1300000000, High: $1900000000)
Year 5: $1650000000 (Low: $1350000000, High: $1950000000)
Year 10: $1800000000 (Low: $1500000000, High: $2100000000)
Year 100: $1800000000 (Low: $1500000000, High: $2100000000)
Key Considerations
- High initial costs with potential for future savings and GDP growth through improved public health.
- Ensuring appropriate funding and oversight for program implementations to maximize efficacy.
- Balancing short-term fiscal impacts with potential long-term economic benefits and improvements in public health equity.