Pa.’s Casey, Senate panel explore ways to address racial health disparities for seniors

U.S. Sen. Bob Casey, D-Pa. (Screen Capture by Nick Field)

By Dan Vock

A panel of U.S. senators on Tuesday wrestled with ways that Congress could address a sobering reality of the coronavirus pandemic: that Black, Hispanic and Native American residents have been especially hard-hit by the virus, a reality that is even more pronounced among older people.

Medically, the different outcomes among racial groups is linked to the prevalence of certain underlying conditions such as high blood pressure, diabetes and obesity among people of color. But those health conditions are shaped by broader societal forces.

“The virus has become a flashpoint on racial inequities, financial inequities and social determinants of health,” Rodney Jones, the CEO of the East Liberty Health Center in Pittsburgh, told the senators. East Liberty treats 11,000 mostly low-income residents. Seventy-seven percent of them are members of a racial or ethnic minority.

“COVID-19 has exposed our health care system’s vulnerabilities and revealed our inability to respond effectively to a pandemic. It has also highlighted the fact that … older adults of color have suffered in significantly greater proportion than their white counterparts,” Jones added.

Black Pennsylvanians make up 11 percent of the state’s population, but 28 percent of its residents who have been infected with COVID-19. Twenty-one percent of Pennsylvanians who have died with the virus have been Black.

U.S. Sen. Bob Casey of Pennsylvania, the top Democrat on the committee, said the racial disparities in how the coronavirus has impacted older Americans mirrors other stark racial gaps in the country.

“Older Americans of color,” Casey said, “have spent a lifetime enduring the structural inequities of racism that has plagued our country since its inception. We must own up to that simple and shameful truth.”

The divisions run throughout American life, he noted, making it more difficult for Black residents than white residents to afford a home, feed their children, go to college, get a job or interact with police officers. Many of those disparities affect other minority groups as well.

“It is no wonder that older adults of color are diagnosed with COVID-19 at higher rates than

[white residents] and dying from COVID-19 at higher rates than [white residents],” he said.

Casey and several other senators cited a May New York Times story that found that nursing homes where a significant number of Black and Hispanic residents lived were twice as likely to have coronavirus outbreaks as homes where most of the residents were white.

More than 40 percent of coronavirus-related deaths in the country, according to the Times, have occurred in nursing homes. That’s more than 57,000 deaths. All told, 316,000 nursing home residents and staff members of nursing homes have been infected.

In Pennsylvania, 4,800 people working or living in nursing homes have died of covid-19. That’s out of a statewide total of 7,000 deaths. Nearly 18,800 residents and more than 3,600 employees have been infected.

Casey and other lawmakers on the Senate’s Special Committee on Aging discussed several potential ways that Congress could help improve the health outcomes for older Black, Hispanic and Native American residents.

The Pennsylvania senator, for example, touted the benefits of expanding Medicaid, the health insurance program run by states and the federal government that covers 64 million Americans. The federal Medicare program also covers Americans age 65 or older, but that program does not cover some key services, such as nursing home care. Two-thirds of Pennsylvania residents in nursing homes were enrolled in Medicaid, even before the pandemic started.

The Affordable Care Act that passed under President Barack Obama gave states incentives to cover more people under their Medicaid programs. After Pennsylvania expanded its coverage in 2015, more than 700,000 additional Pennsylvanians signed up for the insurance within two years. The expansion and a healthy economy drove the state’s uninsured rate to historic lows.

“Unfortunately, the pandemic is wiping away some of these hard-won gains,” Casey said Tuesday, saying that 5.4 million Americans lost their health insurance between February and May of this year. He also noted that President Donald Trump’s administration is supporting a lawsuit that could potentially dismantle the Affordable Care Act, which Casey called “unconscionable.”

Casey has repeatedly pushed to change the way that the federal government reimburses states for Medicaid expenses. He wants the federal government to pick up a bigger share of Medicaid costs when the unemployment rate in a state climbs. That would help cash-strapped states offer coverage in a recession, when their tax revenues are down but more of their residents need health coverage.

Expanding Medicaid would help health providers who care for primarily low-income patients, said Jones, the CEO of the Pittsburgh health center.

“That expanded Medicaid has given people the opportunity to seek health care as a preventative measure, not just when there’s an acute condition,” he said.

Jones also backed Casey’s proposal to automatically increase federal matching funds for states in an economic crisis. “I do not think it should take an act of Congress to make sure that states can respond to the need. I do not think that states should be allowed to cut Medicaid just when we need it,” he said.

Other senators said the federal government should do a better job of tracking the demographic data for patients with COVID-19. They stressed the need to expand telehealth options, to keep medically needy patients in touch with their doctors while avoiding the risk of catching COVID-19  at a hospital or doctor’s office. Many stressed the need to launch public outreach campaigns that would convince people, especially in minority communities, to get vaccinated if and when a coronavirus vaccine is developed.

Dan Vock is a Washington D.C.-based correspondent for States Newsroom, which supports the Capital-Star.