The report, titled Healthcare and Racial Justice: Systemic Change Is Needed for a More Equitable Health System, compiles national and New York State level data to illustrate that healthcare access is a critical racial equity issue and how systemic solutions like a universal, single-payer health plan will significantly improve healthcare access and health outcomes for all. The report found that Black, Indigenous and People of Color (BIPOC) were disproportionately harmed by COVID-19 due to an unequal ability to access quality, affordable healthcare and long before the start of the pandemic, were more likely than white people to be uninsured and to struggle with medical costs.
The Campaign for NY Health and the Black, Puerto Rican, Hispanic and Asian Legislative Caucus released this report together on May 4, 2022.
The New York State Black, Puerto Rican, Hispanic, and Asian Legislative Caucus is a sixty-six-member body of state legislators representing a quarter of residents across the State of New York from Long Island, the metro New York City area, and upstate.
Download the Report Healthcare and Racial Justice: Systemic Change Is Needed for a More Equitable Health System
Download the Executive Summary
Use the Social Media Toolkit for the report.
See coverage from Politico here, amNY here and WSHU Long Island here.
Watch the livestream of the Black, Puerto Rican, Hispanic and Asian Legislative Caucus and Campaign for NY Health press conference releasing the report May 4, 2022.
KEY FINDINGS
Black, Indigenous and People of Color (BIPOC) were disproportionately harmed by COVID-19 due to an unequal ability to access quality, affordable healthcare and long before the start of the pandemic, were more likely than white people to be uninsured and to struggle with medical costs.1
Black Americans are 10% less likely to hold employer-sponsored health coverage than their white counterparts. Having high-quality health insurance is directly related to whether patients seek care.
Many BIPOC work and live in environments that impose higher risks of exposure to COVID-19. Only 17% of Latinx workers and 20% of Black American workers have jobs that permit working remotely, while 30% of white workers can do so.
The U.S. has the highest maternal mortality rate in the industrialized world. Black women are three times more likely – and in New York City, 12 times more likely – to die from a pregnancy-related cause than white women. 63% of these deaths are preventable. Uninsurance and under-insurance are major drivers of the U.S. maternal and child mortality rate.
Public health insurance programs play a major role in providing affordable care and better outcomes, especially for Black Americans.
Insurance coverage increases access to care, but being enrolled in an insurance plan does not guarantee timely care or affordability. Nearly half (46%) of insured adults report difficulty affording their out-of-pocket costs and one in four (27%) report difficulty affording their deductible. About 6 in 10 Black and Hispanic adults (58% each) report delaying or skipping at least one type of medical care in the past year due to cost, compared to half (49%) of white adults. Differences in reimbursement rates between private insurance and public insurance create a disincentive for providers to see lower income patients.
Having health insurance lowers the likelihood of medical debt and the amount owed but even households with health insurance are at risk of incurring medical debt. 17.4% of households with insurance have medical debt compared to 27.9% of households without insurance. Among those with debt, households with health insurance have an average of $18,827.25, while households without health insurance have an average of $31,947.87.
Black households are more likely to hold medical debt. 27% of Black households hold medical debt compared to 16.8% of non-Black households. Medical debt can appear on a person’s credit reports and lower their credit scores, reducing access to credit and making it harder to find a home or a job.
Communities with majority Black and Latinx residents experience provider shortages more than other communities all over the country. Unequal reimbursement rates lead to disparities in access to hospitals and providers.
Polling consistently shows that voters across race and party lines support systemic change to address shortcomings in the healthcare system. New York voters overwhelmingly see government as the key stakeholder that should act to address health system problems and support measures to make healthcare affordable and accessible.
CONCLUSION
A universal system of publicly-funded, guaranteed healthcare, often referred to as “single-payer healthcare,” is the most equitable and affordable way to achieve comprehensive coverage for all. Universal single-payer healthcare will end the burden of medical debt that disproportionately harms BIPOC communities by eliminating cost-sharing – the out-of-pocket costs such as copays that act as financial barriers to care. Bringing all residents into a single public plan would eliminate the inequity in access that results from a fragmented system. Campaign for New York Health recommends universal single-payer healthcare as a policy intervention to create a health system that promotes racial equity and quality care for all.
##
By sharing our personal stories struggling to get care in the current system, we let others know they are not alone. This is not a personal failure on their part, but rather a systemic problem. We need to join together to build the political will to change the system. Please share your story with the Campaign for New York Health in order to shine a light on the need for a universal healthcare system that guarantees care for all of us. A system where no one is left behind.
“The New York State Constitution directs me as an elected official to work to protect and promote the health of our state’s residents. That is why I am a proud cosponsor of the New York Health Act. As the Chair of the Black, Puerto Rican, Hispanic, and Asian Legislative Caucus, I know that it is imperative we pass this piece of legislation that will ensure that the most vulnerable New Yorker’s are given access to healthcare services which will provide substantial support to children and families, especially in Black, Latino, Asian, and Indeginous communities.” said Assemblymember Michaelle Solages, Chair of NYS BPHA Legislative Caucus.
"If we are to effectively address the racial inequities prevalent throughout our healthcare system, we must radically change the way we deliver healthcare to New Yorkers," said State Senator Gustavo Rivera. "As the Campaign for New York Health's new report further highlights, it is critical that we pass the New York Health Act to guarantee comprehensive healthcare coverage to all New Yorkers and in that way, move the needle forward to eliminate our de facto two tier system of care and truly improve our State's health outcomes as a whole."
Senator Luis Sepúlveda said, “We have to pass the New York Health Act. It's a social justice issue, we clearly see how disadvantaged communities are the ones who pay the highest costs of inequality. Latinos, Blacks, women, it is always the same groups of people who have to bear the burden of needs and lack of services. In this case we are talking about a basic right: health. Study after study we see how prevention and health coverage has a positive effect in our communities and in the life of any human being. However, we also have to see how study after study it is the vulnerable communities that suffer the most for not being covered, not being able to pay for health insurance and in the specific case of the studies that concern us here, they are the ones that have the most economic debt for the mere fact of wanting to take care of their health. I support this initiative and I will be mobilizing myself to achieve the passage of the New York Health Act”
“As the newly released report from the Campaign for New York Health makes clear, our state’s health care system needs to prioritize BIPOC individuals who disproportionately lack access to essential services. By providing comprehensive health coverage for all New Yorkers, the New York Health Act will improve health outcomes across all communities. I am proud to support this legislation and advocate for equitable solutions to systemic health care issues this session. Without fundamental changes in our health care insurance system, we cannot provide health care as a right to every New Yorker,” said Senator Jeremy Cooney.
“With the impending overruling of Roe Vs. Wade, New York must be an access and haven state for all who need healthcare and need to see a provider here. This makes passing the New York Health Act and getting to single-payer healthcare more crucial than ever because it is communities of color that will most disproportionately suffer these consequences. I’m proud to stand with my colleagues in the Black, Puerto Rican, Hispanic, and Asian Caucus to clearly state that single payer healthcare is a racial justice imperative and we must pass it this session,” said Assemblymember Jessica González-Rojas.
“As a Black mother, I am too familiar with the obstacles so many women like me face, particularly around maternal healthcare in this state, and broadly this country. BIPOC communities battle our medicare system daily to obtain basic care. It is imperative that we end medical debt and call upon the state to institute universal healthcare. It is truly an injustice that so many people of color, economically challenged families and immigrant populations suffer from insufficient healthcare due to lack of insurance and medical care debt. It’s beyond time to bring humanity to the healthcare policies in our system and absolve medical debt today. Healthcare is a human right.” said Assemblymember Stefani Zinerman.
“Decades of inequitable care and resources across the state of New Work have come to shape the harsh reality of our current healthcare system. Overpriced medical bills and mounting debt discourages members of our community from seeking medical coverage. People of color are especially vulnerable and are disproportionately affected by the lack of quality and affordable care. By creating obstacles to meaningful services and resources for those most in need of care, we further perpetuate illness and the trauma we see on a daily basis within our communities. The reality is many of New York’s residents simply cannot afford to be sick. Establishing guaranteed healthcare systems will allow us to make lasting coverage available for our most vulnerable residents and families. I stand with my state colleagues in calling for the passage of the New York Health Act and End Medical Debt bills to create an adequate, equitable system for the people of New York. We must demonstrate our commitment to the welfare of our communities.” said Assemblymember Demond Meeks.
"As a nurse, a mother, and a black woman, I am all too familiar with the racial inequalities in our healthcare system. These inequalities often lead to preventable deaths in black communities, where the maternal mortality rate is three times higher than in white communities. We have the right to free, high-quality healthcare. The fact that reproductive healthcare is under attack right now makes our fight even more urgent. The legislature must take action to pass the New York Health Act now." said Assemblymember Phara Souffrant Forrest
“Healthcare in the United States has left a detrimental effect on minority and people of color communities and families from the accumulated medical debt and increasingly expensive costs. Many of these communities are not financially excelling; therefore, many of them can be in life or death situations and will avoid medical help altogether because they can not afford it. Numerous African Americans and people of color communities are not getting the proper support they need from their healthcare providers like their fellow counterparts. This is a result of inequitable coverage afforded. Many can not access health insurance for various reasons (related to being unemployed, being formerly incarcerated, and so forth), or they do not have the sufficient funds left over to pay any medical bills. Overall, healthcare is a human right and therefore is essential to continue to move more toward a public health system like the New York Health Act. The New York Health Act will ensure that all New Yorkers receive high-quality healthcare and all people have access to health insurance regardless of their economic status and racial background." said Assemblymember Khaleel M. Anderson.
"Our healthcare system is not working for communities of color, including the one I represent in Upper Manhattan. I have one of the country's top hospitals in my district, yet my constituents still struggle to access and afford vital healthcare services. We need the New York Health Act to limit inequities and create a more just healthcare system," said Assemblymember Manny De Los Santos.
"Eight years ago, I had to file bankruptcy in order not to lose my home because of mounting medical bills, while on short term disability for having had two different surgical interventions on my back, consequences of the toll my work as a nurse has taken on my body. I'm sure I don't have to tell any of you about the long-term effect bankruptcy is having on this Black woman's ability to be considered to have credit in good standing. I have many family members who have lost a limb or two because they can't or couldn't afford medical care, or they have died, much too soon, because they were among those who fall through the large fissures in our current healthcare system. Low-income individuals and families are unable to participate in preventative care under our current system. The wealth and prosperity of our country has been built on the backs of the impoverished and less fortunate, who are contributors to our tax system. The least our country and the state of New York should offer them is affordable healthcare for their contribution to our prosperity. A Single Payer system is a big step in the right direction.” said Tonia Bazel RN, New York State Nurses Association, Infectious Disease Unit
"The examples of structural racism in our healthcare system documented in this report are appalling, but not surprising. This deep inequity won't be fixed by tinkering around the edges of health policy. It's time for policymakers who care about racial justice and equity to take bold action. As long as healthcare is treated as a commodity rather than a right, BIPOC, disabled, poor and other marginalized communities will have less access and worse outcomes. We can't accept this. We need the NYS legislature to pass the NY Health Act to finally guarantee healthcare for all,” said Rev. E. West McNeill, Executive Director, Labor-Religion Coalition of New York State
“The COVID pandemic has not only revealed how broken our current system of healthcare is, it has also made clear how people of color are especially vulnerable in our current system run by predatory private insurance companies. Healthcare inequity is a form of racial injustice, and the only way to fix this is to transform our system to guarantee healthcare as a right by passing the New York Health Act,” said Brahvan Ranga, Political Director, For the Many.
“We welcome New York’s rededication to securing health equity for all its residents,” said Elisabeth Benjamin, Vice President, Health Initiatives of the Community Service Society of New York and co-founder of Health Care For All New York. “This valuable report reveals that the surest mechanism for redressing the many facets of disparities—uninsurance, underinsurance and unequal funding for our health safety net—is the New York Health Act.”
“Access to health care should be a right not a privilege. As we continue to battle the effects of a public health crisis, we must pass policies that ensure that all New Yorkers are able to receive the treatments that allow everyone to live with inherent dignity and respect”, said Ivette Alfonso, Citizen Action of New York State Board President. “Black, Indigenous, and People of Color (BIPOC) communities continue to bear the burden of a health care system that prioritizes profits over people. We call on the legislature and the Governor to pass the New York Health Act this session in order to guarantee that everyone is able to receive the care they need, not just the privileged few.”
"Healthcare inequity based on structural racism resonates with community members of the Northwest Bronx Community and Clergy Coalition where health outcomes have consistently been at the bottom-- #62 out of 62 counties in the state. For years, our membership of 5,000 throughout the Bronx have been engaged in campaigns to address the disparity of healthcare in the Bronx. COVID 19 has had a particularly significant impact on our community based on these pre-existing inequalities. We believe a universal guaranteed healthcare system as proposed in the New York Health Act would address some of the structural racism embedded in today's healthcare system and had it been in place, COVID 19 impact to the Bronx community would not have been as bad,” said Roberta Todd, Health Justice Organizer Northwest Bronx Community and Clergy Coalition
"The evidence shows that public health insurance is crucial to providing better healthcare in particular for people of color. There is no racial equity or justice without high quality, affordable healthcare, regardless of employment status. No one should have to deal with the burden of medical debt, or be unable to see a doctor because of the community they live in. And yet this is the reality for many, especially Black and Latinx New Yorkers. The NYC Democratic Socialists of America stand firm in our position that this means there is no racial justice in New York without passing the New York Health Act." said Maia Roseberg, Communications Coordinator, NYC Democratic Socialists Healthcare Working Group.
“Black and Brown birthing people have been dying at a higher rates than their White counterparts since American chattel slavery. Studies have been done and done and done again, yet solutions sit silently in plain sight, blocked by those who benefit by maintaining the status quo. Join Niecy’s Purple Heart Foundation to get informed about the health disparities facing Blck and Brown birth people and to demand lawmakers pass the New York Health Act!” said Charlene Magee, Founder, Niecy’s Purple Heart Foundation.
Racial disparities in health services are another way that racism affects the health of communities of color. This has been magnified by COVID-19. Public health insurance programs play a major role in providing affordable care and better outcomes, especially for Black Americans. Comprehensive, quality, and affordable healthcare must be a legislative priority. ALAA, along with the Campaign for New York Health, join the Black, Puerto Rican, Hispanic and Asian Legislative Caucus to urge our legislative leaders to bring the New York Health Act to a vote this session. Lisa Ohta, President of UAW Local 2325 - Assoc. of Legal Aid Attorneys
"The New York State Legislature and Governor have the responsibility to work with communities to fix the root causes of systemic inequality. I can only think that ensuring passage of the NY Health Care Act and End Medicaid Debt Bill package is part of that fundamental change needed to advance equity. A genuine difference will be made where our health care system is not divided among those who receive public or private medical care and those who cannot access health services. The fight against access barriers and structural and systemic racism will remain. But it would be so wonderful if we address the problem of a for-profit system that decides who can have coverage or not to the billing tactics that are inflicting harm on patients. All too often lands harder on Black, Latinx, API, and Indigenous communities --only serves to heighten health disparities and create structural barriers to accessing available and affordable health care services," states Anthony Feliciano, Director for the Commission on the Public's Health System.
“Mekong NYC supports universal healthcare as a racial equity policy and urges legislative leaders to pass this bill this session. We truly believe the New York Health Act addresses a vital need and issues impacting all communities of color. We have seen how COVID19 and this ongoing pandemic ravage through our Southeast Asian immigrant and refugee community. This highlighted social and economic inequities that have long existed before the pandemic, lack of access to food, housing, healthcare, and other essential resources. Universal healthcare is a human right and no one should be denied, fear of accessing healthcare, no should ever be burdened by the cost of healthcare or having to choose between having a meal for their family or paying for needed prescriptions. We need Universal healthcare. We need our elected and legislators to pass the New York Health Act.” said Khamarin Nhann, Campaign Director, MEKONG
“The New York Health Act would end the chaotic medical care system that people with disabilities are all too familiar with and its multiple uncoordinated programs, restrictive networks and formularies, deductibles and copays which can function as barriers to care. We are pleased to be able to support the New York Health Act, A6058 (Gottfried)/S.5474 (Rivera), since its comprehensive benefits now include long-term care, as well as primary and preventive care, prescription drugs, laboratory tests, rehabilitative and habilitative care, dental, vision, and hearing.” said Heidi Siegfried, Esq., Director of Health Policy, Center for Independence of the Disabled, NY
“As a patient-led organization that is dedicated to addressing and overcoming social and racial inequities and health disparities through effective advocacy, we strongly support universal healthcare, especially since lupus disproportionately impacts communities of color,” stated Kathleen A. Arntsen, President & CEO of Lupus and Allied Diseases Association. “We must make healthcare more accessible and affordable by classifying it as a basic human right and not as a benefit of employment.”
“New Yorkers are depending on our legislature to put people over profits of private insurance companies and pass the New York Health Act. Yet another study shows how people of color suffer because our leaders fail to give us the universal health coverage we all deserve. How many studies showing the administrative waste and inequity of our healthcare funding do we need for state government to act and pass the New York Health Act?” said Dr. Sunny Aslam, Chair, Physicians for a National Health Program, CNY Chapter
“Our city of Syracuse, which has the highest rates of child and family poverty of any city in the nation, has racial disparities in health care access and outcomes chiseled into the city’s segregated built environment. On one side of Interstate 81 is SUNY Upstate Medical University. On the other side is Pioneer Homes, the state’s oldest public housing project. Pioneer Homes and the surrounding Black community can see Upstate University Hospital just across the interstate, but many residents cannot access its medical services. The rate of health insurance coverage in Black Syracuse is half that of white neighborhoods, while the death rates from asthma, strokes, diabetes, and cancer are double the rates in white neighborhoods. The death rates from Covid-19 in Black Syracuse has been three times the rate in white neighborhoods. 48% of Black Syracusans die before age 65, compared to 18% of white residents. To close these racial inequities without delay, Syracuse needs state legislators to provide universal health care by enacting the NY Health Act in this session.” Howie Hawkins, Chair, Green Party of Onondaga County.
“Universal access to high quality health care is the essential cornerstone to a just, moral, and equitable society.” Robert M. Hayes, President/CEO, Community Healthcare Network
"We believe all New Yorkers deserve to be healthy. Medicaid Matters supports the New York Health Act because access to coverage is the way to make sure that happens. It is time to recognize access to health care is a basic human right," said Lara Kassel, Medicaid Matters.