CHC Follows Up with HHS on Lack of ACA Hispanic Outreach Plan
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October 31, 2017
WASHINGTON, D.C. – Congressional Hispanic Caucus (CHC) Chairwoman Rep. Michelle Lujan Grisham and CHC Health Task Force Chair Raul Ruiz (CA-36) sent a follow-up letter to Acting Secretary of U.S. Department of Health and Human Services (HHS) Eric D. Hargan. The letter calls on the Acting Secretary to address the lack of outreach to Latinos in preparation for the Open Enrollment period, request an urgent meeting, and offer recommendations to ensure a successful enrollment process, which starts on November 1st.
As Members write in the letter, "While this urgent meeting request is processed and scheduled, we also want to provide you the following recommendations to support the successful implementation of the Affordable Care Act (ACA), including the upcoming Open Enrollment period. The ACA has resulted in historic coverage gains for the Latino community, providing over four million Latinos with access to health coverage, and lowering the overall Latino uninsured rate from one in four in 2013 to one in six today. The letter closed by saying, "CHC is ready to work with HHS to ensure the successful implementation of the ACA and provide more Americans with the opportunity to attain affordable, accessible, and quality health coverage and care."
The CHC's first letter was sent on August 17, 2017, to former HHS Secretary Thomas Price after reports surfaced that the department had no outreach plan for Hispanic enrollment in the lead up to the 2018 ACA enrollment period. Unfortunately, HHS never confirmed a meeting date.
Full Text of Letter:
October 31, 2017
The Honorable Eric D. Hargan
Acting Secretary of U.S. Department of Health and Human Services
200 Independence Avenue, S.W.
Washington, D.C. 20201
Dear Acting Secretary Hargan:
The Congressional Hispanic Caucus sent a letter to former HHS Secretary Tom Price expressing concerns with the lack of outreach to Latinos in preparation for the Open Enrollment period. In addition, the CHC requested an immediate meeting HHS Secretary Tom Price to discuss these concerns. The CHC was contacted by HHS staff in order to setup this meeting. Despite several attempts by CHC staff to secure a date for a meeting, HHS never confirmed a meeting date. While HHS Secretary Tom Price is no longer with HHS, all the concerns and issues we raised in our August letter to HHS remain and are even more urgent given that the Open Enrollment period starts in a week. It is critical and urgent that the CHC meet with you as soon as possible.
While this urgent meeting request is processed and scheduled, we also want to provide you the following recommendations to support the successful implementation of the Affordable Care Act (ACA), including the upcoming Open Enrollment period. The ACA has resulted in historic coverage gains for the Latino community, providing over four million Latinos with access to health coverage, and lowering the overall Latino uninsured rate from one in four in 2013 to one in six today.
These recommendations will help ensure that more Americans, including Latinos, can continue to attain affordable, accessible, and quality health coverage and care:
- Commit to supporting a successful Open Enrollment period. Millions of Americans count on the annual open enrollment period to access quality health coverage and care for themselves and their families. It is imperative that HHS take the following steps:
- Restore all outreach and enrollment resources. HHS must restore all resources for in-person navigators and enrollment assisters. The recent decision to enact significant cuts to navigator funding, in some cases by 90 percent, will undoubtedly harm consumers who rely on these resources to enroll in coverage. Navigators are trusted messengers in the communities they serve, provide essential community outreach and educational resources, and help consumers choose the health plan that best fits their needs.
- Ensure the operability of healthcare.gov during Open Enrollment. The recent announcement to take healthcare.gov offline for 12 hours every Sunday will make it substantially more difficult for people to sign-up for coverage, especially given the compressed Open Enrollment period. The healthcare.gov and cuidadodesalud.gov platforms are the lone platforms available for consumers to shop for, and enroll in, marketplace coverage. It is imperative that these platforms are available at all times during these 45 days.
- Engage with stakeholder groups. HHS must engage with key stakeholder groups, such as health advocates, civil rights organizations, and community groups, to create as optimal an enrollment environment as possible for all who are eligible. The lack of outreach from this department is evident in recent decisions that will make it more difficult for many consumers to enroll in coverage. National, state, and local stakeholder groups can be a key resource to the agency and inform an enrollment strategy that is both targeted and responds to the needs and priorities of diverse communities.
- Commit to a transparent and timely waiver-review process rooted in statute. HHS must implement a transparent and timely review process for evaluating state ACA 1332 and Medicaid 1115 waivers based on the standards set out under current law. These decisions should incorporate input from stakeholders such as consumers, health advocates, and civil rights organizations. Stakeholder input will increase the likelihood that approved waivers reflect the healthcare needs and priorities of all Americans, especially vulnerable and underserved communities.
- Base Section 1332 waiver decisions on impact to health coverage and care. Under Section 1332 of the ACA, states can request waivers of certain provisions as long as the plan provides coverage that is as comprehensive, as affordable, and covers a comparable number of residents as under current law. HHS must base its waiver-approval decisions on these guardrails, codified under current law.
- Reject 1115 Medicaid waivers that violate the standards of the Medicaid statute. The 1115 Medicaid waivers must promote the objectives of the Medicaid Act, which is to enable states to furnish medical assistance to poor individuals. To meet this standard, HHS must reject onerous provisions such as work requirements that impede rather than enable the most vulnerable in our communities to access health coverage and care.
- Enforce Section 1557 of the ACA. Section 1557 of the ACA codifies critical civil rights protections within our healthcare system. HHS and its Office for Civil Rights must vigorously enforce this provision to ensure that every American regardless of age, gender, race, ethnicity, or language-of-origin is protected from discrimination when enrolling in health coverage or at the point of service.
- Enhance existing efforts to collect and publish detailed health insurance enrollment data by race and ethnicity. The agency must make every effort to thoroughly collect and make public health insurance enrollment data that includes, but is not limited to race/ethnicity and language. Accurate and comprehensive data is necessary to measure progress and target finite resources to maximize and build upon Latino health coverage gains.
- Commit to meet with members of this caucus on a quarterly basis, while providing advanced notice any time a significant regulatory or policy change is planned. HHS must facilitate an open dialogue with members of this caucus, ensuring both timeliness and transparency. Members of this caucus must have the most accurate and up-to-date information to respond to the healthcare needs of our constituents.
We appreciate your attention to these issues and look forward meeting with you in person to discuss these recommendations and ACA outreach efforts to Latinos. CHC is ready to work with HHS to ensure the successful implementation of the ACA and provide more Americans with the opportunity to attain affordable, accessible, and quality health coverage and care.
Sincerely,
Michelle Lujan Grisham
CHC Chairwoman
Raul Ruiz
CHC Health Care and Mental Health
Task Force Chair
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The Congressional Hispanic Caucus (CHC), founded in December 1976, is organized as a Congressional Member organization, governed under the Rules of the U.S. House of Representatives. The CHC is dedicated to voicing and advancing, through the legislative process, issues affecting Hispanics in the United States, Puerto Rico and U.S. Territories.