New Plans for the PJC’s Access to Health and Public Benefits Project

WASHINGTON, April 9 -- The Public Justice Center issued the following news release:

Ashley Black, the PJC's lead health rights attorney, presented to a packed house at the March Justice for Breakfast. She highlighted barriers in accessing healthcare and public benefits and discussed plans to work toward racial and economic justice in the healthcare system. Over six months, she conducted a scan of the rapidly changing health rights advocacy landscape. She heard from community members about their experiences accessing healthcare. She also gathered feedback from local and national advocates, clinicians and others on gaps in healthcare and advocacy capacity. All of these perspectives helped her develop new advocacy priorities centered on race and health equity designed to reflect community needs. We share the Access to Health and Public Benefits Project's advocacy priorities below.

Expand dental care for low-income adults

Ashley frequently heard from community members how a lack of access to dental care caused them serious health problems. Medical Assistance provides basic dental care for children, but only covers emergency dental care for adults, and managed care organizations only cover limited services. The impact of this minimal coverage is disproportionately borne by Black adults, making it a priority rooted in our race equity analysis. Potential avenues for change include advocating for the establishment of an adult dental program under Medical Assistance and for the development of low-cost dental health clinics in low-income areas of the state.

Eliminate disparities and racism in maternal healthcare for Black women

Black women die in childbirth at three to four times the rate of white women. Studies indicate that stress resulting from racism is associated with pregnancy-related complications and maternal mortality. Culturally competent providers are an important part of the solution, drawing on training enabling them to interact with and respond effectively to people of different cultures. We plan to advocate to expand access to culturally competent maternal healthcare for Black women to eliminate disparities in pregnancy-related mortality, mistreatment during labor, and racism in maternal healthcare.

Address racial disparities in access to Hepatitis C medication

Black adults experience higher rates of Hepatitis C but often have difficulty accessing treatment due to health insurance coverage restrictions, particularly for Medical Assistance. Currently Medical Assistance will only pay for medication for people with moderate to severe liver fibrosis, excluding thousands of people with Hepatitis C who could benefit from the medication. We are exploring advocacy strategies to eliminate this harmful restriction on treatment.

Ensure healthcare providers and state agencies provide language services for people with Limited English Proficiency

Language barriers can make it difficult to access healthcare and public benefits. Under the law, healthcare providers and government agencies are required to provide language services so that individuals with Limited English Proficiency can utilize their services, but that doesn't always happen. Maryland has a large population with Limited English Proficiency. We will advocate for appropriate language services to ensure that this population is afforded equal access to healthcare and social services.

Expand access to mental health services for low-income people of color

While people of color experience mental illness at similar rates as white people, they are less likely to access mental health services. Why? With very few mental healthcare practitioners who are people of color, there are concerns about the ability of therapists to provide culturally competent care, as well as reports of racism and microagressions in therapy. Black adults are also more likely to live in low-income neighborhoods with few options for mental healthcare. We hope to increase access to comprehensive and culturally competent care by advocating to expand community-based mental health services.

Monitor changes to the healthcare and public benefits landscape on the federal and state level

The last few years have seen dramatic changes in the health and benefits landscape. Some states are expanding Medicaid programs in groundbreaking ways to address social inequities and public health crises. Increases in drug pricing have prompted advocates around the country to pursue litigation and legislation to improve access for Medical Assistance beneficiaries to medically necessary medications. To ensure that we are responsive to what the community most urgently needs, we must monitor changes to the landscape.

Protect Medical Assistance and the Maryland Children's Health Insurance Program

Medical Assistance (aka Medicaid) and MCHIP provide healthcare and long-term care services coverage to approximately one in six low-income Marylanders, including children, adults, pregnant women, people with disabilities, and seniors. The majority of Medicaid beneficiaries in Maryland are people of color. Since Maryland opted to expand Medicaid coverage under the Affordable Care Act, attempts to repeal the ACA could reduce access to healthcare in Maryland, which would particularly impact people of color. Without this coverage, many Marylanders could not afford needed medications, psychiatric appointments, diagnostic services, and medical equipment. We must be vigilant and respond when threats to these programs surface to ensure that low-income people have access to comprehensive and affordable healthcare.