By protecting the healthcare safety net, Biden can put us on the path to a stronger country

By protecting the healthcare safety net, Biden can put us on the path to a stronger country


When President-elect Joe Biden received his second dose of COVID-19 vaccine last week, it came at a Newark, Del., essential hospital, one of hundreds nationwide that make it their mission to care for everyone—from dignitaries to our most underrepresented people.

As the Biden administration begins its first 100 days, we urge it to keep that safety-net role top of mind as it tackles a relentless virus that takes its greatest toll on the people of color and communities these hospitals serve.

Why? Because safety-net hospitals also anchor our response to COVID-19, even as they care for our most complex patients. More than half their patients are racial and ethnic minorities, and three-quarters are uninsured or covered by Medicaid or Medicare. Chronic funding challenges that go with their mission and a recent history of destabilizing payment policies only compound the enormous financial pressure on these front-line providers.

The incoming administration must make ending the pandemic its priority, but it also must ensure safety-net hospitals have the support they need as it charts a path to that goal. This means more than adequate personal protective equipment, therapeutics and supplies. It also means a predictable vaccine pipeline and, working with Congress, funding to help hospitals weather revenue lost to deferred elective procedures and the high costs of extraordinary caseloads. We also encourage the Biden administration to continue regulatory flexibility to meet the pandemic’s unprecedented demands, such as expanding telehealth, easing the burden of hospital reporting, and increasing capacity through alternative care sites.

Protecting the safety net now, amid COVID-19, and for the long term offers an opportunity beyond just safeguarding access to care: It provides an important point of intersection with the crucial work ahead to confront structural racism and promote racial equity, which the Biden administration has said will guide its economic policy agenda. To invest in the safety net is to invest in the vibrant yet historically marginalized communities essential hospitals serve—and in doing so, we invest in the population health and economic vitality we need to counter social factors, rooted in systemic racism, that manifest as poor health and poor health care outcomes.

America’s Essential Hospitals has identified structural racism as an urgent public health threat for this reason, and we also have made dismantling structural racism a priority. Healthcare access and equity long have been central to the work of safety-net hospitals because their patients suffer disproportionately from inequities, racism, and persistent health disparities, such as those we see with COVID-19. The data is stark: a third of COVID-19 deaths occur among non-Hispanic Blacks, who make up only 12% of the U.S. population, and similar disparate death rates afflict Latinos and non-Hispanic American Indian and Alaska Native people. We take heart knowing the Biden administration has made racial equity a centerpiece of its agenda, and we are ready to roll up our sleeves and work alongside the administration to build a more equitable world.

Beyond the immediate public health crisis and toward equity and a stronger safety net, there is much the Biden team can do in the short term to correct damaging policies that have eroded key support for safety-net hospitals.

Those policies have caused dramatic payment cuts for hospital outpatient services and drugs, frustrating efforts to expand care to underserved communities. They have deepened structural flaws in Medicaid that undervalue care.

They have forced immigrants to choose between medical care and their status as legal U.S. residents. The new administration can and must reject these ill-advised policies and turn its attention to positive change, such as meeting infrastructure needs and advancing the fight against opioid use disorder.

Safety-net hospitals and their communities face distinct challenges that merit targeted solutions and support from Washington. The next 100 days will be an important barometer of our national commitment to meeting those needs for the safety net and for our patients.



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About the Author

Marie Maynes
Marie Maynes is a Sports enthusiast and writes for the Sports section of ANH.