Addressing Health Care Disparities

Medicaid & Other Public Programs

While racial and ethnic health care disparities affect persons at all income levels, persons of color are more likely than whites to be publicly insured or uninsured. State-administered programs like Medicaid and SCHIP therefore represent important vehicles through with these disparities can be addressed.

Marsha Lillie-Blanton of the Kaiser Family Foundation identified a number of the steps that States can take to improve the effectiveness of Medicaid and SCHIP in addressing health care disparities. They include, but are not limited to:

• Expansion of Medicaid eligibility requirements and the simplification of enrollment requirements.
• Collection and analysis of program data to better identify and understand disparities.
• Design and implementation of quality improvement initiatives and measures to address quality problems affecting minorities.
• Inclusion of requirements for the provision of culturally competent care in the State's contracts with health plans and providers. Purchasing guidelines and model contract language on this subject have been developed for State use.

As highlighted in the previous session, the provision of high quality translation services can have an important impact on quality of care and health outcomes for Medicaid recipients with limited English proficiency.

Mara Youdelman of the National Health Law Program noted that a number of States do provide Medicaid reimbursement for this service and explained the different ways in which States can cover this service under their Medicaid programs.

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