Fourth COVID-19 Stimulus Package Must Promote Racial Equity in Health Care


By Kelsey Lyles,

[ Article was originally posted on ]

Our nation needs a fourth COVID-19 stimulus package.  The Families First Act and CARES Act contained important early responses to the crisis,  but these bills left out a lot that needs to be done. Today I want to focus on one aspect that needs much more attention: Congress needs to pass additional relief for health centers  for our communities to withstand and recover from this public health emergency. 

While the earlier stimulus package did allocate funds to health care systems, the initial $150 billion for hospitals was not enough to last the duration of this crisis, and priority support must go to our safety net health systems and clinics that serve low-income and uninsured patients.

California’s reported COVID-19 cases by race and ethnicity
so far reveal that the death rate among African Americans is disproportionately high, and there is  growing evidence from New York, Milwaukee and other locations  that the spread and impact of the virus across the nation is disproportionately affecting communities of color and particularly Black, Latinx, and Native American folks. The virus exacerbates social determinants of health that already burden low-income communities of color. For folks experiencing homelessness, chronic disease, food insecurity, or unemployment  for example, COVID 19 magnifies their vulnerabilities. People of color tend to be overrepresented in “essential worker” retail and service industry jobs that often lack health benefits or paid sick leave, and which have been particularly at risk for exposure to the virus. 

The Greenlining Institute urges Congress to 1) pass a fourth stimulus package with additional funding and resources for safety net hospitals and community health clinics that serve predominantly low-income and uninsured families and 2) provide  guidance in the use of funds to ensure that low income families of color are well supported and don’t face disproportionate harm from the spread of COVID-19.

“As the health and economic impacts of the pandemic unfold, we need Congress  to prioritize supporting the most vulnerable now more than ever.” Kelsey Lyles, Health Policy lead

We recommend the following urgent health and racial equity policy priorities to ensure that health care systems receive relief funding to support low-income families of color:

1. Require Health Centers to Provide Free COVID-19 Testing and Treatment for Low-Income Families: 

We must incentivize seeking medical care and also ensure that low-income families already suffering from this financial crisis are not also burdened with excessive medical fees and debt. In an emergency, a patient may unknowingly be taken to a hospital that is outside of their medical network for treatment and get stuck with an expensive “surprise” bill not covered by insurance. For low-income and uninsured families, they may forgo going to a hospital altogether because they cannot afford to pay. Some private health insurance companies and state Medicaid programs are leading the effort to waive copays for COVID-19 testing, evaluation, and treatment. Now it is time for hospitals to step up and stop  “surprise” medical billing to patients seeking care, regardless of their immigration status, insurance status, or ability to pay. We urge Congress to require that hospitals use stimulus funds to provide free testing and treatment for low income families and the uninsured to encourage more people to seek health care and stop the spread of the virus. 

2. Require Health Centers to Collect & Report COVID-19 Demographic Data to State Public Health Departments:

Reports across the nation are showing that the spread of COVID-19 is disproportionately impacting communities of color. This stems from a number of systemic issues including lack of healthcare access,  implicit bias of healthcare providers, and greater likelihood of exposure to the virus due to living conditions, unemployment, or “essential worker” status. Hospitals and medical centers need resources and funding  to collect data on important demographic indicators like race, ethnicity, gender identity, age, zip code, and socioeconomic status and report them to their respective State Department of Public Health for transparency. Data transparency is an important accountability measure to ensure that resources, support, and relief get prioritized to the communities most disproportionately affected by the pandemic. 

3. Require Health Centers to Screen and Provide Referrals for Domestic & Intimate Partner Violence

The compounding impacts of rising unemployment, stress, and trauma from COVID-19 are contributing to an alarming increase  in reported domestic violence incidents. While this impacts everyone, low-income women, LGBTQ, and gender expressive folks in particular can be more prone to experiencing this kind of abuse. Hospitals and medical centers must continue to prioritize screening for domestic and intimate partner violence. A group of senators recently called for increased  funding to connect patients with essential counseling, therapy, and support services, and the next stimulus package must provide such support. 

As the health and economic impacts of the pandemic unfold, we need Congress  to prioritize supporting the most vulnerable now more than ever. Health systems need funding as well as guidance to ensure that low-income families are supported by emergency response and relief efforts. Congress must prioritize free COVID-19 testing and treatment for low-income families and the uninsured, demographic data collection and reporting, and resources and support for domestic and intimate partner violence  in a new stimulus package. 

 Kelsey Lyles is Greenlining’s Health Equity Policy Lead. To receive updates on our ongoing response to the Coronavirus pandemic, sign up for The Greenlining Institute's newsletter.



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