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At-Risk Communities Need a Covid Hero to Protect Critical Federal Resources - Op-Ed by Mark Malahosky & Patrick Hildenbrandt

Feb 18, 2021

Governor Cuomo has worked hard to cultivate a national reputation as the Emmy Award-winning hero of his own covid reality show – so why is he stripping federal resources from hospitals, clinics, and health centers on the front lines of the crisis? 

Last year, the Cuomo Administration included a provision in the state budget that would cost safety net providers an estimated $154 million in federal resources the first year and $1.5 billion over five years. This Albany accounting gimmick, set to take effect on April 1, would “carve out” the state’s Medicaid pharmacy benefit. The problem is that this “carve out” results in the state rejecting federal resources provided by the 340B drug discount program. This program makes it possible for health care providers to serve New York’s most vulnerable communities.

Fortunately, there’s a legislative fix that will buy time for a long-term solution. A bill sponsored by Assembly Health Committee Chair Richard Gottfried (A. 1671) would delay implementation of this “carve out” for three years, giving us time to work with the Governor, Legislature, and fellow stakeholders to ensure that the state doesn’t give up federal resources for vulnerable New Yorkers just to fill a budget shortfall. 

As pharmacists in organizations that receive federal support under the Ryan White Care Act, we are on the frontlines in caring for patients with HIV/AIDS and vaccinating thousands of New Yorkers every week against COVID-19. To understand how devastating these cuts are, you have to understand the communities we serve. Half of all Americans living with HIV/AIDS receive medical care from a Ryan White clinic. Our patients are 70% Black or Hispanic, a majority are LGBTQ, 61% live at or below the poverty line, and 62% are experiencing homelessness or need housing assistance.

Our patients have been hit hardest by the pandemic and there remains great mistrust in the health care system from historical wrongs perpetrated against communities of color. Just last week, the Governor traveled to a public housing residence in Brooklyn to call attention to this crisis within a crisis – with Black and Latino Americans 2.8 times more likely than whites to die from COVID-19.   

We work every day to build trust with our patients in these hardest hit communities, and now we’re the ones working to build trust in the vaccine. We are the ones responsible for getting that vaccine into arms – twice – so why would the Governor divert critical funding from that effort?

While the Governor often speaks about vulnerable communities, his own budget is attacking a proven and effective weapon against covid – the 340B drug discount program. The resources 340B brings to safety net providers allows us to engage these most at-risk communities. It provides resources for physicians, nurses, pharmacists, and outreach staff. It supports vaccine clinics where we manage check-in, patient flow, post-vaccine observation, and data transmission to the state. And it allows us to provide transportation to bring patients to the vaccine or the vaccine to patients. 

Community health centers reeling from the pandemic have already had to deal with the state withholding funds. Now, on top of that, the state is removing what for many is our largest resource – the discount from the federal 340B drug pricing program. Undermining this resource will make it impossible for health centers to reach the communities that Albany and Washington so desperately want and need us to reach.

New York State’s most vulnerable communities need more than an Emmy-award winning TV show. We need a real covid hero.

Mark Malahosky is Vice President of Pharmacy Services for Trillium Health. Dr. Patrick Hildenbrandt is Chief Pharmacy Officer at Evergreen Health Services.