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Op-Ed: Carving Out Disparities in Health Care

Dec 7, 2020

Carving Out Disparities in Health Care

Op-Ed by Andre Dixon, Director, Multicultural Workforce and Student Initiatives at Trillium Health

Trillium Health provides services to patients throughout Western New York, with locations in Rochester and Buffalo.

The disparate impact of the COVID-19 pandemic is a flashing siren calling out the systemic racism within America’s health care system. People of color are more likely to be infected with the coronavirus; more likely to lose their jobs in the economic fallout; more likely to suffer extreme cases of the illness; and more likely to die as a result. So why is Governor Cuomo trying to eliminate support for health care clinics that serve the most at risk communities just as we’re battling back the second wave?

The issue relates to a provision the Governor inserted into this year’s budget that “carves out” a federal pharmacy benefit from the state’s Medicaid program, at the expense of safety net providers in the federal 340B drug discount program. The provision, set to take effect on April 1, will cost safety net providers in New York State an estimated $154 million in federal resources over the first year and $1.5 billion over the next five years. 

This will drive up costs for community health care clinics at a time when we are struggling to meet the ever-growing needs of our patients.

The craziest part is that this isn’t even state taxpayer dollars. These are dedicated funds from the federal government that New York would lose out on, so that the Governor can claim “savings” as a part of the Medicaid Redesign Team II process.

For the past 30 years, clinics like the one where I work have received federal funding through the Ryan White HIV/AIDS Program. Ryan White clinics participating in the 340B drug pricing program receive discounts on life-saving prescription drugs that we share with our patients. These discounts allow us to offer the type of expanded services that are critical to patients living with HIV/AIDS.

Ryan White clinics support the most at risk members of our communities. In New York, 66 percent identify as Black or Latinx; over 50 percent are diagnosed with substance use disorder; only 17 percent have private insurance; and 62 percent are experiencing homelessness or need housing assistance.

Our clinics have been at the frontlines of the fight against COVID-19. Cutting this lifeline will force community health providers across Western New York to close facilities and eliminate critical services just as the second wave is ripping through our communities.

Shifting cost from the 340B program onto the backs of the most vulnerable New Yorkers is unconscionable – but that’s exactly what Governor Cuomo is doing. It defies logic that state leaders would be so tone deaf on such a clear case of inequity in our health care system. The Governor has four months to overrule his bureaucrats. Let’s hope he hears that siren before it’s too late.