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Hirono, Colleagues Announce Health Equity and Accountability Act to Create a More Equitable Health Care System

Legislation addresses health disparities in Hawaii and nationwide, developed with Congressional Tri-Caucus support

WASHINGTON, D.C. – Senator Mazie K. Hirono (D-Hawaii), along with Senators Kirsten Gillibrand (D-N.Y.), Jeff Merkley (D-Ore.), Tammy Duckworth (D-Ill.), Richard Blumenthal (D-Conn.), Bernie Sanders (I-Vt.), Cory Booker (D-N.J.), Ben Cardin (D-Md.), and Tim Kaine (D-Va.) announced the Health Equity and Accountability Act (HEAA), sweeping legislation that would address health disparities among racial and ethnic minorities as well as women, the LGBTQ+ community, rural populations, and socioeconomically disadvantaged communities across the United States. HEAA is a blueprint of bold policy solutions that uniquely target a wide spectrum of health equity concerns. The comprehensive legislation would:

  • Expand access to health care including for immigrant and rural communities. The legislation includes Senator Hirono's Covering Our FAS Allies Act, which restores Medicaid eligibility for COFA citizens.
  • Improve care for underserved communities through enhanced language access services, provider training on cultural competency, and investments in diversifying the health workforce.
  • Dismantle barriers and fund programs to support mental, infant, maternal, sexual, and reproductive health for marginalized and underserved individuals and communities.
  • Increase federal resources to address diseases that disproportionately impact minority communities, and engage the entire federal government in building and funding strategies to address social determinants of health.

“The coronavirus pandemic has exacerbated and laid bare health disparities in communities across the country, particularly in communities of color. Even before the pandemic, Pacific Islanders—including COFA citizens and Native Hawaiians—experienced poorer health outcomes, often due to systemic barriers in our health care system and society at large. HEAA dismantles these barriers to accessing information, health education, health services and coverage so that all communities in Hawaii and across the country can thrive,” Senator Hirono said.

In Hawaii, HEAA would help local communities combat diseases like viral hepatitis, which disproportionately affects Asian Americans, Native Hawaiians, and Pacific Islanders, and better understand the health disparities faced by these communities through disaggregated data collection. The bill would also help providers better serve a diverse patient population with culturally and linguistically appropriate health care services through investments like cultural competency education and expanded language access services to assist the over 12 percent of Hawaii residents and about 8 percent of people nationwide who have limited English proficiency. Additionally, HEAA would permanently reauthorize the Native Hawaiian Health Care Improvement Act to continue to provide comprehensive health care to Native Hawaiians.

Senator Hirono also introduced HEAA in 2018. This Congress, HEAA was introduced in the House by Representative Jesús “Chuy” García (D-Ill.) with support from the Congressional Tri-Caucus. HEAA has been introduced in every Congress since 2007. HEAA is endorsed by nearly 200 organizations, including UnidosUS, Asian Pacific Islander American Health Forum (APIAHF), Families USA, Community Catalyst, National Health Law Program (NHeLP), National Urban League, and AIDS Alliance for Women, Infants, Children, Youth & Families. The full list of endorsing organizations can be found here. Bill text can be found here

“It’s not enough to just work for better health care for all—we also need to tackle the unacceptable disparities in health care that Black and Brown families, women, low-income families, rural communities, and LGBTQ+ Americans face every day,” said Senator Merkley.“This legislation includes critical components of the roadmap we need to address those massive inequities, so we can finally ensure that every American’s human right to health care is met.”

“This bill is a bold blueprint for tackling the immense inequities in our health care system. Far too many Americans are unable to access quality health care because of the color of their skin, who they love, where they live, or how much money they have. The COVID-19 pandemic has painfully illuminated these disparities, taking a tragic toll on underserved communities. The Health Equity and Accountability Act broadens access to health care, improves language services and cultural trainings, and increases workforce diversity - necessary strides to make our country’s health care system more equitable for all,” Senator Blumenthal said.

“We can do so much more to help underserved communities access comprehensive healthcare that is culturally-competent, equitable and affordable,” said Senator Duckworth. “The Health Equity and Accountability Act will take an important step in addressing historic and systemic inequalities in our health system by prioritizing the unique medical needs and experiences of all Americans.” 

“Whether someone lives or dies should never depend on factors like race, income, gender, or LGBTQ status. As the COVID-19 pandemic continues to underscore the deep inequities in our health care system, I’m proud to cosponsor this bill to build a healthier, more equitable future,”Senator Kaine said.

“The coronavirus pandemic has devastated historically underserved communities and underscored the importance of equal access to health care for all,” said Senator Gillibrand.“Yet, for far too many Americans health care remains an unaffordable, inaccessible privilege. The Health Equity and Accountability Act (HEAA) will make critical investments to address health disparities and help to ensure equitable access to affordable and quality health care  - regardless of race, gender, zip code, or immigration status. I thank Senator Hirono for her leadership on this bill and in the fight for a more equitable health care system.”

“Even before COVID-19 killed over 200,000 Americans -- disproportionately people of color -- we were confronting serious and deadly disparities in health care access and outcomes,” said Senator Booker. “As we work to get this virus under control, we must confront these inequities and ensure that all Americans, regardless of the color of their skin, socioeconomic status, gender, or sexual orientation have access to quality, affordable health care.”

“The ongoing pandemic has disproportionately affected communities of color, and has tragically further illuminated the inadequate access to care and health systems that serve racial and ethnic minorities in Maryland and across the country,” Senator Cardin said. “I am proud to again cosponsor the Health Equity and Accountability Act, which creates a comprehensive framework to address health disparities and historic racism entrenched within our healthcare system.”

“For the Waimanalo Health Center, serving the community has always been an honor built on the principle that accessing quality health care should never be reserved for those of privilege. As COVID-19 continues to tighten its grasp on our communities, it’s a somber illustration of the critical need for comprehensive legislation that addresses health inequity. Now more than ever, HEAA is essential to healthy and thriving families and communities,” Mary Oneha, CEO of Waimanalo Health Center said.

“Papa Ola Lokahi supports the vision and lay-out the Health Equity and Accountability Act does in comprehensively addressing health disparities and ensuring access to quality health care for everyone in our country, especially Native Hawaiian communities. This bold policy builds upon the coverage gained under the ACA and provides immediate targeted relief to those communities hardest hit by COVID-19,” Sheri Daniels, Executive Director of Papa Ola Lokahi said.

“This Bill will begin the process of implementing policies that strengthen the very backbone of a good health care system. Language access, workforce diversity, caring for our COFA neighbors are all essential to a thriving Kalihi valley!” Dr. David Derauf, Executive Director of Kokua Kalihi Valley said.

“Hep Free Hawaii is a community-based coalition that works at the intersection of health and social justice. The Health Equity and Accountability Act will enhance the health care infrastructure for Hawaii and all other jurisdictions to provide necessary care for viral hepatitis and many other devastating diseases affecting underserved communities. The passage of this bill would have real implications to improve health outcomes and increase systems responses to health inequities made starkly clear by the ongoing COVID-19 pandemic. Mahalo to Senator Hirono for your leadership on this bill!” Thaddeus Pham, Co-Director of Hep Free Hawaii said. 

“The HEAA is a bill that is long overdue! For many years, lip service has been played in regard to health disparities… but there has not been any action since the ACA was passed. Now is the time to not just talk, but to actually do something! The residents of our immigrant, rural community of Lanai are suffering – many have lost their jobs due to COVID-19 and along with their jobs they have lost health care coverage; limited language competency complicates matters further as they try to navigate the maze of various programs. The HEAA provides a path of bold, policy solutions that builds upon the ACA, and, at the same time, provides targeted, immediate relief to our community. Our country has been traveling down a dark path in the last 3 plus years. We need to turn that around and take action to address the inequities and health disparities – the HEAA lays that groundwork,” Diana Shaw, Executive Director of Lanai Community Health Center said.

“Hawaii Health & Harm Reduction Center serves many who are impacted by poverty, discrimination, and other social determinants of health. Accessing appropriate medical care is challenging for sexual and gender minorities, immigrants, limited English proficient persons, indigenous peoples, and Pacific Islander communities. The Health Equity and Accountability Act will strengthen the federal government’s ability to meet the urgent health needs of underserved communities, including those living with HIV, viral hepatitis, and other chronic health conditions. Mahalo to Senator Hirono and the Congressional Tri-Caucus for moving this important bill forward at a time when COVID-19 has shed light on systemic health inequities in Hawaii and across the nation,” Heather Lusk, Executive Director of Hawaii Health & Harm Reduction Center said.

“The COVID-19 pandemic has proven again the inadequate health equity in our Pacific Islander population and the devastation of these health disparities for our Pacific Islander families. Losing a loved one unexpectedly and the separation of families during COVID has had dramatic impact on our community that will last for generations. To have a healthier economy and community, we must address the health disparities in our communities. We Are Oceania supports the Health Equity and Accountability Act because our community benefits when we directly address health inequities,” Josie Howard, Program Director of We Are Oceania said. 

"Addressing health disparities and achieving health equity are goals shared across the University of Hawaii System," said Dr. Vassilis Syrmos, University of Hawaii System Vice President for Research and Innovation. "We appreciate Senator Hirono's vision, dedication, and leadership to promote health equity for all, including for Native Hawaiians, Pacific Islanders, and citizens of the Freely Associated States."

“UnidosUS stands proudly with Senator Mazie Hirono, Representative Jesús ‘Chuy’ García, and the Congressional Tri-Caucus to introduce the Health Equity and Accountability Act of 2020 (HEAA) in the Senate. At a time when Latinos, in particular Latino children, are disproportionately getting sick and dying from COVID-19, Congress must act quickly to enact policies like HEAA that address the alarming health disparities magnified by COVID-19 and strengthen the health care system so that it works for all. Congress can also look to HEAA for bold and innovative ideas that would provide immediate relief to hard-working Americans impacted by COVID-19, including Latinos, and ensure that everyone has access to COVID-testing, treatment, and care,” Janet Murguía, President and CEO of UnidosUS said.

“Communities of color continue to be disproportionately devastated by COVID-19. Unless we take immediate steps to mitigate long standing racial disparities in our health care system, many more preventable deaths will ravage our most vulnerable communities” said Congressman García (D-Ill.). “The Health Equity and Accountability Act will save lives by improving data collection, access to safety net programs for immigrants, equitable federal resources for those in the U.S. territories and culturally and linguistically appropriate services. HEAA is built on our shared, fundamental belief that everyone deserves access to affordable, quality health care, especially during a deadly pandemic.”

“I want to thank CAPAC Senator Mazie Hirono for introducing the Health Equity and Accountability Act in the Senate. Over the past several months, we have seen how the COVID-19 pandemic has exacerbated longstanding health inequities and devastated communities of color across our nation. In fact, Native Hawaiians and Pacific Islanders continue to have some of the highest COVID-19 infection and mortality rates out of any racial group in several states. New data also indicates that Asian Americans are likewise dying at a higher rate due to coronavirus, with deaths increasing by 35% this year compared with the average over the last five years. In order to fully recover from this pandemic, we must ensure that all Americans have access to quality, affordable health care that is culturally and linguistically competent. And we must prioritize disaggregating data and addressing health disparities like diabetes, hepatitis, and heart disease that disproportionately impact our communities. That’s exactly what HEAA does, and it’s why I’m so proud to join with my Tri-Caucus colleagues to support this critical piece of legislation,” CAPAC Chair Congresswoman Judy Chu (D-Calif.) said. 

“The COVID-19 pandemic has exposed racial disparities in the social determinants of health like never before, with Latinos and other communities of color continuing to be disproportionately impacted by both the virus and its economic impacts. Even as we work to get our nation through this pandemic, we must also begin to address the long-standing inequities that have contributed to these unjust outcomes in the Latino community,” said Congressional Hispanic Caucus Chairman Joaquin Castro (D-Texas). “That is why the Congressional Hispanic Caucus is proud to support the Health Equity and Accountability Act (HEAA) which holistically addresses health and social inequities and promotes health equity. The CHC is grateful to Senator Mazie Hirono of Hawaii for leading the introduction of this timely legislation in the United States Senate and to CHC member Rep. Jesús “Chuy” García (IL-04) for leading its introduction in the House. HEAA is a crucial and necessary step to ensure a crisis like the one we are experiencing now never happens again.” 

“Healthcare disparities in our country have been a long standing issue and concern for the Congressional Black Caucus. So much so, we have created a dedicated task force to not only identify the issues but develop targeted policy solutions to address the problems. This year, the spread of the coronavirus has only compounded these issues, leaving Black people even more vulnerable. The Health Equity and Accountability Act comes at a time when our nation must be proactive in addressing the inequalities of our health care system. The legislative response must be holistic and targeted to meet the needs of our communities and that is what this Act aims to do,” Chair of the Congressional Black Caucus Representative Karen Bass (D-Calif.) said.