[Excerpt from article by Kate McEvoy, January 10, 2022]
What was it like to be a Medicaid director during the COVID-19 public health emergency? First, there was an all-too-slow dawning realization. Then a huge wave of activity, followed by just enough critical distance for some observations.
Around late August 2020, lower rates of infection buoyed hope. The brief reprieve gave us a bit of distance to think and evaluate. While gaining perspective remains a work in progress, here are a few observations:
Disparities are pervasive. The public health emergency starkly illuminated shameful racial disparities in infections and death, but also food insecurity and housing instability, especially for African Americans. A New Haven–based organization called DataHaven contributed tremendously to raising attention to these issues by conducting successive large-scale household surveys. Relatedly, Connecticut and other states made substantial progress in gathering and tracking public health data by race and ethnicity. I pray that our unforgivable historical complacency about the racial disparities in Medicaid documented by abundant data — particularly with respect to maternal mortality — has forever been disrupted.
In Connecticut, our Medicaid medical administrative services organization, Community Health Network of Connecticut, provided daily hospital admission, discharge, and transfer data that starkly illuminated the impact of COVID on communities of color. The data fueled a huge push to serve people with care management, establish hyperlocal testing and vaccine sites, and enlist partners trusted by folks who, by reason of history and experience with structural racism, were explicably and justifiably wary. But it was not anywhere near enough. We must work relentlessly to identify, call out, and remedy long-standing racial disparities in access to and utilization of services, care experience, and outcomes among Medicaid members.