Even before the murder of UnitedHealth CEO Brian Thompson, Americans have been concerned about the state of health care across the U.S. With President Donald Trump occupying the Oval Office for the second time, health care advocates are proactively urging the commander in chief to prioritize equitable Medicare and Medicaid coverage for the country’s most underserved communities.
Just days after Trump’s inauguration, Al B. Sure (Albert Joseph Brown III) famed singer and executive chairman of the Health Equity In Transplantation Coalition, released a statement urging the new administration to take a “thorough approach” to public healthcare in a manner that is inclusive to African American and Latino communities.
“If the new administration wants to effectively deliver for Black and Latino Americans, as President Trump promised, it should instead look at how existing public health funding is deployed, and whether it can be better used to address gaps in access,” said Brown.
According to the Organ Procurement and Transplantation Network (OPTN), in 2022, Black, Hispanic, and Latino Americans “accounted for more than 41% of transplants in the U.S., while only representing 32.7% of the general U.S. population.”
And while scores of Black and Brown Americans struggle through the hardships of chronic illness, the weight of extensive medical evaluations and exorbitant test costs are posing additional sources of stress for patients already fighting to survive.
New challenges arose for the transplant community on March 2, 2023, when a private contractor, by the name of “Medicare Administrative Contractor,” announced restrictions placed on “Medicare coverage of transplant patient blood tests that detect early signs of organ rejection.”
A transplant blood test, often used to monitor for organ rejection after a transplant, can cost anywhere between $2,800 and $3,200 per test, depending on the specific type and where the test is administered.
Organ Procurement and Transplantation Network countered Medicare Administrative Contractors announcement by emphasizing the immense benefit federal dollars spent toward organ transplants or post-procedure care provides for Americans in need.
“Every American who can get systemic support for a kidney transplant is one who does not have to rely on costly, painful, and time-consuming dialysis,” Brown continued. “That is a Black, Latino, or rural American who can go to work in a good job thanks to a system that smartly invests dollars back into the community.”
Local Drug Addiction Specialists Talk Inequitable Reimbursement Rates
Even before Trump assumed office for the second time, Dr. Edwin Chapman, who specializes in drug addiction in Washington, D.C., said that his practice was impacted because the District’s local Medicaid carriers saw a significant payment decrease in reimbursement rates starting in 2023.
Largely working with opioid addicted patients, Chapman sees the multi-pronged approach needed to treat residents whose unique circumstances render them high risk for morbidity and mortality due to co-occurring illnesses that may include mental health challenges, homelessness, and economic hardships.
However, Chapman laments that insurance companies insist on neglecting the more layered needs of treatment and support for this particular demographic of patients.
“You have to understand that there’s a reason why these people, in spite of the fact that they’re on medication, continue to use drugs, but the insurance company wants you to treat them as if they’re a stable patient. A patient that is on medication and now drug free,” Chapman told The Informer. “But obviously, there are two different classes of results, which is not uncommon, but that’s how the insurance company makes money, is by underestimating the severity of the patient’s illness.”
While equity advocates criticize the Trump administration for potential health care rollbacks that could harm underserved communities, Chapman reasons the source of the issue is not solely based on the new administration’s projected policies alone.
“I think it’s a double-edged sword. Insurance companies saw Trump coming into the presidency and felt that they could do this and get away with it,” Chapman said. “This didn’t just happen overnight.”
The foreseeable future could be grim for medicaid and medicare patients who rely on insurance coverage to afford them the critical medical attention they need.
“It will put us out of business,” Chapman said, considering the broader implications of insurance company practices and the potential impact they will have on patient care, if these rollbacks persist. “We won’t have the resources to cover our patient’s costs.”