Advocating for Health Equity

With the federal government making health equity a priority, the CAP developed policies addressing Medicaid expansion, Medicaid funding for US Territories, diversifying clinical trials, and social determinants of health (SDOH) to support these efforts. Listen to the August 2023 Advocacy Recap podcast where CAP leaders discuss pressing health equity issues like addressing Sickle Cell Disease (SCD). The CAP is further exploring policy development on pertinent issues like diversifying the health care workforce to bolster health equity advocacy.

The CAP is committed to fostering excellence in the practice of pathology and laboratory medicine. Pursuing the principles of DEI as an organization will enhance our capacity to respond to the needs of members, the profession, our patients, and the public. Together with corporate DEI initiatives for CAP professional staff, the CAP will advance the principles of DEI through education, representation, along with advocacy & program support.

Medicaid Expansion - Strengthening Medicaid is a vital part of ensuring increased health care coverage, especially for low-income people. Expansion efforts should focus on increasing ease of access to Medicaid coverage, simplifying and expanding enrollment, and ensuring adequate physician payment rates that will provide comprehensive patient access to specialty care.

Medicaid Funding for U.S. Territories - U.S. territories must be allowed to participate in the Medicaid program on the same terms as states. Differences in Medicaid financing, including a statutory cap and match rate, have contributed to broader fiscal and health system challenges for the territories.

Social Determinants of Health - Recognizing and addressing the role of social determinants of health (SDOH) is an essential part of combating health care disparities and inequities among patients. The collection, access, distribution, and utilization of SDOH data can help to reduce health disparities among patients and improve medical decision-making, health outcomes for patients, and public health. As experts of diagnostic testing and stewards of laboratory data, pathologists are uniquely positioned to both identify and develop plans to mitigate health disparities in their communities.

Diversity in Clinical Trials - Pathologists provide essential diagnostic expertise that is necessary for guiding treatment decisions and improving patient health outcomes by evaluating and determining the effects of targeted therapies on diverse populations. Addressing barriers to entry for underrepresented diverse populations in clinical trials will improve clinical research, patient safety, and ensure high-quality care in disease diagnosis and management.

Independence in Medicolegal Death Investigations of Physicians Providing Forensic Medical Services - Protecting physicians providing forensic medical services (eg pathologists and non-pathologist physicians acting as medical examiners or coroners, ie “forensic physicians”) from undue influence is necessary to ensure the independence of medicolegal death investigations, to safeguard medical integrity, and to preserve public trust and confidence. 

In October of 2023, the CAP endorsed the National Association of Medical Examiners (NAME) new position noting that ‘excited delirium’ is not a medical diagnosis and should not be used as a cause of death. The American Medical Association (AMA) and the American Psychiatric Association (APA) also support this position.

Health Equity and Accountability Act

Rep. Robin Kelly (D-Ill) reintroduced The Health Equity and Accountability Act (HEAA) in the U.S. House on April 26, 2022. Since 2003, HEAA has been introduced by the Congressional Tri-Caucus, comprised of the Congressional Asian Pacific American Caucus, the Congressional Black Caucus, and the Congressional Hispanic Caucus. The CAP has participated in updating HEAA since 2022 in partnership with congressional staff and stakeholders. CAP statement on the introduction of the HEAA

CAP-Backed Provisions of HEAA

Expanding Medicaid Coverage 

• Permanently increases the Affordable Care Act’s premium subsidies as passed in the American Rescue Plan Act
• Addresses the Medicaid gap by creating a federal program like Medicaid that is operated by the CMS and provides the same benefits
• Treats the U.S. territories like states for purposes of Medicaid

Addressing the Social Determinants of Health 

• Includes the Social Determinants Accelerator Act
• Establishes a council to increase coordination between health and social service program
• Requires the CDC to address social determinants of health by creating a program to improve health equity by coordinating activities across the organization
• Awards grants to eligible organizations to aid in these efforts

Standardizing Public Health Data 

• Instructs HHS’s Data Council to make recommendations on how to implement enhanced data collection and analysis while minimizing cost and administrative burdens of data collection on patients and providers.
• Awards grants for data collection and reporting improvement includes education on the importance of data collection to combat disparities and development of programs to collect and report disaggregated data in a culturally and linguistically appropriate manner.
• Establishes grants for minority-serving institutions to analyze racial and ethnic data on disparities in health care
• Creates the Commission on Ensuring Data for Health Equity to provide guidance that improves the collection, analysis, and use of demographic data in responding to public health emergencies

Workforce Diversity

• Launches a national task force on workforce diversity
• Funds the expansion of existing workforce diversity programs and establishes new programs
• Includes grant funding to expand research on the link between the diversity of the health workforce and the quality of health care
• Funds for loan repayments for underrepresented minority individuals in medical school and other health programs