Attacks on Obamacare threaten coverage gains among minorities

Threats to Obamacare could deal a new blow to communities of color that have been disproportionately ravaged by the coronavirus pandemic as the nation is reckoning with generations of inequity.

The Affordable Care Act’s insurance subsidies, its expansions of Medicaid eligibility and its protections for preexisting conditions have especially helped Americans of color, narrowing historic disparities in access to health insurance and affordable care. The coverage gains are among the most significant since the passage of Medicare and Medicaid and the desegregation of American hospitals more than 50 years ago.

Now, President Donald Trump is again threatening to replace the law if he’s reelected. And exactly one week after the election, the Supreme Court, with its new 6-3 conservative majority, will hear oral arguments in a case brought by conservative states seeking to overturn the entire Affordable Care Act. If the law is dismantled, the communities it aided the most stand to lose the most.

“Health care could be ripped away from millions and the numbers of uninsured Americans of color could skyrocket—aggravating the health care disparities that already exist in this country,” said Sen. Tammy Duckworth (D-Ill.). “It’s especially infuriating that this is happening in the middle of a deadly pandemic that is disproportionately devastating so many seniors, Black, Brown and Native Americans and those with pre-existing conditions.”

Between 2013, the year before the Obamacare markets opened and Medicaid expansion began, and 2018, the rate of Latinx adults without health insurance plummeted from 40 percent to 25. The uninsured rate for Black adults fell from 24 percent to 14. For white adults, it dropped from 15 percent to 9, according to the Commonwealth Fund.

“There is no doubt that the Affordable Care Act, though it left millions uninsured, narrowed the racial gap in health insurance coverage and that’s a good thing,” said Mary Bassett, the former New York City health commissioner who is now a professor at Harvard’s School of Public Health. “Having millions suddenly lose their health insurance seems very likely to have an adverse impact.”

If the health law disappeared, the Urban Institute estimated that the gaps would widen once again, almost back to 2013 levels. And that assessment was in 2019 — before the devastation wrought by the coronavirus which is exacerbating inequality, in both health and the economy overall.

Especially affected would be people of color living in one of the 38 states that expanded Medicaid, the joint federal-state health program for low-income people. Without health coverage, many would lose access to much-needed care for chronic health conditions — and become more vulnerable to serious complications from Covid-19.

Trump says he wants a health system that will give people more choice, at less cost. “It’s in court, because Obamacare is no good,” he said at his second and last debate with Democratic challenger Joe Biden.

Even the Affordable Care Act’s backers admit it was not a panacea. Health inequities, some driven by generations of systemic racism, persist. Private insurance remains out of reach

Read more

For Latino voters, health care is a top issue as Obamacare gains reverse under Trump

SAN ANTONIO — Larisa Alvarado, 36, feared she had the coronavirus when she woke up last week feeling an itch and pain in her leg that later advanced to swelling. She began running a fever and became nauseous.

A friend and poison control expert suggested her symptoms could be from a spider bite, and advised her to see a doctor. But before she went to an urgent care clinic, Alvarado first had to research the cost of a visit and of the medicine a doctor was likely to prescribe—to see if she could afford them.

That’s because she doesn’t have health insurance. Alvarado lost her job as a patient resource specialist with the American Cancer Society after the organization’s fundraising was hit due to the pandemic.

Alvarado is just one of more than 11.2 million Latinos in the United States who don’t have health insurance—in 2019, almost 17 percent of Hispanics didn’t have health coverage, the highest of any group. That was the figure from before the pandemic, which was already up from 10.22 million in 2016.

Now experts say that number is likely even higher given the pandemic’s disproportionate toll on the community.

As people lose work and health care benefits, it’s become an even tougher task to ensure residents get health coverage access, said Joe Ibarra, co-chair of EnrollSA, a coalition of organizations trying to boost insurance enrollment in the San Antonio area.

“In Texas, there is no expanded Medicaid. The rules are really harsh. Folks are losing coverage as a result of losing their jobs and they are left without good options,” Ibarra told NBC News.

Latinos gained the most under the Affordable Care Act after it was enacted in 2010, with about 4 million adults and 600,000 children gaining health care coverage by 2016.

As more people lose health insurance, the cost and the availability of coverage are top-tier issues for Hispanics this election cycle. Latinos rank it even ahead of jobs and the economy and place more importance on it than they did about this time in 2016.

Download the NBC News app for breaking news and alerts

“Latinos are going to the polls keeping health care in mind and their experience with Covid in mind and voting for change for their health and well-being,” Alberto Gonzalez, senior policy strategist at UnidosUS, a Latino civil rights organization, said.

Early in the election cycle, the GOP was pointing to record low unemployment rates Latinos were experiencing as reason to re-elect Trump, while Democrats countered that Hispanics were not economically stable if many had to work more than one job to make ends meet.

But the pandemic’s disproportionate effect on Latinos has forced a reckoning of the gaps in health care coverage, especially in states like Texas with a huge Hispanic population.

Fears of Covid-19 — without health insurance

Before Alvarado lost her job, she was already skimping on her health, forgoing therapy for carpal tunnel to save on the steep copay and deductibles. Now without health

Read more

Longer Armor training span showing gains in skills, lethality, fitness, of tank crews, cavalry scouts | Article

Fort Benning Public AffairsFORT BENNING, Ga. – When Soldiers just out of Armor training are sent to the Army's tank and scout forces, they'll arrive more fully trained, more lethal with their weapons, and more physically fit, officials in charge of their training say in a recent video.The gains in skill, lethality and fitness have come about because the Army lengthened Armor One-Station Unit Training, or Armor OSUT, to 22 weeks, say the officials, who are senior leaders in the 194th Armored Brigade, which produced the video. The longer training span began last fall.The brigade is part of the U.S. Army Maneuver Center of Excellence here, and trains the Army's tank crew members, known by their Army job code of 19 Kilo, and cavalry scouts, coded 19 Delta.Armor OSUT for armor crewmen had been 15 weeks long. For cavalry scouts it had been 17 weeks."When we look at the different conditions, or I should say considerations, of lethality: mental, physical toughness, vehicle proficiency, and field craft and discipline, we've been able to increase not only the rigor but we've also been able to increase the proficiency, especially on vehicle platforms," Col. Dawson A. Plummer, the brigade's commander, says in the video.Among training gains that benefit Armor crewmen and cavalry scouts alike, according to the video, are:• Time to be trained and certified in the Army's Combat Lifesaver Course• Training and certification in basic hand-to-hand fighting skills known as Level 1 Combatives• Greater lethality through more extensive weapons training• Higher physical fitness levels through a greater number of fitness sessions using the Army's rigorous Army Combat Fitness Test, or ACFT.• More time for learning use of map and compass, known as land navigation• More field training that hones basic battlefield skillsIn addition, for Armor crewmen, the longer OSUT is affording more thorough training in:• Driving the M1 Abrams tank• Preventive maintenance of the tank• Tank gunneryFor cavalry scouts, the extended OSUT also allows for:• A chance to get familiar with all three of the combat vehicles they might eventually be assigned to work with: the eight-wheeled Stryker combat vehicle, Bradley Fighting Vehicle, and humvee• Basic preventive maintenance of combat vehicles• Use of radioFor Armor crewmen, the transition to a longer OSUT means Soldiers are trained beyond mere familiarity, to proficiency, Lt. Col. Nathaniel B. Davis, commander of the brigade's 1st Battalion, 81st Armor Regiment, says in the video."The intent behind the transition is to change from where we had been producing Armor crewmen who were familiar as drivers, loaders and gunners, to ones that are competent and proficient as drivers and loaders, familiar as gunners, and ready to contribute at their first unit of assignment," Davis says."As we made the transition from 15- to 22-week OSUT, we focused our efforts on a number of key areas: increasing maintenance tasks, increasing gunnery skills training and testing, increasing the amount and rigor of field training, and increasing the amount and rigor of driver training," Davis says.Driver training has increased "significantly," he says."This has

Read more