Since its inception in 1965, Medicaid has provided health coverage to millions of people in America.
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Can Medicaid waivers help achieve health equity?
States are customizing Medicaid programs to mitigate health disparities
What makes Medicaid dynamic is a flexible approach: states are allowed the freedom to test and design their own distinct programs and approaches, making it a powerful tool with the potential to address health obstacles and tackle racial disparities in outcomes.
Time and again, studies have emphasized the worrying trend of Black and Indigenous mothers dying at two or three times the rate of their white counterparts. States like Oregon and Minnesota are pairing their Medicaid services with community-based experts like certified doulas who are often more attuned to the needs of Black mothers than more traditional health care providers. And there is data to show that Black mothers are two times less likely to experience birth complications when supported by these doulas.
Similarly, children of color too bear the burden of health inequities. Childhood asthma, for example, disproportionately affects Black and Hispanic children. That’s often due to unclean air quality that can accompany poor housing. Since studies have shown that health interventions at the home level can curb asthma symptoms as well as healthcare costs, Medicaid innovation in some states supply pillow covers, air filters or air conditioning to help households fight asthma triggers.
Racial minorities also bear the unequal burden of the diabetes epidemic. Compared to white adults, the risk of diabetes is higher for African Americans and Hispanic Americans. One ingenious way to address that has been to pair trained lifestyle coaches with eligible participants, as part of the National Diabetes Prevention Program. Through a series of dietary and physical changes these coaches are able to prevent or delay the onset of type 2 diabetes.
Considering Black Americans suffer the highest risk for dementia, certain states have adopted Medicaid waivers that are responding to disparities in mental healthcare. Ohio’s Assisted Living Waiver Program provides services like non-medical transportation and housekeeping to people with Alzheimer’s and related dementias.
Medicaid’s flexibility makes it a crucial piece to reducing health disparities in America.