Current Advocacy Activities

October 2021

NHMA, through a partnership with Culture One World with press release and media placements, called on employers of essential workers to mandate COVID-19 vaccines or have regular testing, and provide paid medical/family leave ---to increase vaccinations in our communities.

Dr. Rios was invited to the White House Advisor to the President to meet with Latino Leaders in September (see White House Briefings) on the importance of our issues such as business, education, access to care, Medicaid, increased public health education/vaccinations for COVID-19, climate justice and Latinos in health workforce. More information can be found in this White House press statement on the meeting.

We strongly support the BuildBackBetter Agenda of the White House to expand Medicaid, medical leave, health insurance subsidies, and child tax credits as well as 16 years public education (free preK and community college) and jobs for climate justice and caregiving and telehealth for home care services. Our families will be supported so much by these programs.

NHMA supported the ACIP Committee recommendation to change the vaccinations for adults for pneumoccal pneumonia to one vaccine from two, newly approved by FDA in June.

NHMA proud to announce 2 new government grants – CDC: HIV,  Infectious Disease Control and new Rockefeller Foundation support for the Vaccinate For All Campaign, and continued NHMA Leadership Fellowship and College Health Scholars Program. The NHHF is proud to announce its OMH supported Hispanic Leadership Development Fellowship for graduate students/recent grads of graduate schools to work at HHS for one year. Contact [email protected] if interested.

NHMA joined with its partners in the Campaign for Tobacco Free Kids to keep tobacco tax provisions in the reconciliation package. NHMA signed on to a letter which was presented and submitted for the record during the mark up of the Build Back Better Act in the House Ways and Means Committee in support of the tobacco tax provisions. The provisions are currently a part of the reconciliation package, and NHMA will continue to work with its allies to see that those provisions remain in the bill.

NHMA has had ongoing meetings with several congressional offices to see that a comprehensive paid leave system is implemented in the reconciliation package. Working with our comprehensive paid leave coalition, we have met with the offices of Representatives Spanberger, Slotkin, Underwood, Gonzalez, Cuellar, O’Halloran, Malinowski and Senator Machin. We spoke about the importance of paid leave to allow essential workers to care for themselves and others but also help with maternity care and elder homecare.

NHMA called on Congress to pass the Treat and Reduce Obesity Act (TROA) as standalone bill or include its provisions in the upcoming reconciliation package. If enacted into law, TROA would establish Medicare Part D coverage for FDA-approved anti-obesity medications and intensive behavioral therapy to ensure access to a full continuum of care for Medicare beneficiaries who have obesity. I took part in a news conference calling for the passage of TROA and several letters of support were sent to key lawmakers.

NHMA signed on to a letter to the Administration calling to simplify access to COVID-19 vaccines for office-based physicians, including primary care physicians and pediatricians. Office-based physicians are in the best position to reach the unvaccinated, help people overcome vaccine hesitancy, and determine the need for and timing of additional doses for their elderly patients and those with underlying medical conditions. Distribution efforts continue to prioritize pharmacies and community health centers, but office-based physicians can be key to helping bring about the end of the pandemic if they are given equal access of the vaccines to distribute to their patients.

NHMA also joined a letter to leaders in Congress to include expansion and improved access to Medicaid-funded home-and community-based services (HCBS). An increased investment in the HCBS program will enable state Medicaid programs to support access to care for the more than 800,000 individuals with disabilities and older adults who remain on long waiting lists for services across the country and provide HCBS providers, severely strained by the pandemic, with the funds they need to sustain their services and provide direct care workers with competitive wages, additional training, and more opportunities for professional advancement.

September 2021

Legislative Update- 09/10/21

President Biden and Federal Government announces new comprehensive strategies and policies to combat COVID-19 with the goal of getting more people vaccinated and protecting those still at risk.

Policies included:

  • Requiring vaccinations for all federal workers and federal contractors

  • Requiring all employers with 100+ employees to have their employees vaccinated or submit to weekly testing

  • Providing easy access to booster shots for COVID-19 vaccines

  • Calling on all states to adopt vaccine requirements for all schools

  • Continuing to require masking for interstate travel and doubling fines for those who fail to mask

  • New support for small businesses affected by the pandemic

  • Increasing support for hospitals over burdened by COVID-19 patients 

Working with the Partnership for Medicaid, we urged Congress to consider the following to strengthen the Medicaid program and ensure a strong safety net to protect our most underrepresented patients:

  • Raise Medicaid payment levels: Medicaid payment is 72 percent of Medicare for all services, and 66 percent for primary care. Congress could improve Medicaid payments by creating new payment pathways for activities and services related to improving health equity, protecting supplemental payments, or working with the administration and states to increase Medicaid base payment rates. Congress could also consider the Kids Access to Primary Care Act (H.R. 1025), which would provide Medicaid payment parity with Medicare for the provision of primary care.

  • Increase the federal medical assistance percentage (FMAP) for certain Medicaid services: The Partnership has previously supported an increased FMAP of at least 12 percentage points, when combined with the increase in the Families First Coronavirus Response Act, through the duration of the COVID-19 public health emergency. We have also supported the Coronavirus Medicaid Response Act (S. 439 and H.R. 1353), which would provide an automatic FMAP increase in the event of an economic downturn. 

  • Pass the bipartisan Supporting Medicaid in the U.S. Territories Act: This legislation would extend increased Medicaid funding for Puerto Rico for five years and for additional U.S. territories for eight years. 

  • Strengthen postpartum Medicaid coverage: The Partnership applauds inclusion of a state option to extend postpartum Medicaid coverage in the American Rescue Plan Act. We urge Congress to build on this down payment to ensure that all individuals whose pregnancies are covered by Medicaid can keep their Medicaid coverage for at least one year postpartum. 

NHMA supported the American College of Ob-GYN (ACOG) Statement of Strong Medical Consensus for Vaccination of Pregnant Individuals Against COVID-19. Data from tens of thousands of reporting individuals have shown that the COVID-19 vaccine is both safe and effective when administered during pregnancy. The same data have been equally reassuring when it comes to infants born to vaccinated individuals. 

NHMA supported partner, Green Latinos in the call to Congress for Climate Justice in the Build Back Better Agenda bills being developed in Congress.  Latino communities are on the frontlines of climate change. We live in geographies with high exposure to climate hazards, air and water pollution, and are overrepresented in industries that make us susceptible to their impact, such as the agricultural and construction sectors—both vulnerable to increasing incidence of extreme heat days and wildfire smoke.  These factors are connected to and may worsen existing economic and health disparities, which is especially worrisome because Latinos have unequal access to quality healthcare services. 

NHMA called on Congress to support The LIFT the BAR Act that restores access to public programs like Medicaid, CHIP, and SNAP, by removing the five-year bar and other barriers that deny critical care and aid to people who are lawfully present and their families. This includes people who hold “green cards,” Deferred Action for Childhood Arrivals, crime victims, child maltreatment victims and orphans who hold Special Immigrant Juvenile Status (SIJS), and other noncitizens residing lawfully in the United States.

The legislation also ensures that sponsored immigrants have access to services based on the income and resources that are actually available to them. And it ensures that people across all states have similar access to e the basic protections extended by federal safety net programs, while restoring state and local flexibility to provide benefits to immigrants with their own funds

NHMA supports calls for inclusion of healthcare and climate initiatives in reconciliation package.

NHMA worked with its partners to call for the following to be included in the reconciliation package:

  • Inclusion of dental, vision and hearing in Medicare and proper funding levels with the Better Medicare Alliance

  • Inclusion of access to critical coverage for postpartum care for those receiving Medicaid with the Partnership for Medicaid 

  • Inclusion of multiple climate initiatives including making polluters pay and investments in disadvantaged communities with multiple climate and environmental organizations

  • Inclusion of at least 40% investment in disadvantaged communities through a national climate bank/clean energy technology accelerator with multiple climate and environmental organizations

NHMA calls on Congress and Biden Administration to make combating obesity in Hispanic communities’ priority. Working with the Obesity Care Advocacy Network, NHMA signed onto two letters, one to Congressional leaders to support and pass the Treat and Reduce Obesity Act and one to the Biden Administration to include obesity coverage in Medicare Part D. Obesity is linked to more than 200 serious health conditions including diabetes, heart disease, high blood pressure, and strokes and 44.8% Hispanic Americans are living with obesity. The legislation would expand Medicare coverage of intensive behavioral therapy for obesity by allowing coverage for therapy that is provided by a physician who is not a primary care physician or other health care providers (e.g., physician assistants and nurse practitioners) and approved counseling programs. It also allows coverage under Medicare's prescription drug benefit of drugs used for the treatment of obesity or for weight loss management for individuals who are overweight.

August 2021

Legislative Update — 8/13/21

NHMA convened its Congressional Briefing with Congressman Raul Ruiz, Chair, Congressional Hispanic Caucus on key recommendations to improve Latino families in the Infrastructure Investment and Jobs Act and the Reconciliation Bills being debated in Congress this past month.

Policies include:

  • Tax credits for children, health insurance subsidies, navigators for ACA enrollment and increased Medicaid insurance to cover all children and adults including essential workers and Puerto Rico and expansion in all states;
  • Family and medical paid leave
  • PreK and Community College (added free 4 years public education)

Note that Senator Durbin included an amendment in the Reconciliation Bill calling for (S747 Padilla bill) citizenship for essential workers.

NHMA organized Congressional meetings (Senate HELP, House Ways & Means) with the Health Committee of the National Hispanic Leadership Agenda to discuss these priorities as well as climate justice for the Reconciliation Package.

Dr. Rios was invited to present NHMA Priorities for the White House COVID-19 Health Equity Task Force and was asked about priorities that could have bipartisan support – she responded with the focus on Essential Workers support for healthcare and of course #Vaccinate4All campaign to increase education through media and social media that NHMA is doing.

NHMA joined 60 other national medical and health organizations in a Joint Statement in Support of COVID-19 Vaccine Mandates for All Workers in Health and Long-Term Care that made the news.

NHMA joined organizations in a call to Congress for a bold economic recovery, one that advances justice for communities on the frontlines of climate change and pollution. In addition, NHMA advocated for Climate Justice with key organizations meetings with policymakers to increase support through the Reconciliation Bill being debated in the Senate.

The Food and Drug Administration is poised to authorize an extra dose of the Moderna or Pfizer coronavirus vaccines for some immunocompromised patients this month.

Sens. Michael F. Bennet (Colo.), Catherine Cortez Masto (Nev.), Mark Kelly (Ariz.), Raphael G. Warnock (Ga.) and Maggie Hassan (N.H.), all vulnerable lawmakers up for reelection next year, renewed a push to let Medicare negotiate lower prescription medication prices with an amendment as part of the budget reconciliation process that was not voted on.

July 2021

Legislative Update – 7/9/21

President Biden and the White House and Congress are working on the American Families Plan and the American Jobs Plan in various committees and a bipartisan effort to seek infrastructure to be debated throughout the summer. 

NHMA will be hosting a Congressional Briefing on July 29th to hear from experts on the impact of these policies on health equity.

The Congressional Black Caucus, the Congressional Hispanic Caucus, and the Congressional Asian Pacific American Caucus sent a letter to Speaker Pelosi and Senate Majority Leader Schumer “to urge you to close the Medicaid ‘coverage gap’ in the forthcoming American Families Plan.” The coverage gap leaves over two million Americans with incomes below the poverty line uninsured and without any pathway to health coverage and almost two million more uninsured people with incomes between 100 and 138% of the poverty line who would be eligible if their states expanded. To advance the goals of Medicaid and the ACA, it is also critical to prioritize the elimination of disparities in Medicaid funding for Puerto Rico and U.S. territories. We also request that you work with HHS, so the agency will repeal 45 C.F.R. § 152.2(8), which excludes DACA recipients from the definition of “lawfully present” and, consequently from benefits under the ACA. NHMA Advocacy this past month:

NHMA Commented to White House Office of Management and Budget on how Federal Agencies can improve Health Equity

1.      Equity Assessments and Strategies.

We recommend training of staff to assess equity that includes the importance of working in the community and with local community based organizations to gain cultural competence.

Physicians in our communities need to have the invitations ahead of time for meetings to change schedules with their patients or teaching responsibilities. Hispanic physicians should be increased in the efforts for HHS to include more feedback on how to outreach and communicate with the Hispanic community that tend to be fearful of government.

Advisory committees consisting of local participants of the programs supported by the agency.

Information on social determinants of health and the promotion of databases by zip code for local research and data trends is key as done by CDC --- with new information from the other agencies involved with community’s key SDOH – Transportation (public transportation/rides to the doctor programs), Agriculture (Food insecurity), Interior (safe parks), HUD (housing health clinics/programs, and Model Urban and Rural programs.

2.      Barrier and Burden Reduction

Hispanics need to be a greater focus of HHS programs – Spanish Speaking, less educated, elderly, undocumented, those living alone – would benefit greatly by a Federal partner’s approach like the Census every so often – door to door, emails, mail, radio and TV spots – to have an outreach effort. For example, to let the community know about Health Insurance Enrollment (in addition to the navigators); the importance of vaccines; the importance of Senior Services – agencies, day care, food delivery, transportation; food for families through schools.

3.      Procurement and Contracting.

We recommend an improvement to assess Hispanic focused funding to institutions called Hispanic serving or Hispanic health professional schools that goes beyond a global amount of funding and assesses impact on the population – faculty, students, community education, training resources for non-Hispanics to be trained to care for Hispanics.  (HHS, Dept. of Education, NSF, etc. for STEM and Hispanic Education Funding).

4. Financial Assistance. Approaches and methods for assessing equity in the administration of agency grant programs and other forms of financial assistance.

We recommend assessing the grant recipients and the match to underserved communities as is done. However, there is a need to have a Regional Approach to sustain efforts and to have greater levels of support for a regional entity that can then partner with the local community based organizations.

For example, at HHS HRSA there are Centers of Excellence – to develop recruitment of minority/disadvantaged students and faculty and training and graduation success with the hope to see more graduates practicing in the underserved communities.  The program has a Formula to increase support to the Black, Hispanic and Native American colleges that receive the support. The Formula needs to be revised ($12M goes to 4 HBCUs, the other 12M is split among Hispanic and Tribal Colleges). Given the immense growth of the Hispanic population (projected to be 1 out of 4 Americans in 20 years) The Hispanic Centers of Excellence should be in each region with a great number of Hispanic populations and be supported at higher levels in order to have a greater impact. This effort would help increase the proportions of Hispanic physicians from 5% of the physicians that has been flat lined in general for the past 30 years.

5. Stakeholder and Community Engagement.

  • What tools can agency offices, including communications, civic engagement, enforcement, and policymaking offices, use to better engage or reach underserved communities?

Simple forms, in Federal supported places linked to other federal programs – it would be great with technology to build a database that is across the agencies for consumer support in a community. For example, in health care the county hospitals referral system for poor – community services.

Federal agencies like the social services departments – unemployment should have referrals to community services.

  • What practices should agencies put in place to reach underserved communities in rural areas or underserved communities that otherwise are not able to visit Washington, D.C., to engage with policymakers?

Media, communications campaigns with trusted messengers and in English and Spanish for Hispanics to invite them to participate in programs for their areas. Confront fear and stigma with counter messages – we all are here to build-up our families.

  • What tools and best practices might agencies deploy to establish advisory boards, task forces, and commissions that are inclusive of underserved communities?

Agencies should establish advisory board and task forces that include the target of their programs, not just the grantees. Underserved communities should have advisory boards with community member and not just the elected officials or corporate leaders or professionals that run the programs for the community members. Definitely people who participate in the programs

Joined the American Lung Association and other partners on sending a letter to EPA Administrator Michael Regan

As national health, medical and nursing organizations, we are writing to urge you to move swiftly to set stronger National Ambient Air Quality Standards for particulate matter and ozone pollution. The latest science and medical data demonstrate the urgent need for tighter limits on these harmful and pervasive pollutants, particularly to protect vulnerable populations including children, older Americans, people with living with asthma and other chronic health conditions, pregnant people and communities of color. Our organizations are deeply concerned by the health threats from breathing ozone and particle pollution and have a strong interest in standards that adequately protect health

 

June 2021

Legislative Update – 6/11/21

Dr. Rios participated in the Policy Priorities Discussion with HHS Secretary Xavier Becerra today with the Primary Care and Minority Medical Association leaders. A list of priorities includes ACA and increasing access to insurance, especially to immigrants and essential workers, telemedicine to continue beyond COVID-19, vaccination issues/barriers such as need for mental healthcare, call for structural racism education, school and work vaccine programs, GME, maternal mortality programs, and public health workforce and Latino leadership with public health and at HHS. Secretary Becerra is interested in strategies to make these policies a reality and more given our COVID-19 pandemic needs and challenges.

NHMA endorsed The Health Equity and Access under the Law (HEAL) for Immigrant Families Act (S1660) introduced by Senator Cory Booker in the Senate Finance Committee on May 17 – the bill:

  • Removes the five-year waiting period and outdated list of “qualified” immigrants for Medicaid and CHIP so that all federally authorized immigrants who are otherwise eligible can enroll.
  • Removes the unjustifiable exclusion of undocumented immigrants from getting insurance coverage from the Affordable Care Act’s Health Insurance Exchanges and makes everyone, regardless of immigration status, eligible to purchase qualified health insurance coverage, get premium tax credits and cost-sharing reductions, and enroll in the Basic Health Program, based on existing income eligibility requirements. 
  • Makes sure Deferred Action for Childhood Arrivals (DACA) recipients have access to public and affordable health coverage.

NHMA endorsed The Pursuing Equity in Mental Health Act introduced by Senator Menendez, that would:

  • Establish and fund interprofessional health care teams to provide behavioral health care.
  • Authorize grants to develop cultural competency educational curricula so students training to be social workers, psychologists, psychiatrists, and therapists will be able to properly treat youth, regardless of race or ethnicity 
  • Authorize $650 million to the National Institute on Minority Health and Health Disparities to enhance research into addressing mental and physical health disparities.
  • Authorize an additional $100 million to the National Institute of Health (NIH) to partner with communities and support clinical research, including clinical research on racial or ethnic disparities in physical and mental health. 
  • Reauthorize the Minority Fellowship Program for 5 years and nearly double the current authorized funding level.
  • Direct HHS to establish a Commission on the Effects of Smartphone and Social Media Usage on Adolescents.

NHMA advocated to Congress for patient and provider protections in model testing within the Center for Medicare and Medicaid Innovation (CMMI). Participants must understand the changes CMMI is submitting to their healthcare plans and to their healthcare —this is particularly necessary for patients of minority populations and non-English speaking patients who depend on Medicare for access to vital treatments. Patients should also be asked for feedback on their experiences with model changes.

NHMA voiced concerns regarding H.R. 3, The Lower Drug Costs Now Act, warning that using foreign country prices for prescription medications for pricing of medications in the US would limit physician’s ability to provide access to meds among our most vulnerable patients.

 

 

May 2021

NHMA President’s Update — 5/14/21

Colleagues,

NHMA supported the H.R. 1835/S. 783 the COVID Community Care Act. While the budget reconciliation process did not allow for precision and detail regarding support for medically underserved communities, Congress leaders urged Secretary of HHS to deliver on President Biden’s commitment to equity and realize the intent of the COVID Community Care Act by ensuring a targeted approach for the $63,190,000,000 for COVID response in ARP to serve medically underserved communities. In particular, they requested funding be offered in direct grants to community-based and faith-based organizations to conduct testing, contact tracing, vaccinations, and public outreach in medically underserved communities, as outlined in the COVID Community Care Act. In addition, they encouraged funds allocated through HRSA to target health centers that provide care to medically underserved communities.

NHMA supported Pramila Jayapal (D-WA-7) and Nanette Barragán (D-CA-44), and Senator Cory Booker (D-NJ) in reintroducing the Health Equity and Access Under the Law (HEAL) for Immigrant Families Act simultaneously in the House and the Senate for the first time ever.

The HEAL for Immigrant Families Act would help immigrants get the health care they need by:

  • Removing the five-year waiting period and outdated list of “qualified” immigrants for Medicaid and the Children’s Health Insurance Program (CHIP) so that all federally authorized immigrants who are otherwise eligible can enroll.

  • Removing the exclusion of undocumented immigrants from getting insurance coverage, tax credits from the Affordable Care Act’s Health Insurance Exchanges. 

  • Making sure Deferred Action for Childhood Arrivals (DACA) recipients have access to public and affordable health coverage

On April 14th, the U.S. Department of Health and Human Services (HHS) released proposed regulations to end the Title X gag rule. Since 2019, former President Trump’s gag rule has undermined the Title X program and denied people across the country access to affordable reproductive health care, such as birth control and life-saving cancer screenings.

Due to the decreased trending of COVID-19 cases as a third of Americans have been fully vaccinated, CDC recommended that persons who are fully vaccinated should no longer be mandated to wear masks indoors/outdoors this week. However, check with your local public health department for local guidance.

NHMA joined the Tobacco Free Kids and many other health advocate organizations on calling for the FDA ban against Menthol cigarettes.

This month, NHMA called for the following:

Kidney failure disproportionately impacts Hispanic patients, as well as other communities of color. Following a change in Medicare’s payment policy, some dialysis organizations are implementing new protocols that are not aligned with clinical practice guidelines and that are detrimental to patient care.  For example, step therapy protocols that require patients to try an oral calcimimetic before getting access to the IV calcimimetic, even if the patient has failed or been intolerant to the oral drug in the past; protocols that use drugs in a manner that is inconsistent with FDA approved labeling; and protocols that deny access to certain treatments until the patient’s lab values are far beyond levels where treatment is recommended in clinical guidelines. CMS does not have any relevant quality measures for secondary hyperparathyroidism to assess how patient care is being impacted by these protocol changes. CMS should immediately and publicly describe the steps it is taking to ensure dialysis patients can continue to access the calcimimetic that best meets their needs and that patient outcomes are not being harmed.  

The US government announced this month that it has developed a process for sites to directly order Monoclonal Antibody Treatment for COVID-19 from the distributor, AmerisourceBergen (ABC).  Sites are able to order bamlanivimab/etesevimab (Lilly), etesevimab (Lilly)- to pair with bamlanivimab already on hand) and/or casirivimab/imdevimab (Regeneron) for their facilities.  For more information : https://combatcovid.hhs.gov/hcp/resources-clinicians

April 2021

NHMA President’s Update — April 2021

Colleagues,

It gives me great pleasure to share with you NHMA’s progress toward reducing health disparities and improving the quality of life for Hispanic communities in this past month.

NHMA would like to congratulate former California attorney general, Xavier Becerra, on becoming the first Latino Secretary of the U.S. Department of Health and Human Services. At the 11th Anniversary of ACA Call with the Secretary, I urged for support of a Hispanic Health Initiative that includes leadership development at the department level, which has not been supported since 1996.

Last month during our Annual Conference, we announced our new “Vaccinate4All” Campaign with a call to action for individuals and organizational leaders to become a Vaccinate4All Champion and join us in encouraging vaccination participation through social media. This campaign is supported by the CDC, Johnson & Johnson, and BIO. I encourage you to visit nhmamd.org/vaccinate4all to join us in our efforts.  

NHMA also met with the White House and the U.S. Department of Health and Human Services (HHS) on a reoccurring basis to discuss COVID-19 strategies for our most vulnerable communities. However, in true advocate fashion, we did not stop there. Acknowledging private medical practices’ needs for antimicrobial therapy and vaccines, we called for increased support for them and the patients/communities they serve.

Likewise, we joined the American College of Physicians and various other medical associations, in calling for the support of the H-1B Visa that was stopped by the Trump Administration. The H-1B Visa increases access to healthcare by allowing a foreign national IMG to enter the U.S. for professional level employment for up to 6 years without having to return to his/her home country.

Other initiatives NHMA championed during the month of April:

  • Supported the Biden Administration’s American Rescue Plan
  • Supported the reintroduction of the Tri-Caucus and Senator Warren’s COVID Community Care Act
  • Supported the Improving Social Determinants of Health Act of 2021 (S. 104/H.R. 379)
  • As a member of the Adult Vaccine Coalition, NHMA backed efforts that urged the Appropriations Committee to support $1.13 billion for the National Immunization Program at the Centers for Disease Control and Prevention (CDC)’s National Center for Immunization and Respiratory Diseases
  • Joined the U.S. Department of Health and Human Services (HHS) COVID-19 Community Corps as a founding member.
  • Joined the Modern Medicaid Alliance in advocating for an increased FMAP of 12 percent to provide support for children, people with disabilities, mental health and substance abuse services and community-based care.
  • Joined the CDC Coalition in requesting an increase of $10M to CDC in FY22 to expand prevention programs.
  • Joined environmental justice groups in requesting investments that will prioritize environmental justice, strengthen economically disadvantaged communities, improve public health, reduce pollution, and help dismantle systemic racism and promote equity for communities of color

At the beginning of this month, HHS announced $10 billion to increase vaccine access and confidence in hard-hit vulnerable communities, including $3 billion of CDC funding to support outreach efforts in the states through community-based organizations and trusted community leaders. HHS also announced $250 million in minority health grants to increase vaccine uptake in minority communities, and CDC has provided $255 million in awards to community and civic groups for vaccine outreach. NHMA is proud to be a founding member of the HHS COVID-19 Community Corps – a “nationwide, grassroots network of local voices and trusted community leaders to encourage vaccinations, with more than 275 founding member organizations that have the ability to reach millions of Americans.”

Lastly: As you now know we have welcomed 3 new team members this past week. I am excited and look forward to all they will accomplish as they champion for the critical work we undertake at NHMA.

Yours in the work,

Elena V. Rios, MD, MSPH, FACP

President & CEO, National Hispanic Medical Association

President, National Hispanic Health Foundation

March 2021

On March 11, 2021, President Biden signed the American Rescue Plan Act of 2021 (ARP) into law that will reduce health care costs, expand access to coverage, and ensure nearly everyone who buys their own individual or family health insurance through a Marketplace can receive a tax credit to reduce their premiums. The ARP will also reduce poverty by providing child tax credits for families’ income taxes, and supports jobs for public health and healthcare providers. Individuals with incomes below $75K or couples below $150K will receive $1400 and unemployment recipients will receive an extra $300/week until September. ART supports pregnant women, children, and struggling families can maintain access to the essentials during the emergency, like housing, diapers, internet service, soap, and food. NHMA supports the ART and will educate our members to understand we need these changes to become permanent.
 
NHMA meets with the Biden Administration:
Dr. Rios was invited to meet with the White House along with other national Hispanic leaders to discuss our activities and plans to reduce COVID-19 and increase vaccines in our communities. Rios mentioned the importance of appointing Latinos to HHS this year.
 
NHMA meets with the Congressional Hispanic Caucus:
Dr. Rios met with the Congressional Hispanic Caucus on our priority issues and focused on health care access, immigration reform, healthcare career pipeline and leadership development, and our new #Vaccinate4All Campaign.
 
NHMA supported the expanding Medicaid which is the largest health care program in the country, covering about 1 in 5 Americans, including millions of children, older adults, people with disabilities, and nearly 2 million veterans. This year Medicaid should support COVID-19 vaccinations and expand since so many more will be impacted by the pandemic.
 
NHMA supported the importance of expanding policies to improve the environment and has met with the Secretary of the Department of Energy on the new focus on decreasing energy from fossil fuels such as supporting the development of electrical cars. 
 
NHMA State Advocacy: NHMA invited physician members to meet with Congresswoman Frankel (Florida) about COVID-19 and Latinos and also supported the California Medicine Scholar Program and Regional Pipeline Programs to the California legislature.

February 2021

Washington, DC -  NHMA has supported the continued COVID-19 Relief legislation including the Community Cares Act to support healthcare supplies, vaccines and distribution to new FEMA/national guard sites, federal clinics, pharmacies, and mobile units to hard to reach persons, and public healthcare infrastructure with new jobs for test, trace, data collection, educators, and assistance to individuals including child tax credits and increased minimum wage to $15/hr and more. We also support the Congressional Hispanic Caucus priorities to support immigrants who have worse health outcomes, given more impact from the pandemic as essential workers and other challenges. 

NHMA has supported the Biden White House executive orders to open ACA enrollment for 3 months, to join the Paris agreement and the World Health Organization, to support DACA and stop building the US-MX wall, and to increase the federal  plannngCOVID-19 response with increased vaccine doses and notices ahead to assist the appointment process. 

NHMA has supported the Senate Confirmation of Xavier Becerra to become the HHS Secretary as a leader who can work with the agency and stakeholders to build up the health and mental health care and social services needed across the nation so impacted by COVID-19. 

NHMA is preparing to start partnership with CDC and developing its "Vaccinate4All" campaign and to develop the NHMA Leadership Fellowship to train mid-career physicians to be leaders in public health and decision-making positions to increase healthcare prevention and education that is culturally competent and linguistically appropriate. NHMA is also going to train leaders from other Hispanic health professional organizations and community organizations in our NHMA Chapters' target areas with webinars and social media and new media projects. We plan to build our advocacy strategies with our partners to share with the new White House Health Equity Task Force.

March 2019

Sen. Udall, Senate Leaders Introduce Bill to Ban Chlorpyrifos Nationwide

Legislation endorsed by the NHMA

Washington, DC – A day after President Trump’s EPA once again argued for delaying its own ban of chlorpyrifos in court, Senator Tom Udall (D-NM) introduced the Protect Children, Families and Farmworkers from Nerve Agent Pesticides Act, legislation that would ban the dangerous chemical. Earthjustice, the environmental law organization representing labor leaders, farmworker communities, and environmental activists in litigation against the EPA on its lack of commitment to protecting people from chlorpyrifos, announced its support for Sen. Udall’s bill.

Chlorpyrifos is a widely-used agricultural pesticide linked to reduced IQ, attention deficit disorder and other developmental damage in children. Chlorpyrifos, an organophosphate that comes from the same chemical family as sarin nerve gas, is used on staple foods, such as strawberries, apples, citrus, broccoli, and more. Weeks after former EPA boss Scott Pruitt met with the head of the largest manufacturer of chlorpyrifos, Dow Chemical, Pruitt falsely claimed in 2017 the science is “unresolved” and decided EPA would study the issue until 2022.

“The scientific evidence is clear and this bill is needed because EPA continues to ignore science and the law. Chlorpyrifos is toxic to farmworkers and is linked to neurodevelopmental problems in children,” said Dr. Elena Rios, president of the National Hispanic Medical Association. “We must have a chlorpyrifos ban.”

This week, in oral arguments before the 9th U.S. Circuit Court of Appeals, Earthjustice attorney Patti Goldman argued for faster action on a nationwide ban, contending that EPA continues to sit on administrative objections to its approach to chlorpyrifos. “The Trump Administration is fighting tooth and nail for a pesticide EPA’s own scientists found unsafe to children,” Goldman said. “Make no mistake, chlorpyrifos in our food means children are needlessly eating, drinking and breathing this dreadful pesticide.”

More: What You Need to Know about Chlorpyrifos

December 2018

NHMA Submitted the following comment regarding the proposed rule change to the Public Charge.

The National Hispanic Medical Association, representing 50,000 Hispanic physicians, strongly opposes the Public
Charge Proposal that the U.S. Department of Homeland Security announced on September 22, 2018. The proposed
changes would greatly undermine achievements made in access to preventative services and medical care for
Latino legal immigrants by penalizing their participation in nutritional, health care, and housing assistance
programs. These programs are essential for millions of families to lead a healthy life, and we fear many immigrants
who have been long-term U.S. workers will be deported if these changes are implemented.

Since 1892, federal immigration law has had a “public charge” test that makes immigrants ineligible for entry to
the United States or permanent residence (green card), if they depend or may in the future depend on the
government as their main resource for living expenses. Under current policy, government support from emergency
health care, prevention of infectious disease, disaster relief, nutrition assistance programs, and housing assistance
programs are not counted towards public charge. The benefits considered in determining who is likely to become
a public charge are cash assistance such as Supplemental Security Income (SSI) and Temporary Assistance for
Needy Families (TANF) and government-funded institutional long-term care. Furthermore, the Clinton-era
welfare reforms already put major social service programs out of reach for most legal immigrants until they’ve
been here for five years.

The Trump Administration is now calling for healthcare and other benefits that meet basic needs to be considered
in a “public charge” determination such as:
• Non-emergency Medicaid (with limited exceptions for certain disability services related to education),
• Supplemental Nutrition Assistance Program (SNAP),
• Low-Income Subsidy for prescription drug costs under Medicare Part D, and
• Housing assistance such as Section 8 housing vouchers and rental assistance

The proposal has already made immigrant families afraid to use programs that are essential to their health and
well-being. If the rule is finalized in its proposed form, it would mark a significant and harmful departure from
current policy, penalizing working class immigrants who seek the same American Dream that for generations has
been a source of strength for our country. It is irresponsible of this administration to make immigrant families
choose between their health and their immigration status. According to the Kaiser Family Foundation, 19 million
children in the US have an immigrant parent, and 90 percent of these children are American citizens. Parents
should not be punished for accepting help so they can provide food, a home, and healthcare to their children.
Millions of Hispanics in the US are or have family members who are at various stages of the naturalization process,
and many already face barriers to housing and medical care. These rules would only exacerbate existing inequities,
magnifying the stresses that come with housing insecurity, food insecurity, and lack of health insurance. Forcing
these families to forgo medical care will allow preventable illnesses to develop and leave chronic conditions
untreated, increasing costs to the healthcare system and for US taxpayers. Addressing the needs of families enables
them to lead productive lives, to the betterment of our country. It is in the interest of the Federal government and
to the benefit of all Americans that the basic needs of lawfully present immigrants and their children are supported.

The National Hispanic Medical Association urges the Department of Homeland Security to renounce this
proposal. Our organization is willing to work with the Trump Administration to develop common sense reforms
to our immigration system that respect the health and dignity of all immigrants and their families.

 

August 2018

National Hispanic Medical Association Decries Trump Administration Weakening of Clean Cars Standards, Highlights Negative Impact of Rollback on Latino Communities

Today, Dr. Elena Rios, President of the National Hispanic Medical Association (NHMA), released the following statement in response to the Trump administration’s decision to roll back America’s clean car standards, and highlighted the negative impacts that this misguided decision could have on Hispanic communities:

“President Trump, EPA Acting Administrator Andrew Wheeler, and acting NHTSA Administrator Heidi King are rolling back protections that Hispanic communities depend on. Rolling back the clean car standards will make our air more polluted and will force drivers into dirtier, less-efficient vehicles that are more expensive to drive. Cleaner, more efficient vehicles reduce dangerous tailpipe pollution, helping to prevent harmful health impacts like asthma attacks and heart disease that disproportionately affect our communities, who often live in neighborhoods with higher levels of harmful air pollution.”

“Furthermore, these standards are saving Americans money to the tune of $60 billion and counting. Hispanics and low- and middle-income families will be hit hard if the fuel economy standards set to save them money on gasoline are taken away. By dismantling protections like clean car standards, the Trump administration is failing our communities families.”

June 2018

CALL TO ACTION: Unlawful & Immoral Family Separations & What Can You Do? 

NHMA is against this dangerous, illegal and immoral practice of family separations. The uncertainty over immigration, as well as practices currently in place including the border separation of children from their parents/caregivers, have a dangerous impact on the mental, physical and emotional well-being of our communities. While Latinos show similar rates of mental illness as other racial and ethnic groups, their access to care and quality of treatment is much poorer. Additionally, Latinos seek treatment less frequently, whether that be because of language barriers, legal status, social stigma or lack of health insurance. Mental health conditions contribute greatly to how a person then cares for their physical well-being. People with serious mental health conditions have been shown to have higher incidences of cardiovascular disease, osteoporosis, and diabetes. A chronic, serious mental illness can significantly shorten life expectancy. Latinos struggling with mental illness should reach out to a health care provider, and physicians should strive to be well-versed in cultural and linguistically appropriate treatment of the Hispanic population.

  1. Please call your member of Congress (click here and type in your zip code to find your Representative and their contact information and click here to find your Senator) and urge them to hold this Administration accountable for their actions.
  2. Join and support a march on Washington and Families Belong Together rally led by MoveOn and others. Distributed actions will be planned across the country
  3. Contribute financially if possible. 

CALL TO ACTION: Vote “NO” on “Border Security and Immigration Reform Act of 2018” (H.R. 6136) and “Securing America’s Future Act of 2018” (H.R. 4760)

NHMA urges Members of Congress to oppose both Speaker Ryan’s “Border Security and Immigration Reform Act of 2018” and Representative Goodlatte’s “Securing America’s Future Act of 2018” ( H.R. 4760). Both bills hold Dreamers hostage in return for provisions that would upend our immigration system and betray American values.

Speaker Ryan’s “Border Security and Immigration Reform Act of 2018” pairs Deferred Action for Childhood Arrivals (DACA) provisions with severe cuts to legal immigration, policies that undermine vital protections for vulnerable populations, and dramatic increases in funding for immigration enforcement. Among other provisions, the current bill would:

  • Drastically reduce legal immigration by eliminating several family-based immigration categories and eliminating the diversity visa program.
  • Undermine protections for vulnerable populations, including raising the credible fear standard for asylum seekers and eliminating certain TVPRA protections, sending children more quickly back to the countries from which they fled.
  • NOT address the family separation crisis, which can be stopped right now by this Administration. Instead, the bill would jail children and their families for long periods of time.
  • Balloon funding for enforcement, including additional Border Patrol agents, a $25 billion appropriation for the border wall, and funding to keep children and families in jail.
  • NOT adequately protect Dreamers. The bill provides for contingent nonimmigrant status and creates a “point system” that would leave many Dreamers without protection.

Representative Goodlatte’s “Securing America’s Future Act of 2018”( H.R. 4760) is an anti-immigrant wish list that slashes legal immigration to untenably low levels, mandates unnecessary and harsh enforcement tactics, creates millions of criminals out of thin air by making unlawful presence a crime, and seems focused on excluding the largest number of Dreamers from the very few weak protections it claims to provide. Among other provisions, the bill would:

  • Eviscerate legal immigration by gutting the family-based immigration system and eliminating the diversity visa program.
  • Make employment verification mandatory for all employers.
  • Criminalize unlawful presence, creating millions of criminals out of thin air.
  • Mandate long-term detention of nearly everyone in removal proceedings despite due process, capacity, and cost prohibitions.
  • Undermine access to asylum for individuals who have been persecuted abroad, including heightening the credible fear standard.
  • Eliminate safeguards for vulnerable children by amending the Trafficking Victims Protection Reauthorization Act of 2008 (TVPRA).
  • Require a massive buildup of immigration enforcement, including construction of a wall, hiring of additional CBP, and waiving crucial polygraph requirements.
  • NOT adequately protect Dreamers. As written, the bill provides only a contingent nonimmigrant status to eligible applicants for renewable three-year periods, excludes anyone who does not have valid DACA on the date of enactment, and imposes punitive eligibility requirements.

Please call your member of Congress (click here and type in your zip code to find your Representative and their contact information and click here to find your Senator) and urge your representatives to provide our communities with a clear  and dignified path to citizenship and

NHMA opposes House farm bill set for a second vote Friday, June 22, 2018. It would cut millions of Americans’ SNAP benefits. 

The House will vote on a farm bill for the second time in just over a month on Friday after it was defeated in May by a margin of 213-198. The farm bill comes to a vote every 5 years, with this year’s version increasing work requirements for eligibility for the Supplemental Nutrition Assistance Program (SNAP), otherwise known as food stamps. This would ultimately reduce or terminate SNAP benefits altogether for millions of people, including many Latinos.

According to the most recent Census data, 19% of Latino households lack adequate food, compared to 13% in the overall population. The benefits of SNAP for the Latino community are tremendous. The USDA and the Census Bureau estimate that around 10 million Latinos are able to put sufficient food on the table each month because of SNAP benefits. SNAP raised around 2.5 million Latinos, almost half of them children, above the poverty level in 2015. Latinos account for over 20% of all SNAP participants in the U.S. This population would, therefore, be disproportionately affected if SNAP benefits were to be taken away or made nearly impossible to qualify for.

The House farm bill aims to increase work requirements for SNAP. The opposition argues that only around 8% of SNAP participants are able-bodied adults, while the rest are children, seniors, people with disabilities and adult caretakers. Of those able-bodied adults, research has shown that around 25% of them already work while receiving benefits, and almost 75% worked either the year before or the year after they received SNAP benefits.

The health of Latinos is at risk if the House farm bill is enacted. SNAP benefits allow for healthier food to be purchased. SNAP has been associated with better health outcomes, as food insecurity is linked to reduced ability to manage illness. Food insecurity also results in higher costs of health care. Studies have shown that increased food insecurity is correlated with more chronic illnesses, less adherence to medications, and more emergency room visits.

A Senate-proposed bipartisan farm bill was approved by the Senate Agricultural Committee on June 13th and is expected to be brought before the full Senate before the July 4th recess. The Senate farm bill extends SNAP, a key difference between the 2 bills. Included in the bill is permanent funding for farmer’s markets, another way to get healthy food onto the tables of low-income SNAP participants.

The House and Senate must reach a negotiation by the end of September, when the current farm bill will expire. Please call your member of Congress (click here and type in your zip code to find your Representative and their contact information) and encourage them to vote no to the House farm bill (H.R 2).

May 2018

NHMA Participates as a panelist in House Committee on Natural Resources hosted Roundtable Discussion

Dr. Rios served as a participant in a routable discussion on the intersection of environmental and conservation policy and public health for our communities. Dr. Rios spoke on the disproportionate impacts of air pollutants on respiratory health of Latinos and the importance of public lands, parks and other accessible green spaces for not only our communities’ physical health, but also their mental health.  The briefing was widely attended by committee staff from the House Committee on Natural Resources, Congressional staffers and Congresswoman Nanette D. Barrágan & Ranking Member Raul Grijalva. 

Comments on the National Institute of Minority Health and Health Disparities (NIMHD) proposed new structure submitted by the Minority Physicians Alliance.

The Minority Physicians Alliance represents a coalition of five minority medical organizations – the Association of American Indian Physicians, the Association of Black Cardiologists, the Council of Asian and Pacific Islander Physicians, the National Hispanic Medical Association, and the National Medical Association who are all committed to health equity in the United States especially by reducing racial and ethnic health disparities.

The Alliance strongly supports the vision of the NIHMD – to raise national awareness about the prevalence and impact of health disparities and disseminate effective individual-, community- and population-level interventions to reduce and encourage elimination of health disparities.

We agree that the NIHMD restructuring is designed to streamline specific functions, areas of operations, and roles and responsibilities to maximize productivity and increase efficiency and timeliness of these operating areas: research, science policy and planning, communications, and administrative services.

We recognize the importance of integrating administrative functions (data management) of the current structure and expanding the other areas of the new Administrative structure (Administration, Communications, Extramural Research Administration, and Policy, Legislative and Data Management).

Given the underrepresentation of our member physicians and scientists in biomedical, health services  and community health research, we urge the expansion of research training that increases diversity among the health disparity researchers that goes

We recognize that the Research Training function is critical and should be expanded to all the following new areas of focus of research activity in the new NIHMD structure:

    • Biological and behavioral sciences
    • Clinical and health services research
    • Community health and population science
  • Intramural research – tobacco, cancer, population health

In summary, the Minority Physicians Alliance supports the new NIHMD structure because it will promote more effective research activities that we believe will improve the critical knowledge about strategies to increase health equity and to improve the health of all Americans.

April 2018

Please join the National Hispanic Medical Association in advocating for the following that impact Hispanic health:

  • NHMA fully supports the Congressional Tri-Caucus Health Equity and Accountability Act. It will be released in the end of April and includes the following sections:
      • Data Collection and Reporting
      • Culturally and Linguistically Appropriate Health Care
      • Healthcare Workforce Diversity
      • Improvement of Health Care Services
      • Improving Health outcomes for Women, Children and Families
      • Mental Health
      • Addressing High Impact Minority Diseases
      • Health Information Technology
      • Accountability and valuation
    • Addressing Social Determinants and Improving Environmental Justice

Dr. Elena Rios, NHMA President & CEO, along with the Association of American Medical Colleges and FamiliesUSA, worked on Title III, Health Care Workforce Diversity, to ensure that there are programs in place that help our communities be able to attend a terminal health care degree program and for our families to be able to receive cultural and linguistically competent care.

  • NHMA also urges Congress to protect public lands, national forests, parks and other accessible green spaces. Studies that shown that:
      • Being active has been shown to improve mental health by reducing stress levels and alleviating symptoms of depression. Unfortunately, 60 percent of U.S. adults, and much lower percentage of Latinos, do not get the minimum recommended amount of physical activity needed to achieve health benefits each day.
      • Several studies have shown that parks can increase the physical and mental health of seniors who live near them.
    • Having access to these valuable spaces is imperative for our communities, who often time don’t live in areas that allow for a lot of movement and fresh air (apartment complexes and shared homes)
  • We support Congressman Joseph Crowley’s bill; H.R. 2267 “Resident Physician Shortage Reduction Act of 2017
      • This bill would add 15,000 Medicare supported direct graduate medical education (DGME) and indirect medical education (IME) residency slots over fiscal years 2019-2023.  
    • It would require the Comptroller to conduct a study on strategies for increasing health professional workforce diversity. 

Please contact your representative today and  (Click here to find your Senator and Click here to find your Representative)

February 2018

National Hispanic Medical Association Announces Recommendations for Cardiovascular Disease and Hispanics

Cardiovascular Disease (CVD) is a leading cause of death among Hispanics. Unfortunately, there’s a significant void in the knowledge base of the physician and patient advocacy community about cardiovascular disease diagnosis, access to care, and health care workforce training related to Hispanic populations. As such, there is a critical need to raise awareness about these issues to improve the future health of the Hispanic population in the United States.

In 2017, the National Hispanic Medical Association convened a Summit Series to increase awareness of: cardiovascular disease prevalence, prevention and diagnosis in the Hispanic/Latino community; access issues pertaining to CVD healthcare services; and education and advocacy for health care professionals and patients. The Summit Series was part of NHMA’s broader effort to increase health equity among Hispanics.

We were proud to welcome legislators at all three Summits to set the stage for a compelling dialogue with opening remarks, and share the important work related to their constituencies. It was an honor to welcome:

  • State Representative Diana Arevalo (Texas District 116), Member of the Mexican American Legislative Caucus and the Healthcare Committee for the National Hispanic Caucus of State Legislators;
  • Honorable Assemblyman Marcos A. Crespo (New York District 85), Chairman of the Puerto Rican/Latino Task Force; and
  • Los Angeles County Supervisor Hilda Solis (California District 1), former Secretary of Labor.

If you missed the Summit, you can download the final presentation decks click Here. NHMA developed and issued a comprehensive final report that shares key issues and recommendations to improve Hispanic/Latino health and access to care.