I applaud the Biden team and the Equity Research & Innovation Center (ERIC) at Yale for focusing on equity in the vaccine rollout and working to address what this pandemic has been a harsh reminder of: Too many Americans of color face vast inequality in our health care system. And it’s systemic.

As health insurers have pushed premiums and deductibles higher over the past decade, people of color, especially those with lower incomes than Whites, have been harmed disproportionately.

In 2019, before the pandemic, the U.S. Census found the median White household had $76,000 a year in income. That number dropped to $56,000 for hispanic households, and $45,000 for Black households.

For those families who are above Medicaid eligibility but still living paycheck-to-paycheck as more and more Americans now do, the insurer-led increase in high deductibles and copays over the last decade has hurt Black and Latino Americans more than their White counterparts.


Now, the pandemic has worsened our nation’s racial equity health problems.

Black Americans are three times as likely as Whites to die from COVID-19. And in the pandemic’s first six months, indigenous, Black and Latino Americans were four times more likely to be hospitalized with COVID-19 than their White counterparts.

I am happy to hear Dr. Marcella Nunez-Smith, the founder of ERIC, discuss the need for sustained focus on these inequities in our system, beginning with vaccine distribution.

The Biden team’s work can’t stop there. A focus on rising deductibles and copays, which burden Americans of color the most, must be a top priority of health reforms to follow the pandemic.

To understand just how devastating high deductible health plans (HDHPs) are to people of color, just look at the findings of a Boston University study last year that looked at the effect of HDHPs on cancer treatment.

BU researchers found that 24.6 percent of Black cancer patients on HDHPs took less medication in order to save money, compared to 8.6 percent of White patients on similar plans.

They also found that 28.1 percent of Black patients and 7.7 percent of White patients on HDHPs delayed filling a prescription in order to save money, much higher than the 16.2 percent of Black patients and 7.1 percent of White patients on other types of plans.

And 14.9 percent of Black patients on HDHPs couldn’t afford a specialist compared with 6.2 percent of White patients. On other types of plans, 4.9 percent of Black patients and 2.9 percent of White patients could not see a specialist for financial reasons.

Enrollment in HDHPs may compound the many structural inequities that Black cancer survivors are already facing, which may further drive disparities in health outcomes for survivors,” the researchers wrote.

Biden team: You know Black communities are being hit the hardest during this pandemic, but Black patients with cancer and other diseases are being hit even harder by a system that permits insurers to saddle Americans with deductibles they can’t meet.

The Potter Report is co-published by To Be Fair, Inc. 501(c)3/Tarbell.org and Business Leaders for Health Care Transformation.