1:25pm By Gary Puckrein, Ph.D. | The nation’s population is quickly becoming more and more black and brown. In states like California, much of the population growth over the last decade is in the African American and Latino communities.  Traditionally, communities of color are disproportionately impacted by health disparities with high rates of diabetes, hypertension, and heart disease.  So the experts have reasoned that by increasing access to health insurance, we will improve health outcomes for citizens across the socio-economic spectrum.

According to a recent Kaiser Commission report on Medicaid and the uninsured, about one-quarter of uninsured adults say they have forgone care in the past year because of its cost — as compared with only four percent of adults with private coverage.  The report points out that silent health problems, such as hypertension and diabetes, often go undetected without routine check-ups. Uninsured non-elderly adults are far less likely to have had regular preventive care, including cancer screenings as compared to those with coverage. According to recent census data in California, nearly one in five people are uninsured, and these numbers increased by tens of thousands in just one year –from 2009 to 2010. But in 2014, all this will change due to the Affordable Care Act (ACA), which will require Californians to purchase health insurance. To ensure that low-income individuals can buy health insurance, the ACA also provides tax subsidies to people who cannot afford it. Every state will be required to set up a health insurance exchanges– or Internet marketplace — that will quickly increase citizens’ access to health care. Whether run privately or by the government, these portals or exchanges will give consumers an opportunity to compare health insurance options and find the one that best suits their needs.  They pit insurance providers in direct competition with each other forcing them to provide the best value for consumers’ healthcare dollars. In the next two weeks, policy makers in Washington, D.C. will be finalizing the details on how states will go about setting up these programs. If policy makers get it wrong by 1) not accounting for residents of all socioeconomic levels, or, 2) by not adopting the proper tools for citizens to access health care coverage, states like California stand to be disproportionately hurt.

As states and federal government begin the work of enrolling tens of millions of uninsured Americans, the government, the private sector, and community-based organizations should work together to provide citizens with tools to discern what health insurance coverage is best to meet their individual needs and should push them to immediately sign up for that coverage. In addition, as the Government considers the tools for implementing the program, it should look to private sector successes. For example, policy makers should take advantage of private Internet market places  — the government calls them web-based entities (WBEs) — that have enrolled millions of individuals, including large numbers of the uninsured, into quality health insurance plans. In Washington, policy makers at the Department of Health and Human Services (HHS) are debating how best to manage consumers’ ability to use WBEs, which are websites currently utilized by thousands of consumers that allow immediate access to health insurance.  This will help states more effectively and quickly sign up citizens for health care coverage and ensure that people have immediate access to the care they need.  Federal and state regulators should oversee health plans so citizens know they’re getting the types of services they would expect in their health care plan. Policymakers should understand the dire implications that poorly worded and implemented federal policy would have on large population groups. HHS Secretary Sebelius must ensure that the regulatory language is properly articulated so as to allow all citizens – both those who qualify for the federal subsidy and those who don’t – equal access to enroll through WBEs.

A common sense approach like the use of WBEs will further the President’s goal of implementing the Affordable Care Act in a way that maximizes the number of uninsured individuals enrolled in a qualified health insurance plan – regardless of income – while at the same time allowing states the ability to retain their traditional role of regulating agents and brokers.  In states like California, a commitment to fairness will help expand the number of Californians who get health care and help patients get the best care possible. We have a chance to finally close the health care gap by making sure that all citizens have access to the health insurance they need as quickly as possible and further bring hope of better health to families across the country.  Will our government heed the call?

Gary Puckrein, Ph.D. is president and chief executive office of the National Minority Quality Forum, a research and educational organization dedicated to ensuring that high-risk racial and ethnic populations and communities receive optimal health care. This nonprofit, nonpartisan organization integrates data and expertise in support of initiatives to eliminate health disparities.