Insurance should end surprise medical billing

Op/Ed & Letters 6 • March 11, 2020 The LEGACY

Big insurance must help end surprise medical billing

DR. BEN F. CHAVIS, JR.

It is a serious financial problem that far too many African-Americans - from impoverished individuals to working-class families - face these days in the bewilderingly complicated health-care market: Getting hit with an unexpected bill after a hospital stay or visit to the emergency room.

Known as “surprise medical billing,” these unexpected costs arise when a patient goes to a hospital for emergency or non-emergency care, only to find out afterwards that one of the medical providers who administered care was not covered in the patient's insurance network. This outrageous situation benefits one group and one group alone: powerful insurance executives, who have managed to get off the financial hook for such bills, even as insurers shrink insurance coverage networks to wring more and more profits out of the system.

But this predatory practice is overwhelming to a family already dealing with the emotional and financial burdens of a medical crisis, typically adding thousands of dollars in unexpected expenses that can wipe out savings accounts or otherwise strain tight household budgets.

So, what can be done to stop and end surprise medical billing? The good news is that both Republicans and Democrats in Congress agree that legislation is needed to protect patients against unexpected medical charges. But as with many complicated issues confronting Congress, lawmakers have been divided on the details of such legislation.

Part of the paralysis in Congress stems from confusion and disinformation, as insurance executives and their allies try to frame the debate to their advantage. When Congress tried to address the issue last year, for example, the insurance lobbying machine swung into action, attempting to place the blame for surprise bills on out-ofnetwork medical providers who end up having to charge patients when insurers refuse to cover a medical bill.

Big insurance almost got its way in that legislative debate when a handful of lawmakers threw support behind a legislative proposal that would shield insurance companies

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from paying what they ought to pay. The legislation, championed by Sen. Lamar Alexander (R-Tenn.), specifically called for setting benchmarked rates for out-ofnetwork medical providers.

But far from solving the problem, this approach would make matters worse. It not only frees insurers from their responsibilities. It fails to compensate providers for the cost of the care that they actually provide. And that, in turn, means either patients will get stuck with the bill or medical providers will have to absorb big losses that ultimately jeopardize their ability to stay in business.

Fortunately, the proposed bill stalled after the medical community warned that the benchmarked rate favored by the insurance industry would allow insurers to exert a new troubling level of control over health-care prices and the larger health-care delivery system.

Now, as Congress begins to take up the issue once again, health insurance companies that evaded significant scrutiny last year seem to be drawing close scrutiny now, both inside and outside of Washington. Speaking to a group of faith

(continued on page 7) leaders and policymakers in South Carolina, an important stop for the 2020 Democratic presidential primary, Reverend Al Sharpton criticized the surprise medical billing legislation backed by insurers and stressed the urgent need to deal with the continued lack of access to adequate health insurance coverage for minority communities.

“Washington is getting it wrong,” he wrote in an opinion piece published after his South Carolina trip, adding that the bill introduced by "Sen. Lamar Alexander (R-Tenn.) to ‘solve’ the surprise billing problem would literally insulate insurance companies from covering these costs, at a time when profits for insurance companies have reached record highs.”

In the U.S. House of Representatives, Ways and Means Committee Chairman Richard Neal (D-Ma.) predicted that health insurers would do little more than look out for their own interest if they were given the authority to set rates for out-of-network providers.

“My concern with giving too much weight to such a benchmark rate is that we already know insurers

WE DID IT.

March 6, 2020 was a historic day for representative democracy in Virginia. The General Assembly passed SJ18 (Barker) for the second year in a row with support from both parties. Gerrymandering has always been a bipartisan problem that has required a bipartisan solution.

With this vote, the Commonwealth is continuing on the path to amend the state constitution to create our firstever redistricting commission. The legislature has taken a significant step towards truly reforming the way Virginia draws its electoral districts by:

* Including citizens in the redistricting process for the first time;

* Enshrining the protections of the federal Voting Rights Act in the Virginia Constitution;

* Requiring full transparency of the commission’s meetings; and * Instituting preventative

measures to ban gerrymandering on the basis of race and partisanship.

Getting to this point has been a long process, and there have been spirited conversations about some provisions of the bipartisan amendment -- even among those who have long supported reforming Virginia’s broken redistricting practices.

We feel that these discussions have made the amendment and accompanying enabling legislation even stronger, and OneVirginia2021 will work with redistricting and voting rights advocates of every political persuasion to ensure that the commission’s work is successful if the November referendum passes. In the end, we all want the same thing: to improve the outdated and unfair practices of Virginia’s redistricting process.

And while voters will have the final say on November’s ballot, we are energized by the endorsements of over a dozen Virginia-based advocacy organizations, nationally-recognized redistricting experts, every major newspaper in Virginia and over 70 percent of registered voters in the Commonwealth.

Looking forward, we are committed to ensuring the passage of this ballot initiative in November.

We are also grateful to our legislative champions [and] our 120,000+ grassroots supporters. Brian Cannon OneVirginia 2021

(from page 6) are looking for any way they can to pay the least amount possible,” he said. “They will work to push those rates down, regardless of what it means for community providers like physicians, hospitals, and our constituents who they employ." There were similar concerns in the U.S. Senate, where Senator Bill Cassidy (R-La.) warned that insurers began gaming the system in California once benchmarking rates became the law of the land in that state in 2016. “Insurance companies cancel contracts and then they have the negotiating power and they establish" their own rate, he said, adding that such benchmarking of rates would likely put hospitals "out of business.” It’s worth noting that lawmakers are raising such concerns despite the considerable backing the insuranceindustry legislation has had from two powerful lawmakers: Senator Alexander, chairman of the Senate Committee on Health, Education, Labor, and Pensions; and Frank Pallone, the chairman of the House Energy and Commerce Committee, whose jurisdiction includes health care issues. More than that, Senator Cassidy introduced legislation that would eliminate surprise medical billing by establishing an arbitration system between insurers and providers -- rather than sticking the disputed medical charges to patients. And that legislation is gaining strong bipartisan support, as is a similar bill in the House that is being advanced Representatives Representative Phil Roe (R-Tenn.) and Representative Raul Ruiz (D-Calif.), both of whom are doctors. Surprise medical billing is a problem we can no longer ignore, particularly at a time when roughly two-thirds of Americans say that they are concerned about their ability to pay for an unexpected medical expense for themselves or for a family member. And this practice it is especially hard on African Americans and other people of color in the U.S. who already face significant barriers to health care and who generally receive lower quality of care than the rest of the nation. Congress has an opportunity to make things right by ending the practice of surprise medical billing. Black Americans and all others in America shouldn't be saddled with exorbitant bills that they had no reason to expect - and that impose an unjust financial burden. Chavis is president and CEO of the National Newspaper Publishers Association (NNPA) representing the Black Press of America. He can be reached at dr.bchavis@nnpa.org.

8 •March 11, 2020 Faith & Religion

Faith leaders: Fear remains a barrier for minority participation in U.S. census

ADELLE M. BANKS

RNS — As the once-a-decade count of Americans nears, U.S. Census Bureau officials brought faith leaders together to talk about their role in getting congregants across the country to participate.

“You are your community’s most trusted voice,” Steven Dillingham, director of the U.S. Census Bureau, told about 100 leaders gathered last month for the bureau’s interfaith summit in an auditorium of the Washington National Cathedral. “We appreciate your help in delivering our message to your congregations and assuring them that the 2020 census is easy, it is safe and it is important to their community and our nation.”

But, while speakers from a range of faiths cited numerous ways they are working to encourage participation in the count that officially starts April 1, issues of trust and safety were exactly what were on the minds of some of the attendees.

Pastor John Zayas of Chicago voiced concerns about threats by the Trump administration to sanctuary cities, including the presence last summer of armed Immigration and Customs Enforcement agents in his city.

“Do we have a guarantee from the administration, from the department, that our information doesn’t go to those places?” he asked. “Because there’s legitimate fear here.”

The Rev. Gabriel Salguero, president of the National Latino Evangelical Coalition, responded, saying congregations, like his in Florida, need to become “safe spaces.” Some members of Calvario City Church in Orlando, where he is the senior associate pastor, have been certified by the Census Bureau as onsite trainers who can assist people in responding to the census online.

“I think we have to acknowledge the fear,” said Salguero in response to Zayas’ question. “And then I think the question is: And then what? If there’s fear, what are the antidotes to that fear?”

Census Bureau officials pointed out that Title 13 of the U.S. Code notes the bureau cannot release identifiable information to law enforcement.

But the Rev. Nelson Rivers III, an officer of the Rev. Al Sharpton’s National Action Network, said “to be paranoid is a natural response to being black and brown in this country.” He noted the government is run by a different administration than it was in 2010, when the last census was taken.

“I’m from a community that realizes the policy depends on who’s enforcing it,” said Rivers, NAN’s vice president of religious affairs and Bishop Reginald Jackson

external relations. “Right now, we have a guy who’s demonstrated that the law doesn’t mean jack to him.” In response to Rivers, Dillingham stood up along with other Census Bureau executives and spoke of the bureau’s track record.

“I can assure you that not only does the law require us to do our job professionally and protect confidential information, we have all the systems in place, the most sophisticated systems available, to protect the information,” he said. Albert E. Fontenot Jr., associate director of decennial census programs, added that it is time to reverse the longtime undercount of people of color in the U.S. census.

“For decades the black and brown communities in America have been undercounted,” he said. “And if we allow fear to cause us to be undercounted one more time, we are putting power in the hands of people we do not want to put power in their hands.”

Leaders of Christian, Jewish, Muslim and Buddhist faiths cited examples of how they are urging congregants to participate in the count that affects the distribution of some $675 billion in federal funds and determines congressional representation. A Muslim woman in Virginia is making sure every child is included, even if just 1 day old. A rabbi in New York said he is working to help technology be available in hard-to-count areas. A Catholic nun in Ohio has urged college students to join the count. Bishop Reginald Jackson, a Georgia leader of the African Methodist Episcopal Church who is encouraging his denomination’s churches to make sure every congregant’s family is counted, said he understood the concerns voiced by Rivers and others.

“I think your question highlights why it’s important that all faith leaders in this crowd and across this country have a responsibility,” Jackson said. “Because the fact of the matter is it’s going to take folk who look like them and who live where they live to get them to trust us on this census.”

Beyond the census interfaith summit, other groups have been working to include houses of worship and faith leaders in encouraging religious constituencies to take part in the count that affects funding of public services such as schools, hospitals, roads and emergency response for at least the next 10 years. Faith in Action, a national community organizing network, launched a campaign last year. Other organizations, including Faith in Public Life and Fair Count, have offered toolkits with key dates, sermon tips and frequently asked questions (including one answering that the census will not include a citizenship question).

At a recent Congressional Black Caucus leadership summit, Fair Count Vice President Jeanine Abrams McLean said her organization has paid for internet installations in churches and other locations in parts of Georgia where there was no online access.

McLean, the daughter of two ministers, said the access will help people whether or not they worship in the newly wired churches.

“I know that people say everybody doesn’t go to church,” she said. “You might not go to that church. But you might know somebody that uses that church’s food pantry or that church’s clothes closet.”

If I could do one thing, I’d have a daycare closer to work.

If you could do one thing for your community, what would it be? More daycare centers? More funding for Head Start? Completing the 2020 Census is a safe and easy way to inform how billions of dollars in funding flow into your community for hundreds of services. Respond online, by phone, or by mail.

2020CENSUS.GOV Complete the census at:

There’s a digital divide in the Richmond community. Black girls are not graduating with digital skills needed for work in the 21st century. What’s worse, because of systemic and institutional racism, they also lack access to networks and mentors to help them succeed.

Girls For A Change notes that its research shows that black girls in Richmond are active and engaged in their education, yet out of all girls in Greater Richmond, they are most likely to be pushed out of the classroom. By age 14, black girls are already experiencing a race and gender wage gap, and 57 percent report that they don’t feel safe at school.

In 2017, the National Science Foundation reported only 5 percent of managerial jobs in STEM were held by black women and men combined. Currently in Virginia there are over 36,000 unfilled data analytic jobs with a starting pay of $88,000. The problem of diversity is clear.

“The problem is systemic,” said Angela Patton, CEO, Girls For A Change CEO.

“Breaking the cycle of poverty takes more than teaching a girl to code. Even if she teaches herself digital skills to get the job she wants, she will have a hard time breaking through without a network and certifications to prove her talent - no matter how talented she is.” Patton continued that with no network, no skills, no mentors to show her the way, she will have no opportunities on the horizon.

“She will face barrier after barrier to get ahead and will get nowhere. Her only option in order to survive will be to get a job with no real trajectory. This vicious cycle is what many girls in our community face,” said Patton.

Wouldn’t it be great if the Richmond workforce and startup scene had a more diverse make-up?

Immerson Lab events

3/20 2-4pm: Talk Tech and Sip with Capital One’s VP of Technology Reboot your afternoon over coffee and conversation with Tech Whisperer Maureen Jules-Perez, VP of Technology at Capital One. Maureen will discuss the digital divide and how to get more women in tech.

3/23 12-2pm Pick Her Brain: Q&A with Kristen Cavallo, CEO of the Martin Agency Wouldn’t it be great to grab lunch or coffee with one of the first women CEOs in the Ad Industry? Now you can. Girls For A Change invites you to join them for an intimate luncheon with Nationally recognized CEO Kristen Cavallo. Kristen will answer your burning questions about life as a CEO, working in the ad industry, marketing & branding, and more.

3/31 7:30am-12pm Founding Female: Stories of Success in RVA Join Girls For A Change for an empowering morning with some of Richmond’s most successful entrepreneurs. The morning will start off with a Keynote by Charis Jones, CEO of Sassy Jones, the Richmond based business making headlines for its tremendous retail success. You will also hear remarks from the First Lady of Virginia and get a chance to hear from a panel of powerhouse Richmond women who will share their stories of success.

What if the next “Top Ten Cities” list Richmond landed on was “places for black women in technology and entrepreneurship?” What if there was a bigger pool of diverse applicants to hire from in fields like technology and science? It’s time for black girls and other girls of color to have equal opportunities to pursue careers in STEM fields or start businesses within our city.

There can be, noted Patton. “March is Women’s History Month and Girls For A Change is calling on the community to celebrate and support the launch of a new program that will fill the gaps we’re seeing. The Immersion Lab is the first of its kind learning and skills development center and event space,” she said. Virginia’s first lady, Pamela Northam, said that while great strides have been made in recent years by engaging young women, sparking wonder and igniting curiosity in STEM education, more can still be done.

“It is imperative that we are thoughtful and strategic in our approach to reach every student, no matter who they are or where they live,” said Northam. “There is beauty and strength in diversity and Virginia cannot move forward if half of us are left behind.”

The Immersion Lab is a girl led event space and workforce development program designed to set girls of color up with the skills, experience, and professional networks needed to succeed. The program will close opportunity gaps by providing digital skills training and certifications within a space designed specifically for them – where they won’t be pushed out. Girls will have a place to learn alongside mentors and instructors who want to see them succeed while also earning volunteer hours and work experience running the event space accessible to the community. Patton said the unique program allows the community to invest in young girls of color by booking the Girls For A Change event space with the option to offer girls the opportunity to put their skills to work running an event.

The lab will be located within WORK Studios at 1657 W. Broad St. in Richmond. During March, Girls For A Change is hosting a series of events called “Herstory Now” to raise funds for the equipment and furniture needed to make the space their own. GFAC has invited some of the most successful and innovative Richmond women to join them in the celebration of Women’s History Month.

stored in a secured registry.

Data collected through Together for Health – Virginia research program will be used to guide Massey in targeting community outreach and education efforts addressing health behaviors such as tobacco cessation, obesity/weight management, HPV vaccination, cancer screening and early detection. It will also serve to identify causes of cancer disparities across the state, by examining the impacts of financial barriers, health literacy, access to health care services and medical mistrust. Results will be shared with state and local agencies to guide programs aimed at improving health.

“We need the help of community members and citizen collaborators to tell us about their behaviors and how they engage with health information so we can learn and discover better ways to promote health and well-being in their communities,” saidFuemmeler, who is also collaborating with Massey Cancer Prevention and Control research members David Wheeler, Ph.D., M.P.H., associate professor in the VCU Department of Biostatistics, and Sunny Jung Kim, Ph.D., M.S., M.A., assistant professor in the VCU Department of Health Behavior and Policy. “The programs that we implement will only be effective if we have a deep grasp of all the factors that impact cancer risk, so it’s important that participants in the program represent all of the diverse populations living in Virginia.”

Massey is one of the only safety-net cancer centers in Virginia, meaning that it treats all patients regardless of their health insurance coverage or ability to pay for treatment. As such, Massey plays an important role as a cancer care provider for high-risk and underserved populations, uninsured and Medicaid patients. Together for Health – Virginia is funded by a one-year supplement to Massey’s National Cancer Institute Cancer Center Support Grant of more than $225,000.

took my first step, I fell in love,” she said.

During her time at VCU, she participated in over 22 university organizations, committees and task forces. She served as student body president from 2010-11 and was the 2011 recipient of the VCU Division of Student Affairs Distinguished Service Award. Other awards include the VCU Alumni 10 Under 10, the University Leadership Award, the University Service Award and the Monroe Park Campus Student Government Association Christopher Mays Award. In 2010, she co-created VCU Qatar Day, an annual cultural awareness event. “[It] was such a phenomenal experience,” she said. “I think that things happened for a reason to lead me to VCU. I can’t imagine where I would be right now if it weren’t for VCU.”

Making a difference

McClure made the decision not to go to law school after graduating from the VCU School of Business with a bachelor’s in economics. “I realized I didn’t need a law degree to make a difference and do what I wanted to do,” she said.

Instead, she took a job with the nonprofit Association of the United States Army and in three months went from an administrative assistant to supervisor. “We were the voice for the soldier and their family,” she said of the Arlington, Virginia-based organization.

McClure held two other jobs before accepting the position of program policy director in the office of Lt. Gov. Justin E. Fairfax in 2018. Her work included developing policy initiatives and designing and implementing three statewide roundtables on evictions. She resigned her position in protest in 2019 after sexual assault allegations were raised against Fairfax.

When McClure was in the lieutenant governor’s office, she worked to raise statewide awareness of housing issues, such as evictions, and bring support and legislation to the problem. “My main goal in life is to move toward ending homelessness,” she said.

After resigning, she continued working to coordinate efforts on reducing and preventing evictions during an interim position with the Virginia Department of Housing and Community Development.

“When she left the lieutenant governor’s office we reached out to her,” said Pamela Kestner, deputy director of housing at the Virginia Department of Housing and Community Development. “She comes to the table wanting to learn and share. She’s an incredible young woman.” Kestner would have liked to have McClure stay with the department, but “we knew she was destined for bigger things.”

Virginia Sen. Jennifer McClellan

has worked with McClure closely over the years. “I’m proud of her many contributions to the commonwealth,” McClellan said. “Her work has directly impacted and improved the lives of Virginians — especially our most vulnerable. Adele’s commitment to public service is deeply appreciated and her background and experiences are drivers in all that she does.” -VCU NEWS