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Next steps in health reform: Hospitals, Medicaid expansion, and racial equity

Editor's Note:

This article appeared originally in the Journal of Law, Medicine, & Ethics.

In 2018, Virginia became the 33rd state to approve Medicaid expansion under the ACA. This decision came just as the Commonwealth braced to mark the one-year anniversary of violent Neo-Nazi attacks in Charlottesville that claimed three lives and reminded the nation that racism and xenophobia are alive and well in America. The juxtaposition of these two events reminds us that health care providers – specifically hospitals – could act to significantly reduce the adverse health impacts of racial inequity that affect all populations.

In “Next Steps in Health Reform: Hospitals, Medicaid Expansion, and Racial Equity,” Dayna Bowen Matthew provides a brief history of hospitals’ role in desegregation during America’s Civil Rights era as inspiration for an integrated approach to the opioid epidemic, wherein hospitals use Medicaid expansion to advance health equity and racial healing.

Matthew outlines how hospitals could use the opportunity presented by Medicaid expansion to reduce inequitable population health outcomes and model a path forward toward broader racial equity. She also notes that hospitals can leverage their role as economic drivers in communities to equalize health and social outcomes for all. And she suggests the urgent need for innovative opioid crisis intervention presents a fertile proving ground for new ways that hospitals can act to reduce the impact of racial inequity.

Read the full paper here.


The author did not receive financial support from any firm or person for this article or from any firm or person with a financial or political interest in this article. She is currently not an officer, director, or board member of any organization with an interest in this article.

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