Those on the Fringe Feel Full Impact of Katrina’s Aftermath
For a brief moment, the nation was focused on the devastation that was wrought by Katrina. Images of people stranded without homes, transportation, medical care or any other support have forever scarred our memories. Strikingly, many of these images captured the challenges faced by the poor, the homeless, and the disadvantaged. And yes, many of these portraits were of African Americans. For the moment, the nation joined together in sympathy and compassion for our fellow Americans who were dealt an unfair blow by nature.
Familiar Images
For some of us though, the images were all too familiar. The images of impoverished African-American 
men, women, and children seeking medical care, social services, and support are far too common across America’s landscape. Whether in Miami, New York, Albuquerque, Denver, Lansing, or Oakland, poor people of color exist in the margins. The August census figures (which don’t account for the impact of Katrina or Rita) indicate that the struggle to be healthy and to survive is ever increasing – from 2003 and 2004, 800,000 more Americans joined the ranks of the uninsured, now estimated at 45.8 million.
Local Communities vs. Federal and State Government
Until Katrina’s wrath, federal and state governments dedicated minimal attention to issues of poverty and disparities among ethnic populations. Communities have been bearing the brunt and the responsibility of coping with the economic, health and social impact of these inequities. Across the nation, it is common to find community groups collaborating to improve access to health care and
serving those in need. Communities are developing and implementing community-based solutions to provide for and protect the most vulnerable among us. Communities enlist trusted messengers to connect those who need care with the health systems that provide quality preventive and primary care. Communities are adopting a holistic view of health – embracing the importance of treating the body, the mouth and the mind. Communities are doing their part, but Hurricane Katrina’s painful images remind us that federal and state governments are clearly lagging behind and must step up to the plate as well.
Let’s look at Katrina’s silver lining.
The federal government has seemingly agreed to provide (though there is still wrangling on the details) temporary Medicaid for uninsured evacuees living below the federal poverty income threshold.
At the core of the dispute is whether or not Medicaid would be offered to childless adults.
The Grassley-Baucus bill introduced on September 16th would extend Medicaid health coverage for five months to low-income childless adults from Katrina-struck areas.
Meanwhile, thousands of victims who have applied for emergency Medicaid coverage are “treading water”.
Louisiana’s deputy Medicaid director said that 56 percent of an estimated 10,500 persons applying for Medicaid are on hold because current Medicaid rules exclude childless adults.
Meanwhile, those needing care continue to rely on the generosity of local and community providers. Isn’t it time for federal and state governments to do their fair share by developing a system that serves all Americans in their time of need, not just when a storm obliterates their community? Hurricane Katrina exposed the fragility of our nation’s communities.
A Healthcare System for All
The natural disaster that struck the nation’s Gulf Coast brought to light the despair and tragedy that befalls the 37 million people living in poverty who are disproportionately people of color. Let’s take this opportunity to not simply patch the healthcare system temporarily for a few, but follow the communities’ lead and treat all Americans appropriately. Federal and state leadership can result in the development of a system that works for all Americans. Louisiana’s, Texas’, Mississippi’s and even Florida’s Medicaid and other public benefits have simply been shifted to the budgets of other states. National leadership that aligns resources so that federal resources are made available in actual and regulatory manner to serve all Americans during the aftermath of a storm and beyond is required if we are to continue to be the land of the free and the home of the brave.
A bird flu epidemic or some other public health threat could take hold of a community without insurance coverage (viz. African Americans, Latinos, and other poor people) and force us to see what we’d rather ignore. America’s national security is at risk because we continue to neglect the needs of the poor. We cannot fix what we refuse to accept. The media have brought the needs before our eyes exposing the issues. Just as we were warned about the fragility of the levees, we have also been warned about the dangers and disparities inherent in lack of health coverage and access.
We must use the rational solution of coverage for all, even while we modify the overall package so that we can enroll all in need. It is time to set aside the endless dialogue that exhausts resources while witnessing the sickness and death of America’s communities and its people. Soon, the images will fade for most of the nation. But we cannot allow the inequities to remain the glaring reality for America’s vulnerable.
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Marguerite Ro, MPH, DrPH is Senior Policy Analyst for Community Voices and Henrie M. Treadwell, PhD is Director of Community Voices and Associate Director for Development at the National Center for Primary Care