Black Communities Disproportionately Struggle with COVID-19

Howard Castay, Jr., Board Member, Teche Action Clinics

The COVID-19 pandemic has had a particularly devastating impact on Black communities nationwide. According to the CDC, African Americans are being hospitalized at a rate of approximately five times that of white counterparts. This is unacceptable. Yet hospital loans make matters even worse.

FIX MAAPP and Protect Black Communities

Adding insult to injury, many of the at-risk hospitals serving Black communities may soon find themselves in dire financial straits. This is a problem that Louisiana’s congressional delegation—particularly Senator Dr. Bill Cassidy—should work to solve before it is too late.

The issue is the Medicare Accelerated and Advance Payment Programs, or MAAPP—a program that has been around for years but was recently expanded by Congress under the Coronavirus Aid, Relief, and Economic Security (CARES) Act. It gives hospitals advance Medicare payments for three to six months to help provide financial assistance in these trying times.

Now, however, the program’s overly rigid loan repayment terms are about to kick in, and hospitals serving vulnerable communities could be left in financial ruin, unable to properly respond to the unfolding health care crisis that is disproportionately hurting Black communities. Of the $1.5 billion that went to Louisiana hospitals, the large portion was used by the 16 hospitals in and around New Orleans, Baton Rouge and Lafayette. These are our people being served! Still, we must Fix MAAPP and Protect Black Communities.

Louisiana Senators Cassidy and Kennedy

There are many issues that Louisiana Senators Bill Cassidy and John Kennedy need to address-

Including (but not limited to):

·      Repayment start date. With an initial repayment start date of 120 days after receiving funds, most hospitals must begin repaying their loans on August 1. This is simply not enough time, particularly with all that hospitals are still going through. 

·      Medicare fee-for-service payments. Once repayment begins, hospitals will be denied 100% of Medicare fee-for-service payments until their loans have been paid off in full. That alone will cut roughly one-quarter of hospitals’ payments, undermining their ability to treat patients.

·      High interest rates. If health care providers are unable to pay off their loan in the given timeframe—one year for acute hospitals and seven months for physicians and other providers—then that loan begins accruing interest at a staggering near 10 percent.

Health care is a human right, but unfortunately it is one that is not fairly distributed in our society. COVID-19 is devastating African American and other minority communities. We need to be doing more to strengthen our health care institutions, not saddling them with increased financial burdens. Oschner, Tulane Medical Center, and Louisiana’s LCMC are predicting huge revenue losses due to COVID and its impact on new equipment costs and patient reluctance to schedule other essential services and surgeries.

A passenger’s body temperature is being tested at the gate of entry upon arrival at the Murtala International Airport in Lagos, on March 2, 2020. – Nigeria is monitoring 58 people who had contact with an Italian man infected with the new coronavirus, the health minister said Monday, as officials scrambled to stop the disease spreading. Africa’s most populous country on Friday confirmed the first case of the virus in sub-Saharan Africa after the patient was diagnosed in the economic hub Lagos. (Photo by BENSON IBEABUCHI / AFP) (Photo by BENSON IBEABUCHI/AFP via Getty Images)

Our Senators should make it a priority to fix these outdated MAAPP loan repayment terms by extending the start of loan repayments to at least 12 months; reducing the amount of repayment taken from Medicare claims from 100% to 25%, and waiving the interest rate or at the very least reducing it to 1%. 

More changes must take place, but that would be a tremendous start and a signal to Black communities that Congress is on our side in this fight.

We Must Fix MAAPP and Protect Black Communities!


Howard Castay Jr. is owner of Castay Media, Inc., an important voice for the African American community in southeast Louisiana, and a Board member of the Teche Action Clinics, serving families in Jefferson, St. John, St. Mary and Lafourche Parishes.

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