Steve Clemons: Today we have a special edition of the Coronavirus Report that builds off of the highly successful, content rich, if I do say so myself, national virtual online summit titled “Health Reimagined” presented by The Hill a few days ago. The discussions were so good we wanted to make sure you had a chance to hear them, particularly this one, this conversation with U.S. House of Representatives member Lauren Underwood.
[Centers for Disease Control and Prevention] Director [Robert] Redfield and you know, he put it right out there and he said, “Look, this you know, every crisis creates an opportunity, and maybe we need to get some of the wrongs that we’ve had embedded in our society — systemic racism, inequality, people being left out — and maybe use this as an opportunity.” And I’m interested in what you thought of what he said and what can be done.
Lauren Underwood: Well, I think that a focus on co-morbidities and other issues that people might have as preexisting conditions is relevant when we’re talking about maybe disparities in death rates, but what we also see a significant disparities in infection rates, and so that extends beyond social determinants of health. I’m really glad that that is part of their conversation here and that they’ve elevated the long-standing career staff that have been, longtime, working on racial and ethnic health disparities at the CDC, this health equity officer that he’s talking about. However, we do know that communities of color are often essential workers, they’re front-line workers. They don’t have an option to stay at home or work from home, and that they are sacrificing, potentially, their own health and well-being and that of their families in order to serve their communities in their essential jobs. And so, you know, I think that this is a systemic problem within our health care system and that we’re gonna have to wrap our arms around this issue in order to have a comprehensive solution. And I have not seen a comprehensive solution to date from this administration.
Clemons: I think that Dr. Redfield was also saying he — there’s sort of an absence of strategy in a lot of places. But you know, you have the insights of being a nurse. You’ve been out there. Lena Wen is gonna be on later and say, “Hey, people in that field and profession know they’re putting themselves on the line. They know that there are risks for being out there.” But isn’t there a part of the social contract where we need to do more than we’re doing? And when you have colleagues in Congress, Republicans and Democrats, do they come to you and ask, “Hey, what aren’t we doing that we should be doing?”
Underwood: That’s right. So, it’s not part of the social contract to ask a nurse to wear a soiled, contaminated N95 mask day after day after day. That is not the social contract. And so when we talk about the sacrifices that we are asking our health care workers to make, we cannot be sacrificing clinical norms and standards of high-quality care just because we’re in a pandemic. I mean, the United States has been battling COVID-19 for four months now, and we could have jump-started our domestic manufacturing capacity, but the president, decided not to fully activate his authorities under the Defense Production Act. And so as we enter and continue through this phase of resurging cases across the country – I mean, I’m seeing headlines in newspapers saying, “Oh, no, we’re in this place again with not enough PPE, we’re in this place again where we don’t have the satisfactory equipment or the number of hospital beds” or whatever other issue. And so I think that we have a real problem right now in this response and that is not part of the social contract.
Clemons: What else do you think Congress needs to be doing that it is not doing? Nancy Pelosi has, and I’m sure you’re part of it, a next wave, the 3 trillion dollar CARES Act, dealing with other things that were undone. But is there something between that? Because everyone is saying, “Well, that’s not gonna fly in the Senate.” What is the next piece of doable legislation and doable support for the country that you think we need?
Underwood: So in the HEROES Act, we call for free coronavirus treatment, and that is so critically important because in this time of COVID-19 we know that there are so many people who are symptomatic who are delaying getting tested and certainly avoiding seeking treatment because they know that they cannot afford a week in an ICU. They know that they cannot afford to pay for being on a ventilator. And that has been a real barrier to people being able to get control of the virus and its spread throughout the community. We know at baseline the American people have been cutting their pills in half. At baseline, they’ve been tapering their insulin because it’s just too expensive. And so the Congress has been trying to address those issues. But during the time of the pandemic, there’s an additional sense of urgency. And so that is why it is so very important, so very important that we take the opportunity to extend free coronavirus treatment to everybody in this country.
Clemons: How is your district looking at Washington right now, your constituents? Do they think this is all Keystone Cops, or do they look at Washington for helping to support them? I’m just interested in the field with people you talk to, and they look to you and they look at what’s going on here. Do they think they’re getting what they should be getting?
Underwood: Well, there are certainly problems. And rolling out the Paycheck Protection Program that there are still unmet needs among are small-business owners. The looming threat of the unemployment benefits expiring at the end of this month has certainly been a real challenge for folks. And I would say that there’s a huge segment of our community, younger people, recent graduates that are looking for student debt relief. And that is something that when we think about this economic crisis that COVID has jump-started, we really have to deal with the full range of economic issues. So it’s not just housing. It’s not just paycheck to paycheck, but it’s looking at the entire financial situation of the American people and making sure that we’re at least stabilizing so that we don’t see hundreds and thousands of Americans thrown into financial distress that no amount of cash infusion into the Fed would be able to address.
Clemons: We have a question — we’ve been taking some questions from the field. We’ve got a great one for you that I would like the post from Jill. Jill?
Jill Alloman: Hi. My name is Jill Alloman. I’m a certified nurse midwife. I work as faculty at Frontier Nursing University in Kentucky. I also worked with the American Association of Birth Centers. My question is for Rep. Underwood. How can we reduce the racial and economic disparities that impact maternal and infant health so seriously, especially when much of the current health focus is on the pandemic? Thank you.
Clemons: Such a big question, maternal and infant health. And I just want to share with the audience that the rates of difference when you look across racial lines are staggeringly horrible. And so, your thoughts on that?
Underwood: Yes, thank you, Jill, for the question. So, as the pandemic was coming into the effect here in the United States, we were preparing to introduce something called the Black Maternal Health “Momnibus” Act and the Black Maternal Health Caucus that I co-founded with Congresswoman Alma Adams in April of 2019. And so the Momnibus Act, actually introduced in March, is a comprehensive set of legislation to address this long term disparity that black women are three to four times more likely to die as a result of childbirth in this country. We’re tackling workforce issues, data collection issues, mental health, the experiences of incarcerated women and women veterans, right, looking at the social determinants of health that we heard Dr. Redfield mention and apply them specifically to these maternal health disparities, supporting the community groups that have been, long term, involved in this issue. And so this is really a comprehensive bill. We have some bipartisan support, and we’re really just excited about this national conversation that’s happening around saving moms’ lives. But there’s no time like the present. COVID-19 has certainly impacted maternal health in this country. The CDC actually put out a report in June that said that Black and Latinx women are more likely to have severe COVID illness when they are pregnant, and that is something that is extremely alarming. And so when we think about these disparities we have to have a wide-angle-lens focus, and this Momnibus Act would allow us to tackle many of those issues.
Clemons: Thank you so much. Congresswoman, I’m gonna ask you real quick one last question, because it’s been on my mind. You used to work with the Department of Health and Human Services, you know this field really well. I don’t know if you heard my discussion with Secretary Alex Azar earlier, but I asked him about their efforts to replace ObamaCare and whether there was anything real there and you know he shared that he thought there was. … And I asked him about, well, you know, a lot of people worry about pre-existing conditions and where the Trump administration is on that, and he says, “We’re absolutely, absolutely mandating that preexisting conditions remain covered,” that we’re absolutely committed to it. This is the Trump administration, and I just want to ask you, do you believe him? And do you believe that?
Underwood: I absolutely do not believe it, but I think it’s a very nice sentiment. In the meantime, we just passed a bill, The Patient Protection and Affordable Care Enhancement Act, last week on June 29. The first ACA enhancement bill that has passed in 10 years. Listen, congressional Republicans had four terms since the ACA was signed into law to make the improvements that they thought. Instead, they tried to repeal and diminish and tear down these critical health protections that hundreds of millions of Americans rely on every year. And so guess what? We stepped up big time, and we’re working to lower premium prices, expand coverage, expand Medicaid and make sure that the American people are truly protected.
Clemons: I want to thank you so much. I just want to acknowledge, you sound great. Your picture froze, so we put a little bit more on me, photo-wise, than the congresswoman. But that’s why — but I want to thank you so much. I hope we can have you back because I know there’s a lot we need to discuss. And I really appreciate your perspective here today.