that includes preventive services and out-of-pocket costs. The ACA will lead to new coverage for 32 million Americans who are currently uninsured.

The law also addresses the challenge of the acquisition of insurance for those living with preexisting conditions. Under the new law, it is no longer allowable to drop a patient if he or she gets sick. It is also no longer allowable to deny coverage in the first place.

Access to Health Care Services

Community health centers (CHCs) are an important source of care for individuals in low-income communities, said Martinez. The ACA provides additional support for the creation and expansion of CHCs, including support for nurse-managed health centers and improved access to case management services. School-based clinics are also provided support through the ACA, as schools are often the only point of access for child health services in low-income communities. Martinez indicated that health information technology should be used to facilitate enrollment for services in low-income communities of color and to give patients greater control over the decisions involved in their access to health care services.

Workforce Preparation

The ACA creates a new commission to focus on workforce issues. The commission will consider both worker competence and workforce diversity. Martinez explained that it is clear that individuals in low-income communities have inadequate access to medical specialists and to health care professionals trained in cultural competence. Cultural competence, in fact, should be promoted among all health care providers. The ACA contains initiatives to ensure that medical schools provide training in cultural competence to students as preparation for their future work with patients from different cultural contexts.

Improving Quality of Health Care Services

The creation of quality measures that assess both health care provision and health outcomes is the fourth piece of the ACA relevant to achieving reductions in health disparities. It is not enough, Martinez said, to have health insurance and access to care in communities of color. The quality of health care must also be considered. Chronic disease management, particularly in low-income communities of color, is also critical.



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