Tag Archives: Affordable Care Act

Falling Through the COVID19 Cracks

When COVID19 snared President Trump in early October, he promptly received a dose of Regeneron and an airlift to Walter Reed Army Hospital;  physicians dispensed a course of therapeutics – Remdesivir and the steroid dexamethasone, and  supplemental oxygen as needed. That extraordinary spell of cutting edge treatment soon put the president back on the campaign trail almost within the week.

The price tag for the president’s helicopter ride and specialized, experimental treatment cost roughly about $1 million say experts, and was free, and funded by taxpayer dollars.

“I would not be surprised if it were to exceed $1m,” said Dr Bruce Y Lee, a healthcare researcher at the City University of New York.

The five star treatment afforded to Trump, however, is beyond the reach of average Americans, even those with insurance. With private insurance to cushion the cost, an average American would have to pony up $520 a vial  or $3120 for a course of anti-viral treatment.

At the other end of the healthcare spectrum are the uninsured – people who cannot afford even a single dose of Remdesivir, let alone an entire course of treatment, said Dr. David Hayes-Bautista Director of the Center for the Study of Latino Health and Culture, UCLA Health, at an October 23 Ethnic Media Services briefing.

His study of how the coronavirus impacts populations of color found that low-paid and uninsured workers in underserved communities rarely have health insurance to pay for treatment.

Without any protection, said Bautista, COVID19 finds gaps in care in the social services umbrella and the healthcare maze that marginalized communities have to navigate, and “the coronavirus falls upon them like rain.”

For uninsured workers who forage for healthcare access or have none, treatment is simply out of the question.

Quoting a UC Davis study, Bautista explained that $3120 for farmworkers in California is the equivalent of two month’s salary. What that means for farmworkers – many of whom are at high risk of exposure to COVID19 within the industry that employs them –  paying for treatment if they get infected means having to forgo food, rent, and other necessities that two months of income covers.

Disadvantaged populations have far higher case rates and mortality rates than non-Hispanic whites, said Dr. Bautista

When the virus hit, California shut down. People ‘grabbed their laptops’ and went home to work, but essential workers could not. Doctors, nurses and healthcare workers had to make sure they had PPE and equipment to treat COVID19 patients.

Other essential workers said Bautista, included meat packers, truck drivers, shelf stockers, grocery store workers, “folks working to make sure the rest of us can eat”, and check-out clerks who were far more exposed to the virus because “about 300 people pass within an arms-length.”

Those that tend to work in these occupations are mostly people of color, explained Bautista and the industries that expose them to the pandemic offer less access to care, treatment and follow up. As a result, California has high rates of exposure and mortality. The state now has a total of 922,005 positive cases. and a total of 17,626 deaths reports the California Department of Public Health.

In California, farm workers have been especially hard hit by COVID19. During the pandemic, migrant farmworkers continue to work shoulder to shoulder in ‘cuadrillas,’ and packing houses, or ride in crowded buses, putting their lives on the line to put food on our tables.

Vulnerable farmworkers (largely Latino, almost 100% immigrant, and 60-80% undocumented), are left out of the Affordable Care Act (ACA) because of their temporary status and cannot afford private health insurance. And yet, the county gave them letters confirming their essential status to travel, so they could go to work when the pandemic broke out. Workers were urged to see a doctor if they had symptoms, but without health insurance, “how would they pay to see a doctor, asked Bautista. “Some do not even know any doctors!” Their situation was further complicated by a requirement in the first few months of the pandemic, for sick people to get a doctor’s recommendation just to get a test – one they could barely afford.

“You could wind up paying $100 to almost $2000 for one test!” said Bautista. “In a farm worker family that quickly adds up.”

Even if a vaccine becomes available, said Denise Octavia Smith, Exec Director, National Association of Community Health Workers (NACHWA), it may be refused. Among Black and indigenous communities who have endured hundreds of years of medical testing and research on enslaved populations against their will, there exists a longstanding fear of vaccines, “We won’t be used as a guinea pig for white people.’’

Smith, who is tracking the disproportionate impact of Covid19 on under-resourced health systems, suggests supporting more community health workers familiar with barriers to care and wellbeing that marginalized populations experience, as trusted messengers to build bridges within these communities. This way, people who believe in efficacy of vaccine can get it when it becomes available

That moment could come sooner that they think. In a move that could transform life in COVID19  times for marginalized communities, the CDC is considering recommendations by ACIP (Advisory Committee on Immunization Practices ) to “remove unjust and barriers to good health and well-being” in some racial/ethnic minority groups that bear the disproportionate burden of the COVID19 disease.

The recommendations ask the CDC to “commit to fair stewardship in the distribution of a scarce resource.” Under review are outreach strategies that will  overcome barriers to access, and reduce health disparities in each phase of vaccine distribution.

The interventions must ensure that all affected groups, populations, and communities are treated fairly and have equal opportunity to access the vaccine and treatment, not just the privileged few.

The coronavirus doesn’t discriminate. Even the President got infected. What’s different is he had access to treatment well beyond the reach of essential workers who work to put food on our table. They are the ones “we forgot about,” said Bautista, and who will fall between the cracks of our healthcare jigsaw puzzle without a safety net.


Meera Kymal is a contributing editor at India Currents

Image: WorldBank, migrant worker in strawberry farm

How I Became a Political Activist

When our fresh-out-of-college son got his first job as a field organizer with the Democratic Party in Maryland, my husband and I privately began worrying about what kind of a future the son of two Indian immigrants could have in this unorthodox career. But in breaking out of the Asian parenting stereotype, we’d told our children we wouldn’t push them into medicine or engineering and instead would support their individual choices. I must confess this was easier said than done, for our children sure tested our resolve! 

First, our daughter went to music school to pursue her passion for opera, and then our son, Aman, declared that he was getting into politics. 

One day, Aman called me from work, “Mom, can I put you down for a two-hour shift for phone-banking or canvassing?” 

“What’s that?” I asked.

“Oh, the organizer will give you a list of voters with whom you can either talk on the phone or you knock on their door. Either way, your job is to convince them to vote for Hillary.” 

This was an alien concept for me. Growing up in India, elections had merely meant seeing billboards with smiling faces of random politicians or seeing truckloads of party-workers with loud-speakers chanting names that I’d paid scant attention to. My experience in American politics had been equally limited. Although I’d been here two decades, I’d only chosen to become a citizen in 2008, because I wanted to cast a vote for America’s first Black President. 

I hesitated before replying, “I don’t know if I can do that. I have an accent, I look different…” 

He interrupted me, “That’s nonsense, Mom. You’re American, that is all that matters. As a lawyer, you don’t need me to tell you that if a female President is to be elected, people like you must become politically active – you are a woman of color, an immigrant. I’m putting you down for two hours on Friday morning.” 

He hung up. 

So there I was. For two months every Friday morning, I showed up at the Party Headquarters to talk to random strangers on the phone about which local or national issues were important to them, and then probe whom they intended to vote for in the Presidential election. 

Despite some rude hang-ups and nasty comments, with each phone call, my trepidation decreased and I began to feel more comfortable in this role. Soon I discovered some kindred spirits among the other volunteers and made a few friends. 

A while back I had rolled my eyes when my son said to me, “Mom, “this whole campaign-business is addictive,” but now I was discovering how right he was. I too had gotten sucked in, so much so that – now as a “regular” at the office, I often ran into our Congressman and the two Senators from Maryland and chatted them up like we were old friends. 

In July, when Donald Trump won the nomination at the Republican National Convention, panic began to set in among the volunteers at the office. I too felt my blood pressure rising. My family, like most others who weren’t working at the Party office, were dismissive of this mounting anxiety because they were sure that America would never send  “a xenophobic, race-baiting, sexist, anti-Muslim and Mexican-hating man to the White House.” 

Yet, on my calls each Friday, I sensed the tide turning and my fear increased. My calling-list comprised of only Democrats in Maryland, a very Blue state; even then, every session resulted in responses that left me in shock. 

Several people said that they were willing to vote for the entire Democratic ticket except for Hillary. One man even yelled at me when I tried to question what he had against Hillary. “She is the devil,”  he said, “and Donald Trump is our lord and savior!”

By the time October rolled around, I was in a state of frenzy. I phone-banked three times a week, went out canvassing, and constantly tried recruiting people to volunteer. But despite my overwhelming sense of urgency, others seemed to be blasé about the election. Most were sure it was a slam dunk for Hillary, and they dismissed my response as a mere overreaction. 

I will never forget the evening of the 6th of November 2016.  As the results from each state began to roll in, I watched in shock as all my past premonitions came to fruition. But this time my own sense of growing horror was reflected in the faces around me. My whole family watched with tears in their eyes as Hillary gave her speech late that night. 

Over the following weeks, analyses of voting patterns revealed that several minority voters in key swing seats had sat out the election. Even though I had worked very hard for months, it was only now that I fully understood what my son had meant when he’d said that more people like ME needed to become active participants in our democracy. 

 So, after giving myself a few weeks of rest, I set to work. Using Facebook, I contacted other like-minded people in my area, and we began to organize a local chapter of the Indivisible movement and our little grassroots group of “resistors” was born. 

On a protest march

The day after Donald Trump was sworn into office, we collected on the National Mall for the Women’s March. Following this, we met on a monthly basis and continued to grow our ranks. In April, we joined other groups with homemade placards to attend the Tax March, followed by the Climate March. 

Soon, the newspapers started reporting about how grassroots groups such as ours were mushrooming all over the country. The Resistance became a household term and our homemade signs got featured on magazine covers. 

With speaker Nancy Pelosi

The last three and a half years have seemed almost Sisyphean to the members of political grassroots groups. Through our advocacy, networking, boycotting, and protesting, we’ve won some battles and lost some.  The two feel-good highlights were lobbying to save the Affordable Care Act with just one vote in the Senate and then flipping forty-one House seats in the Blue Wave in 2018 (which handed Speaker Pelosi the gavel once more). Unfortunately, the failure to secure the release of immigrant children held in the detention camps created by the Department of Homeland Security or to secure support for the Deferred Action for Childhood Arrivals (DACA) were difficult setbacks. 

Through other ups and downs of this political roller coaster, such as the regretful withdrawal of the US from the Paris Accord, the reneging of the Iran Accord by America, the non-consequential findings of the Mueller report, and even the failed impeachment trial, the grassroots groups have continued their work –  increasing voter registration (especially among immigrant communities), phone-banking and letter-writing to prospective voters for either regular elections or special elections. 

We’ve helped gather support for progressive legislation at the state, local and federal levels. Now with the upcoming 2020 election, the groundswell of activism is beginning to gather force once more. 

Even with the advent of this unprecedented pandemic, our enthusiasm hasn’t waned. Circumstances have taught us to adapt and almost all our efforts from fundraising to phone-banking to letter-writing are being organized through virtual meetings and zoom calls. A month ago, a virtual fundraiser organized by the Biden campaign was attended by a hundred and seventy-five thousand supporters. It raised over $11 million.

I often tell my friends that in the last few years I have morphed into a new me. Despite the decline in America’s standing on the world stage, I now stand taller as an American than ever before; not because I agree with the turn our country has taken, but because I now understand how much behind-the-scenes work goes into bringing about real change and how much is at stake for not just our generation but also the next. 

The next generation of Indian-Americans is coming of age and for their sake, I hope that our community begins to be more active in political engagement. Many of us came to the US to make better lives for ourselves but now is the time for us to step out of the immigrants’ cocoon and fulfill our civic duty to a country that welcomed us all. 

This is a time like none other in American history, a time when the very foundation of its democracy has been shaken and this time calls on all of us to become political activists. 

Shabnam Arora Afsah is a writer, lawyer, and short story writer who is working on her first novel based on the Partition of India. She is a committed political activist and also runs a food blog for fun!


Edited by Meera Kymal, contributing editor at India Currents