2018 - 2019 Government Affairs Activations

March 2019

Sen. Udall, Senate Leaders Introduce Bill to Ban Chlorpyrifos Nationwide

Legislation endorsed by the NHMA

Washington, DC – A day after President Trump’s EPA once again argued for delaying its own ban of chlorpyrifos in court, Senator Tom Udall (D-NM) introduced the Protect Children, Families and Farmworkers from Nerve Agent Pesticides Act, legislation that would ban the dangerous chemical. Earthjustice, the environmental law organization representing labor leaders, farmworker communities, and environmental activists in litigation against the EPA on its lack of commitment to protecting people from chlorpyrifos, announced its support for Sen. Udall’s bill.

Chlorpyrifos is a widely-used agricultural pesticide linked to reduced IQ, attention deficit disorder and other developmental damage in children. Chlorpyrifos, an organophosphate that comes from the same chemical family as sarin nerve gas, is used on staple foods, such as strawberries, apples, citrus, broccoli, and more. Weeks after former EPA boss Scott Pruitt met with the head of the largest manufacturer of chlorpyrifos, Dow Chemical, Pruitt falsely claimed in 2017 the science is “unresolved” and decided EPA would study the issue until 2022.

“The scientific evidence is clear and this bill is needed because EPA continues to ignore science and the law. Chlorpyrifos is toxic to farmworkers and is linked to neurodevelopmental problems in children,” said Dr. Elena Rios, president of the National Hispanic Medical Association. “We must have a chlorpyrifos ban.”

This week, in oral arguments before the 9th U.S. Circuit Court of Appeals, Earthjustice attorney Patti Goldman argued for faster action on a nationwide ban, contending that EPA continues to sit on administrative objections to its approach to chlorpyrifos. “The Trump Administration is fighting tooth and nail for a pesticide EPA’s own scientists found unsafe to children,” Goldman said. “Make no mistake, chlorpyrifos in our food means children are needlessly eating, drinking and breathing this dreadful pesticide.”

More: What You Need to Know about Chlorpyrifos

December 2018

NHMA Submitted the following comment regarding the proposed rule change to the Public Charge.

The National Hispanic Medical Association, representing 50,000 Hispanic physicians, strongly opposes the Public
Charge Proposal that the U.S. Department of Homeland Security announced on September 22, 2018. The proposed
changes would greatly undermine achievements made in access to preventative services and medical care for
Latino legal immigrants by penalizing their participation in nutritional, health care, and housing assistance
programs. These programs are essential for millions of families to lead a healthy life, and we fear many immigrants
who have been long-term U.S. workers will be deported if these changes are implemented.

Since 1892, federal immigration law has had a “public charge” test that makes immigrants ineligible for entry to
the United States or permanent residence (green card), if they depend or may in the future depend on the
government as their main resource for living expenses. Under current policy, government support from emergency
health care, prevention of infectious disease, disaster relief, nutrition assistance programs, and housing assistance
programs are not counted towards public charge. The benefits considered in determining who is likely to become
a public charge are cash assistance such as Supplemental Security Income (SSI) and Temporary Assistance for
Needy Families (TANF) and government-funded institutional long-term care. Furthermore, the Clinton-era
welfare reforms already put major social service programs out of reach for most legal immigrants until they’ve
been here for five years.

The Trump Administration is now calling for healthcare and other benefits that meet basic needs to be considered
in a “public charge” determination such as:
• Non-emergency Medicaid (with limited exceptions for certain disability services related to education),
• Supplemental Nutrition Assistance Program (SNAP),
• Low-Income Subsidy for prescription drug costs under Medicare Part D, and
• Housing assistance such as Section 8 housing vouchers and rental assistance

The proposal has already made immigrant families afraid to use programs that are essential to their health and
well-being. If the rule is finalized in its proposed form, it would mark a significant and harmful departure from
current policy, penalizing working class immigrants who seek the same American Dream that for generations has
been a source of strength for our country. It is irresponsible of this administration to make immigrant families
choose between their health and their immigration status. According to the Kaiser Family Foundation, 19 million
children in the US have an immigrant parent, and 90 percent of these children are American citizens. Parents
should not be punished for accepting help so they can provide food, a home, and healthcare to their children.
Millions of Hispanics in the US are or have family members who are at various stages of the naturalization process,
and many already face barriers to housing and medical care. These rules would only exacerbate existing inequities,
magnifying the stresses that come with housing insecurity, food insecurity, and lack of health insurance. Forcing
these families to forgo medical care will allow preventable illnesses to develop and leave chronic conditions
untreated, increasing costs to the healthcare system and for US taxpayers. Addressing the needs of families enables
them to lead productive lives, to the betterment of our country. It is in the interest of the Federal government and
to the benefit of all Americans that the basic needs of lawfully present immigrants and their children are supported.

The National Hispanic Medical Association urges the Department of Homeland Security to renounce this
proposal. Our organization is willing to work with the Trump Administration to develop common sense reforms
to our immigration system that respect the health and dignity of all immigrants and their families.

August 2018

National Hispanic Medical Association Decries Trump Administration Weakening of Clean Cars Standards, Highlights Negative Impact of Rollback on Latino Communities

Today, Dr. Elena Rios, President of the National Hispanic Medical Association (NHMA), released the following statement in response to the Trump administration’s decision to roll back America’s clean car standards, and highlighted the negative impacts that this misguided decision could have on Hispanic communities:

“President Trump, EPA Acting Administrator Andrew Wheeler, and acting NHTSA Administrator Heidi King are rolling back protections that Hispanic communities depend on. Rolling back the clean car standards will make our air more polluted and will force drivers into dirtier, less-efficient vehicles that are more expensive to drive. Cleaner, more efficient vehicles reduce dangerous tailpipe pollution, helping to prevent harmful health impacts like asthma attacks and heart disease that disproportionately affect our communities, who often live in neighborhoods with higher levels of harmful air pollution.”

“Furthermore, these standards are saving Americans money to the tune of $60 billion and counting. Hispanics and low- and middle-income families will be hit hard if the fuel economy standards set to save them money on gasoline are taken away. By dismantling protections like clean car standards, the Trump administration is failing our communities families.”

June 2018

CALL TO ACTION: Unlawful & Immoral Family Separations & What Can You Do? 

NHMA is against this dangerous, illegal and immoral practice of family separations. The uncertainty over immigration, as well as practices currently in place including the border separation of children from their parents/caregivers, have a dangerous impact on the mental, physical and emotional well-being of our communities. While Latinos show similar rates of mental illness as other racial and ethnic groups, their access to care and quality of treatment is much poorer. Additionally, Latinos seek treatment less frequently, whether that be because of language barriers, legal status, social stigma or lack of health insurance. Mental health conditions contribute greatly to how a person then cares for their physical well-being. People with serious mental health conditions have been shown to have higher incidences of cardiovascular disease, osteoporosis, and diabetes. A chronic, serious mental illness can significantly shorten life expectancy. Latinos struggling with mental illness should reach out to a health care provider, and physicians should strive to be well-versed in cultural and linguistically appropriate treatment of the Hispanic population.

1. Please call your member of Congress (click here and type in your zip code to find your Representative and their contact information and click here to find your Senator) and urge them to hold this Administration accountable for their actions.
2. Join and support a march on Washington and Families Belong Together rally led by MoveOn and others. Distributed actions will be planned across the country
3. Contribute financially if possible. 
   

CALL TO ACTION: Vote “NO” on “Border Security and Immigration Reform Act of 2018” (H.R. 6136) and “Securing America’s Future Act of 2018” (H.R. 4760)

NHMA urges Members of Congress to oppose both Speaker Ryan’s “Border Security and Immigration Reform Act of 2018” and Representative Goodlatte’s “Securing America’s Future Act of 2018” ( H.R. 4760). Both bills hold Dreamers hostage in return for provisions that would upend our immigration system and betray American values.

Speaker Ryan’s “Border Security and Immigration Reform Act of 2018” pairs Deferred Action for Childhood Arrivals (DACA) provisions with severe cuts to legal immigration, policies that undermine vital protections for vulnerable populations, and dramatic increases in funding for immigration enforcement. Among other provisions, the current bill would:

• Drastically reduce legal immigration by eliminating several family-based immigration categories and eliminating the diversity visa program.
• Undermine protections for vulnerable populations, including raising the credible fear standard for asylum seekers and eliminating certain TVPRA protections, sending children more quickly back to the countries from which they fled.
• NOT address the family separation crisis, which can be stopped right now by this Administration. Instead, the bill would jail children and their families for long periods of time.
• Balloon funding for enforcement, including additional Border Patrol agents, a $25 billion appropriation for the border wall, and funding to keep children and families in jail.
• NOT adequately protect Dreamers. The bill provides for contingent nonimmigrant status and creates a “point system” that would leave many Dreamers without protection.

Representative Goodlatte’s “Securing America’s Future Act of 2018”( H.R. 4760) is an anti-immigrant wish list that slashes legal immigration to untenably low levels, mandates unnecessary and harsh enforcement tactics, creates millions of criminals out of thin air by making unlawful presence a crime, and seems focused on excluding the largest number of Dreamers from the very few weak protections it claims to provide. Among other provisions, the bill would:

• Eviscerate legal immigration by gutting the family-based immigration system and eliminating the diversity visa program.
• Make employment verification mandatory for all employers.
• Criminalize unlawful presence, creating millions of criminals out of thin air.
• Mandate long-term detention of nearly everyone in removal proceedings despite due process, capacity, and cost prohibitions.
• Undermine access to asylum for individuals who have been persecuted abroad, including heightening the credible fear standard.
• Eliminate safeguards for vulnerable children by amending the Trafficking Victims Protection Reauthorization Act of 2008 (TVPRA).
• Require a massive buildup of immigration enforcement, including construction of a wall, hiring of additional CBP, and waiving crucial polygraph requirements.
• NOT adequately protect Dreamers. As written, the bill provides only a contingent nonimmigrant status to eligible applicants for renewable three-year periods, excludes anyone who does not have valid DACA on the date of enactment, and imposes punitive eligibility requirements.

Please call your member of Congress (click here and type in your zip code to find your Representative and their contact information and click here to find your Senator) and urge your representatives to provide our communities with a clear  and dignified path to citizenship and

NHMA opposes House farm bill set for a second vote Friday, June 22, 2018. It would cut millions of Americans’ SNAP benefits. 

The House will vote on a farm bill for the second time in just over a month on Friday after it was defeated in May by a margin of 213-198. The farm bill comes to a vote every 5 years, with this year’s version increasing work requirements for eligibility for the Supplemental Nutrition Assistance Program (SNAP), otherwise known as food stamps. This would ultimately reduce or terminate SNAP benefits altogether for millions of people, including many Latinos.

According to the most recent Census data, 19% of Latino households lack adequate food, compared to 13% in the overall population. The benefits of SNAP for the Latino community are tremendous. The USDA and the Census Bureau estimate that around 10 million Latinos are able to put sufficient food on the table each month because of SNAP benefits. SNAP raised around 2.5 million Latinos, almost half of them children, above the poverty level in 2015. Latinos account for over 20% of all SNAP participants in the U.S. This population would, therefore, be disproportionately affected if SNAP benefits were to be taken away or made nearly impossible to qualify for.

The House farm bill aims to increase work requirements for SNAP. The opposition argues that only around 8% of SNAP participants are able-bodied adults, while the rest are children, seniors, people with disabilities and adult caretakers. Of those able-bodied adults, research has shown that around 25% of them already work while receiving benefits, and almost 75% worked either the year before or the year after they received SNAP benefits.

The health of Latinos is at risk if the House farm bill is enacted. SNAP benefits allow for healthier food to be purchased. SNAP has been associated with better health outcomes, as food insecurity is linked to reduced ability to manage illness. Food insecurity also results in higher costs of health care. Studies have shown that increased food insecurity is correlated with more chronic illnesses, less adherence to medications, and more emergency room visits.

A Senate-proposed bipartisan farm bill was approved by the Senate Agricultural Committee on June 13th and is expected to be brought before the full Senate before the July 4th recess. The Senate farm bill extends SNAP, a key difference between the 2 bills. Included in the bill is permanent funding for farmer’s markets, another way to get healthy food onto the tables of low-income SNAP participants.

The House and Senate must reach a negotiation by the end of September, when the current farm bill will expire. Please call your member of Congress (click here and type in your zip code to find your Representative and their contact information) and encourage them to vote no to the House farm bill (H.R 2).

May 2018

NHMA Participates as a panelist in House Committee on Natural Resources hosted Roundtable Discussion

Dr. Rios served as a participant in a routable discussion on the intersection of environmental and conservation policy and public health for our communities. Dr. Rios spoke on the disproportionate impacts of air pollutants on respiratory health of Latinos and the importance of public lands, parks and other accessible green spaces for not only our communities’ physical health, but also their mental health.  The briefing was widely attended by committee staff from the House Committee on Natural Resources, Congressional staffers and Congresswoman Nanette D. Barrágan & Ranking Member Raul Grijalva. 

Comments on the National Institute of Minority Health and Health Disparities (NIMHD) proposed new structure submitted by the Minority Physicians Alliance.

The Minority Physicians Alliance represents a coalition of five minority medical organizations – the Association of American Indian Physicians, the Association of Black Cardiologists, the Council of Asian and Pacific Islander Physicians, the National Hispanic Medical Association, and the National Medical Association who are all committed to health equity in the United States especially by reducing racial and ethnic health disparities.

The Alliance strongly supports the vision of the NIHMD – to raise national awareness about the prevalence and impact of health disparities and disseminate effective individual-, community- and population-level interventions to reduce and encourage elimination of health disparities.

We agree that the NIHMD restructuring is designed to streamline specific functions, areas of operations, and roles and responsibilities to maximize productivity and increase efficiency and timeliness of these operating areas: research, science policy and planning, communications, and administrative services.

We recognize the importance of integrating administrative functions (data management) of the current structure and expanding the other areas of the new Administrative structure (Administration, Communications, Extramural Research Administration, and Policy, Legislative and Data Management).

Given the underrepresentation of our member physicians and scientists in biomedical, health services  and community health research, we urge the expansion of research training that increases diversity among the health disparity researchers that goes

We recognize that the Research Training function is critical and should be expanded to all the following new areas of focus of research activity in the new NIHMD structure:

• • Biological and behavioral sciences

• • Clinical and health services research

• • Community health and population science

• Intramural research – tobacco, cancer, population health

In summary, the Minority Physicians Alliance supports the new NIHMD structure because it will promote more effective research activities that we believe will improve the critical knowledge about strategies to increase health equity and to improve the health of all Americans.

April 2018

Please join the National Hispanic Medical Association in advocating for the following that impact Hispanic health:

• NHMA fully supports the Congressional Tri-Caucus Health Equity and Accountability Act. It will be released in the end of April and includes the following sections:
  • • Data Collection and Reporting
  • • Culturally and Linguistically Appropriate Health Care
  • • Healthcare Workforce Diversity
  • • Improvement of Health Care Services
  • • Improving Health outcomes for Women, Children and Families
  • • Mental Health
  • • Addressing High Impact Minority Diseases
  • • Health Information Technology
  • • Accountability and valuation
  • Addressing Social Determinants and Improving Environmental Justice

Dr. Elena Rios, NHMA President & CEO, along with the Association of American Medical Colleges and FamiliesUSA, worked on Title III, Health Care Workforce Diversity, to ensure that there are programs in place that help our communities be able to attend a terminal health care degree program and for our families to be able to receive cultural and linguistically competent care.

• NHMA also urges Congress to protect public lands, national forests, parks and other accessible green spaces. Studies that shown that:
  • • Being active has been shown to improve mental health by reducing stress levels and alleviating symptoms of depression. Unfortunately, 60 percent of U.S. adults, and much lower percentage of Latinos, do not get the minimum recommended amount of physical activity needed to achieve health benefits each day.
  • • Several studies have shown that parks can increase the physical and mental health of seniors who live near them.
  • Having access to these valuable spaces is imperative for our communities, who often time don’t live in areas that allow for a lot of movement and fresh air (apartment complexes and shared homes)

• We support Congressman Joseph Crowley’s bill; H.R. 2267 “Resident Physician Shortage Reduction Act of 2017”

• • • This bill would add 15,000 Medicare supported direct graduate medical education (DGME) and indirect medical education (IME) residency slots over fiscal years 2019-2023.  
  • It would require the Comptroller to conduct a study on strategies for increasing health professional workforce diversity. 

Please contact your representative today and  (Click here to find your Senator and Click here to find your Representative)

February 2018

National Hispanic Medical Association Announces Recommendations for Cardiovascular Disease and Hispanics

Cardiovascular Disease (CVD) is a leading cause of death among Hispanics. Unfortunately, there’s a significant void in the knowledge base of the physician and patient advocacy community about cardiovascular disease diagnosis, access to care, and health care workforce training related to Hispanic populations. As such, there is a critical need to raise awareness about these issues to improve the future health of the Hispanic population in the United States.

In 2017, the National Hispanic Medical Association convened a Summit Series to increase awareness of: cardiovascular disease prevalence, prevention and diagnosis in the Hispanic/Latino community; access issues pertaining to CVD healthcare services; and education and advocacy for health care professionals and patients. The Summit Series was part of NHMA’s broader effort to increase health equity among Hispanics.

We were proud to welcome legislators at all three Summits to set the stage for a compelling dialogue with opening remarks, and share the important work related to their constituencies. It was an honor to welcome:

• State Representative Diana Arevalo (Texas District 116), Member of the Mexican American Legislative Caucus and the Healthcare Committee for the National Hispanic Caucus of State Legislators;
• Honorable Assemblyman Marcos A. Crespo (New York District 85), Chairman of the Puerto Rican/Latino Task Force; and
• Los Angeles County Supervisor Hilda Solis (California District 1), former Secretary of Labor.

If you missed the Summit, you can download the final presentation decks click Here. NHMA developed and issued a comprehensive final report that shares key issues and recommendations to improve Hispanic/Latino health and access to care.