Nationwide there is strong momentum for advancing health equity. On April 8, 2021, the Centers for Disease Control and Prevention (CDC) declared racism a public health emergency that causes inequities throughout our health care system. American Indian and Alaska Native, Latinos, and Black populations have disproportionately borne the burdens of the COVID=19 pandemic, experiencing significantly higher case rates, hospitalizations, and deaths as compared to their share of the total population. Inequitable access to treatment and the effects of discrimination and structural exclusion have strong and lasting negative impacts on the health and health care of people of different races, ethnicities, and sexual orientation, among other characteristics.

Advancing health equity is an essential way for State Medicaid Agencies (SMAs) to increase access to high-quality, affordable, whole person, patient-centered care for populations that have been historically and contemporarily marginalized. SMAs serve diverse populations that are disproportionately impacted by structural racism and experience disparities in health care access and outcomes.

In addition, the federal government has named health equity as one of its main priorities. On January 20, 2021, the Biden administration pledged to advance racial equity and support underserved communities through federal government programs. Similarly, the Administrator of the Centers of Medicare and Medicaid Services (CMS), Chiquita Brooks-LaSure, identified advancing health equity and addressing health disparities as the agency’s first strategic pillar.

NORC at the University of Chicago has created a health-equity framework to support states in their efforts to advance health equity within their Medicaid programs. The Framework for Advancing Health Equity seeks to help and guide states in creating a roadmap for advancing health equity in their Medicaid programs. This roadmap for advancing health equity describes ways SMAs can develop a health equity strategy and identifies levers SMAs can use to encourage Medicaid system transformation toward health equity, while elevating member voices and ensuring engagement of various stakeholders in the process.