SACRAMENTO, Calif. -- The Build Back Better Act, now headed to the U.S. Senate, would be a huge win for consumers, according to groups fighting for better health care.

Forty-two members of California's congressional delegation voted in support of the measure, which aims to keep premiums affordable for Covered California enrollees, lower the price of prescription drugs, and cap prices on diabetes medication, and cap out-of-pocket expenses for older Americans on Medicare Part D.

Rachel Linn Gish, director of communications for the group Health Access California, said it was a heavy lift and a big victory just to pass it out of the House.

"There's still time to speak up in both thanking your congressional members," Gish noted. "But also reaching out to your senators to make sure the bill gets out of the Senate as strong as possible."

The Build Back Better Act would also add a hearing benefit to Medicare, prevent huge spikes in the cost of prescription drugs, and extend through 2024 subsidies helping millions of families get insured through Covered California. Opponents say the price tag is too high.

Gish contended Build Back Better is the most significant change in health policy since the Affordable Care Act. She noted one of the bill's biggest impacts healthwise is a provision allowing Medicare to start negotiating down the price of prescription drugs, something currently forbidden.

"Right now, prescription drugmakers can charge whatever they want, whatever the market will bear," Gish asserted. "Giving Medicare the ability to actually go back and forth with drugmakers to lower those costs for their consumers is a huge step in the right direction."

If the Senate makes any changes to the bill, it would still have to go back to the House for a concurrence vote before it lands on President Joe Biden's desk.

This month, Minnesota has raised state reimbursement rates for dentists who accept patients enrolled in the state's Medicaid program.

Groups working with families in need believe it will get more young children into a dentist's office.

Kraig Gratke, executive director of the Minnesota Head Start Association, said roughly 88% of the kids signed up for Head Start around the state are covered by the Medical Assistance (MA) program.

To meet federal requirements, Head Start has to help ensure families are getting annual dental care for their kids, but he acknowledged it is not always easy.

"In outstate Minnesota, there's just not a lot of dentists," Gratke pointed out. "And then, not a lot of dentists were taking MA because reimbursement wasn't high enough."

The state said it is addressing what many described as notoriously low rates. As part of a $61 million package adopted last year, all dentists will receive the same rates for the same services under Medical Assistance and MinnesotaCare. In some situations, payment increases could reach 98%.

The Department of Human Services (DHS) said in 2019, more than 60% of Minnesota children living in poverty did not see a dentist.

Gratke suggested not having consistent dental care could end up being very disruptive to a child's development, especially if they're in need of serious care.

"It makes it very difficult to learn, to manage behavior," Gratke asserted. "It's very hard on little ones."

State officials say benchmarks for health plans are being applied to the new rate structure. This year, DHS wants at least 45% of public health program enrollees to have a dental visit. In 2024, the goal rises to 55%. If a managed-care organization cannot meet those benchmarks, the department said it will step in to provide direct dental coverage.

A new report suggests discrimination in medical settings affects the quality of care for many Ohioans.

In a survey of more than 800 people, discrimination was not a rare experience, and for women and people of color; it was common.

In the survey, Black women reported feeling "less respected" twice as often as white men, and Black men were four times more likely to report being harassed in a health-care setting.

Greg Braylock, Jr., vice president and chief diversity, equity and inclusion officer for ProMedica, a health-care system based in northwest Ohio, said he isn't surprised by the findings.

"We've known in health care for decades that we've had disparities in how people experience health care, the outcomes that they have," Braylock observed. "But we have failed as an industry to sufficiently address these negative differences in outcomes that we see."

Some 22% of those surveyed said they have accepted discrimination in medical settings as "a way of life," but 24% said they did not return for future appointments, which may mean delaying or avoiding needed care. Just 15% of people who said they felt discriminated against went on to file a complaint.

The report noted many hospital systems have equity training, but few have anti-racism initiatives.

Dawn Pullin, director of behavioral health and addictions for the Northeast Ohio Black Health Coalition, contended such efforts only scratch the surface of the problem.

"That training that we've done over the last 20-30 years has brought us to this place where this survey is still necessary, where health is still a crisis," Pullin asserted. "Where Black and African American people are dying daily because of the lack of services, and their skepticism about engaging the hospital setting."

Pierette Talley, executive director of the Ohio Unity Coalition, believes hospitals and other health-care institutions have made a good start toward addressing racism. But she said they need to dig deeper than community forums, health fairs and government-required anti-discrimination measures.

"They must be in touch with the community that they serve and work together to figure out what are the issues and how they can best be addressed," Talley urged. "So that we are rooting out racism at an institutional level and not just looking at some bad actors."

The report was released by the Multiethnic Advocates for Cultural Competency, the Ohio Unity Coalition, the Northeast Ohio Black Health Coalition, and the Universal Health Care Action Network of Ohio.

A coalition of doulas in Connecticut hopes to expand their participation in public policy discussions about the care they deliver with the support of a new grant. Doulas support pregnant people throughout the birthing process.

The Connecticut Health Foundation is providing the Doulas for Connecticut Coalition a $76,000 grant for state policy advocacy.

Cynthia Hayes, a certified interdisciplinary doula, said the grant will allow them to educate legislators on policies to ensure equitable access to doula care.

"We're looking to have reimbursement through insurance companies and especially through Medicaid," Hayes explained. "Because often those families that are receiving Medicaid are among our vulnerable citizens, and they need the help."

Hayes pointed out they are also interested in supporting legislation to ensure doulas are compensated fairly, as salaries vary from state to state.

Lucinda Canty, a nurse-midwife, is project director for the grant. She said it is about backing the pregnant person to stand up for what is right for their body during the childbirth experience.

"It's really just about empowering her because our health-care system is overwhelming and pregnant women, especially during childbirth, are so vulnerable," Canty stated. "So just having someone there that said, 'She has these questions. This is what she wants. What can we do to let this happen?' "

Black women are 2.6 times as likely as white women to die within six weeks of childbirth.

Tiffany Donelson, president and CEO of the Connecticut Health Foundation, said doulas can help address the disparity.

"Oftentimes, it's that voices of women of color as they are going through the childbirth experience is not heard by providers," Donelson observed. "Doulas can ensure that there's another voice that can support an individual through the process."

Research shows doulas can reduce the likelihood of birth complications and increase breastfeeding rates.