As 2021 draws to a close and we look towards 2022, we reflect on the incredible foundation laid by policymakers this year to improve health and wellbeing for all by creating opportunities and lowering barriers to addressing social determinants of health (SDOH).
2021 started off with the release of long-anticipated guidance from the Centers for Medicare and Medicaid Services outlining opportunities for state Medicaid and CHIP agencies to address social determinants. Additionally, as part of its overarching efforts to advance health equity, the Biden-Harris Administration awarded $3 million in grant funding to state and local governments across the country to develop Social Determinant Accelerator Plans, and requested $153 million in funding for the Center for Disease Control and Prevention’s Social Determinants of Health program; issued several reports on SDOH interventions and data sharing; announced plans to embed health equity and address social needs throughout its Innovation Center models and Medicaid and CHIP and issued a request for information on how alternative payment models can incent the collections of SDOH and health equity data; and incorporated SDOH assessment standards into version two of the U.S. Core Data for Interoperability, among many other exciting steps.
Meanwhile, from January through mid-December 2021, over 270 bills related to SDOH were introduced in Congress – 150 bills related specifically to SDOH, 48 related to health equity, and 75 related to maternal and infant health. Legislation like the Social Determinants Accelerator Act (H.R. 2503/S. 3039) and the LINC to Address Social Needs Act (S. 509/H.R. 6072), among others, have potential to make a significant impact in this space by facilitating cross-sector coordination and the collecting, reporting, and exchange of health and social needs data.
There have also been a number of hearings to consider legislation to address SDOH and advance health equity. The Senate HELP Committee held a hearing entitled “Improving Health Equity and Outcomes by Addressing Health Disparities,” which focused on health inequities in relation to the COVID-19 pandemic. The House Energy & Commerce Committee, Subcommittee on Health held a legislative hearing entitled “Empowered by Data: Legislation to Advance Equity and Public Health” to discuss what actionable steps Congress can take now to improve access to, and the coordination of, public health, health care and social services. The Subcommittee and Full Committee proceeded to hold markups of multiple bills that would address social determinants in important ways, and in December, the House passed two bipartisan bills, the CARING for Social Determinants Act of 2021 (H.R. 3894), and the Social Determinants of Health Data Analysis Act (H.R. 4026).
Additional activity around social determinants of health and health equity in Congress included: House Ways & Means Committee release of its framework to achieve health and economic equity, entitled “A Bold Vision for a Legislative Path Toward Health and Economic Equity”; the creation of the House Ways & Means Committee’s Racial Equity Initiative (REI) and working group to address the role of racism and other forms of discrimination in perpetuating health inequities; a Senate Finance Committee request for information on evidence-based solutions to improve maternal health; and a hearing held by the House Committee on Oversight and Reform on the maternal health crisis, entitled “Birthing While Black: Examining America’s Black Maternal Health Crisis.” Finally, Representative McGovern (D-MA), the Chair of the House Rules Committee, held a series of roundtables and hearings on Ending Hunger in America to shine a light on the hunger crisis in the US and develop ideas to tackle this problem both legislatively and administratively.
This year also brought about the launch of the bipartisan Congressional Social Determinants of Health Caucus, which will explore opportunities to improve the impact of services delivered to address social determinants with the support of federal funding and amplify evidence-based approaches to holistic well-being. Since its launch in July, the Caucus has held a public launch event and a briefing on transportation as a social determinant, and solicited public comment on challenges and opportunities related to SDOH through a request for information that resulted in hundreds of responses.
As we reflect on the progress made in the past year, we look forward to continuing to work alongside the Administration and Congress to keep this momentum going in 2022 and beyond.