By C. Nicole Mason

There is much to be celebrated with the passage of the historic healthcare reform legislation. The new law will extend coverage to most of the 37 million uninsured, end discrimination for individuals with pre-existing conditions and tighten regulations for insurance companies. Missing from the legislation, however, is a clear plan to decrease health disparities and inequalities among African Americans.

From the beginning, blacks overwhelmingly supported overhauling the healthcare system. In a CBS poll leading up to the healthcare vote, 67 percent of African Americans agreed that changes in the system were necessary. Their support for healthcare reform was not so much about what was in the legislation, but more about their confidence in President Obama. Among African Americans his approval rating stands at 85 percent.

As with the economic stimulus package, blacks are eager to see how the health care reform legislation will directly impact them and their families. If the healthcare reform legislation is implemented in ways similar to the economic stimulus bill, it is unlikely blacks will see change in proportion to their support of Obama.

For example, the impact of the economic stimulus package in African-American communities has been negligible. In fact, their situation has only worsened over the last year with unemployment rates among black men and women close to 17 percent. And only a tiny fraction of contracts through the American Recovery and Reinvestment Act, less than ten percent, have gone to minority owned businesses. In both bills, there are no clear provisions to address the specific needs of racial and ethnic minority communities with regard to economic recovery or healthcare reform.

In the case of health care reform, however, Obama has an opportunity to get ahead of the ball and be proactive with regard to addressing issues of health disparities and inequalities. With a solid win under his belt, he just might have the leverage to push for some secondary health reforms that include funneling resources to address issues of obesity, chronic diseases and the quality of hospitals and health care facilities in racial and ethnic minority communities, among others.

Making sure that people who cannot afford insurance can get it is only one piece of the healthcare pie. This will be accomplished as the legislation is implemented at the state and local levels through employer sanctions and subsidies to families to obtain insurance.

Ensuring that when individuals go to the hospital or healthcare facility in their communities they will receive quality treatment is an equally important issue especially for communities of color. There is also a need to probe the social and environmental factors that put blacks at higher risk for certain diseases, such as HIV/AIDS and hypertension. African Americans also have higher rates of infant mortality, are at higher risk for certain kinds of cancer, and are more likely to die from the lack of care or treatment than Whites.

Earlier this year, the Advisory Committee on Minority Health pulled together by Obama issued a report detailing how healthcare reform will meet the needs of minority communities and eliminate health disparities. Recommendations issued by the committee include establishing a federal health equity commission, developing a healthcare workforce that is representative of the communities served, supporting the enhancement and availability of a wide range of community-based interventions to ensure that programs are responsive to diverse populations, and strengthening the public health infrastructure so that it can accommodate a growing population

These are all good ideas; approaches to eliminating health disparities should always be community focused and centered. The Administration will have to take the next step and outline concrete goals and benchmarks. We will need to know how many professionals will have to be trained over the next 10 years to change the healthcare workforce; dedicate resources to demonstration projects for culturally and community specific interventions to reduce chronic disease and infant mortality rates; and develop a system to evaluate providers and facilities to ensure they are providing the best level of services to individuals and communities.

Improving health outcomes for people of color and eliminating disparities is a huge charge. All of the above recommendations are certainly attainable within the context of a system overhaul, but unless there are dedicated resources and investment from the White House to realize many of these goals, it is possible they will fall by the wayside. We also need to get clear about our goals and the outcomes we would like to see over the next ten years.

For healthcare reform to truly be a success for all Americans, Obama and his Advisory Committee must be deliberate and intentional in their approach to alleviating health disparities. There should also be measurable benchmarks and outcomes so that we can track progress in key areas of focus, such as increasing the number of racial and ethnic minority health professionals over the next ten years.

Given the opposition to healthcare reform, getting the initial legislation passed was a significant victory for Obama. He should build on this victory by working to ensure that the health disparities and poor health outcomes that have plagued communities of color for decades are addressed in ways that are meaningful and tangible.

Dr. C. Nicole Mason is the Executive Director of the Women of Color Policy Network at the Wagner School of Public Service at New York University.