The U.S. Commission on Civil Rights says some little-noticed provisions in the House health care bill are racially discriminatory, and it intends to ask President Obama and Congress to rewrite sections that factor in race when awarding billions in contracts, scholarships and grants.
The commission also fears the programs, which are designed to improve health care in underserved areas, will not be effective.
In a draft of a letter the commission approved Friday, the group raises constitutional questions about giving preferential treatment to minority students for scholarships, and about favoring medical schools and organizations that have a record of sending graduates to areas with inadequate health care services.
"These programs are unlikely to reduce health care disparities among racial and ethic groups," according to the draft letter obtained by The Washington Times. "A growing body of evidence indicates that increasing access to high-quality physicians - whatever their racial or ethnic ancestry - is the best way to mitigate such disparities."
The draft letter also cites testimony from Dr. Amitabh Chandra of Harvard University who said the idea that expanding the number of minority physicians and providing "cultural competence training" will bridge the health status gap is "grounded in hope more than science," according to the draft language.
It cites research from Dr. Chandra that found that improving the quality of health care in the 500 largest minority serving areas would improve minority health care more than the elimination of racial disparities within every provider in the U.S.
The commission approved the draft language by a vote of 4-2, with two abstentions. Two Republicans and two independents voted for it, two Democrats voted against it, and two Republicans abstained. The letter needs to be approved again before being sent.
The commission, which has four Republican members appointed by President George W. Bush, as well as two independents and two Democrats appointed by Congress, has come under scrutiny in recent months by liberals who say the group hasn't done enough for minorities.
The Leadership Council on Civil Rights, a civil rights coalition of nearly 200 national groups, said the commission has become too political and, in this case, is attempting to squash equal-opportunity programs.
"The U.S. Commission on Civil Rights is overstepping its bounds yet again with another slanted and incorrect interpretation of logical and constitutional standards," said Wade Henderson, president and chief executive officer of the Leadership Council. The group is "injecting themselves in the health care debate without any expertise and understanding of how the training in the House bill will work."
The federal government already has policies in place that target physicians to underserved areas, such as the National Health Corps, which forgives medical school debt in exchange for working in those underserved areas.
There are many types of underserved areas, said James D. Reschovsky, a senior researcher at the nonpartisan Center for Studying Health System Change. The definition is largely based on the number of primary care physicians per capita, and includes rural and urban regions.
"If you subsidize peoples' medical education on the condition that they serve in underserved areas, that should have a beneficial effect," he said. "I'm assuming that the physicians will still have to get through their medical exams and so on, so it has nothing to do with compromising the quality of care, per se."
Grants and scholarships would be available from the Department of Health and Human Services to educate minority and underserved populations in public health, dentistry and health specialties, as well as to students who agree to serve in those areas of the country after graduation.
Versions of the House health care bill have passed in three committees and will be combined before the full House votes on the legislation in September. But it's already running into resistance over the August recess in town-hall discussions with members of Congress throughout the country.
The momentum shows no sign of slowing. Mr. Obama on Monday said debate is healthy and is slated to host a town-hall meeting of his own in New Hampshire today.
Liberal groups have accused conservative organizations of planning attacks at the town-hall meetings, many of which have turned into heated shouting matches.
AARP, one of the largest advocacy groups in the debate, announced a large television advertising campaign intended to counter Republicans' claims that the bill would ration health care.
• Jerry Seper contributed to this report.
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