WASHINGTON — The National Institutes of Health’s Office of Minority Health (OMH) has removed pages from its website dealing with the Affordable Care Act (ACA), according to a report from the Sunlight Foundation’s Web Integrity Project (WIP).
“Among the removed pages was the main ‘Affordable Care Act’ page, which contained information about the ACA, OMH’s role in implementing the law, and linked to seven additional ACA-related pages — five of which OMH has since removed from the site,” the foundation’s Aaron Lemelin explained in a blog posted Thursday.
“The removal of the content undermines access to information about improving healthcare for minority communities by an agency that was set up to reduce health disparities and which has in the past viewed the ACA as key to that mission,” he added. “A de-emphasis on outreach to minority communities, in particular, goes against evidence that suggests outreach and access to ACA-related information are central to further reducing health disparities.”
In particular, “Among the removals documented in WIP’s report were ACA resources in the National Partnership for Action to End Health Disparities (NPA) section of the OMH site,” wrote Lemelin. “After the ACA became law, a significant task of the NPA, a group of partners, leaders, and stakeholders initially convened by OMH and committed to combating health disparities, was to provide outreach and education to underserved populations about the benefits of the law. Reflecting this task, the ‘Learn About the NPA’ page previously listed ‘Education and Outreach on the Patient Protection and Affordable Care Act of 2010’ as the first of its ‘five top priorities for action.'”
However, in the last year, OMH stripped that from the page, now titled “About the NPA,” and replaced it with “Strengthening access to quality health care.” Similarly, the site renamed the “Affordable Care Act Education and Outreach” page to “Strengthening Access to Quality Healthcare” and removed two paragraphs referencing the ACA provisions to combat health disparities.
Sarah John, director of research for the WIP, said in a phone interview that the foundation’s researchers identified the OMH “as potentially likely to have interesting changes; we use software that scours pages and identifies changes all the way into the source code and lets us know whenever there’s a change. We kept seeing changes from OMH, and this [report] is an aggregation of changes we saw over 2 years.”
Sometimes information is returned to websites once the foundation issues one of its reports, John added. “One of the reports we did was about the removal of … a set of materials for Latino outreach; after our story, that [information] was returned.” On another occasion, the foundation reported on changes at the healthcare.gov website for the ACA’s health insurance exchanges — including removal of information on how to apply for health insurance by phone or through the mail — “but after our report, it was put back — almost immediately. So it could happen.”
The foundation asked OMH for a statement on this latest removal. “When asked for comment about these removals, the OMH press secretary suggested that the ACA is an initiative of another office, the Centers for Medicare and Medicaid Services (CMS), which administers the ACA. As explained below, the ACA is responsible for the continued existence of OMH. While the press secretary noted that OMH ‘regularly supports the initiatives of other federal offices, summarizing or linking to their information and resources,’ he did not specify whether this was the case for the removed ACA content,” Lemelin wrote.
When contacted by MedPage Today, an OMH spokesman gave a similar answer regarding the ACA being administered by CMS, and added, “When OMH updates its pages or links, that information is still available to the public. As is standard website management practice, the Office of Minority Health routinely reviews and updates the content on the OMH website. We also continue to make improvements to the site by reorganizing content on the site.”
As an example, he noted that “one of the links referenced by the Web Integrity Project was restructured and is available here.” The archived page features healthcare.gov — the website for enrolling in health insurance in the ACA’s insurance exchanges — very prominently in the center, and also includes a link to a page on “The Healthcare Law and You.” The new page instead suggests that viewers go to the “From Coverage to Care” website at CMS to “help you understand your health coverage and connect to primary care and preventive services that are right for you.” The page gives two links to the From Coverage to Care site — each links to a different page, one of which mentions healthcare.gov while the other does not.
The consequences of removing the pages affect “healthcare professionals and people wanting to do [ACA] outreach, because that information is [now] much harder to find,” John said. “The basic information about the ACA is largely available elsewhere — but not the outreach information of the disparities action plan … It’s difficult to find information about what [the Department of Health and Human Services] is doing to eliminate health disparities.”