May 31, 2023
AAPI Heritage Month offers us all a time to reflect on the contributions made by Asian Americans and Pacific Islanders and uplift community members who work to make a difference and leave a lasting impact on those around them. Diversity is the most important thread weaving us together – by recognizing the diverse backgrounds, perspectives and approaches within individuals in our community, we can ensure that the health care industry continues to evolve to meet the needs of those in all pockets across the United States. ACHP is proud to lift up the voices of those within and near to this community, such as Daniel Tsai, Deputy Administrator and Director of Center for Medicaid and CHIP Services at CMS, in our ongoing effort to celebrate diversity.
Tell us about yourself and how you view the Center for Medicaid and CHIP Services’ role in promoting equity?
First, I love Medicaid and what I get to do with my team. This is an exciting and intellectually engaging field with complex and hard problems to solve. And I love that we get to do it as part of the nation’s social safety net, serving and providing equitable health coverage to everybody across the country – particularly in underserved communities.
Health equity in the Medicaid program means multiple things at multiple levels. It means enrollees have coverage and can access it without a bunch of red tape, which is why the work requirements discussions are so concerning. Equity also means parity in access to health care services and providers in a way that you and I would expect for ourselves and our families. Everything we are doing as an administration with Medicaid is focusing on health equity – getting people covered and making sure they retain their coverage.
How do you define diversity? Why is it important that we celebrate diversity in our communities?
I can answer that in many ways. First, across the entire Medicaid system – state Medicaid teams, health plans, providers – it’s so important that we have folks from a range of racial, ethnic, socioeconomic, sexual orientation, and gender identity backgrounds providing voices and doing the work. The Medicaid program exists to serve people across a full range of backgrounds, so having those diverse voices at the table is imperative.
Second, I strongly believe – personally and professionally – it’s deeply important for us to be in equal relationships with folks from a range of different backgrounds. It adds to the richness of life, and it ensures folks aren’t stuck in their own bubbles. In the Medicaid policy-making context, it makes our operations and communications stronger and more robust. We often find ourselves in situations where there is a perceived power differential in a conversation or relationship, with someone in a perceived position of power and influence engaging with someone in a perceived less powerful position. That’s inherently inequitable, which is why it’s so important to have a diverse set of backgrounds and experiences at the table.
From your viewpoint within CMS, and considering your past experiences, what are the most important steps health systems can take to promote equity in health care?
I wish every system would have the same approach to serving and providing service to Medicaid enrollees. Across urban and rural areas, the time it takes many enrollees to access care, or to find a provider who will see Medicaid enrollees, should disturb all of us. Medicaid has so many strengths, but there is room to improve equitable access in underserved communities.
What life and/or career advice would you give to your younger self?
I would tell myself, professionally speaking, to find the intersection where areas of great intellectual interest meet skill sets you bring to the table. And third, very importantly for me, is where those two variables meet a mission of service to the world. If those three things – interest, skills and mission of service – come together, I would tell my younger self to not veer off that path.