Unsanitized and unfair: How covid-19 bailout funds refuel inequity in the us health care system

Colleen M. Grogan, Yu An Lin, Michael K. Gusmano

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


Context: The CARES Act of 2020 allocated provider relief funds to hospitals and other providers. We investigate whether these funds were distributed in a way that responded fairly to COVID-19- related medical and financial need. The US health care system is bifurcated into the "haves"and "have nots."The health care safety net hospitals, which were already financiallyweak, cared for the bulk of COVID-19 cases. In contrast, the "have"hospitals suffered financially because their most profitable procedures are elective and were postponed during the COVID-19 outbreak. Methods: To obtain relief fund data for each hospital in the United States, we started with data fromthe HHS website.We use theRANDHospital Data tool to analyze how fund distributions are associated with hospital characteristics. Findings: Our analysis reveals that the "have"hospitals with the most days of cash on hand received more funding per bed than hospitals with fewer than 50 days of cash on hand (the "have nots"). Conclusions: Despite extreme racial inequities, whichCOVID-19 exposed early in the pandemic, the federal government rewards those hospitals that cater to the most privileged in the United States, leaving hospitals that predominantly serve low-income people of color with less.

Original languageEnglish (US)
Pages (from-to)785-809
Number of pages25
JournalJournal of health politics, policy and law
Issue number5
StatePublished - Oct 1 2021
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Health Policy


  • CARES Act
  • COVID-19
  • Hospitals
  • Safety net


Dive into the research topics of 'Unsanitized and unfair: How covid-19 bailout funds refuel inequity in the us health care system'. Together they form a unique fingerprint.

Cite this