Close the Medicaid Coverage Gap to Advance Health Equity

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September 29, 2021


Dear Senator,

On behalf of The Leadership Conference on Civil and Human Rights, a coalition charged by its diverse membership of more than 220 national organizations to promote and protect the civil and human rights of all persons in the United States, and the 26 organizations listed below, we write to urge your support for the permanent and comprehensive Medicaid coverage gap policy as outlined in the House Energy and Commerce Committee section of the reconciliation package. This is a top priority for the civil and human rights community and it is imperative that the Senate take action to ensure that those without access to any health care, which includes some of our most vulnerable communities, are finally able to access health care, especially as our nation continues to battle the COVID-19 pandemic.

Closing this gap would provide coverage for the first time to about 2.2 million people living below the poverty line[1] in the 12 states[2] that have refused to take up the option to expand Medicaid to cover people with low incomes. Despite substantial federal incentives to do so, including the added incentives in the American Rescue Plan Act passed earlier this year, none of these states, many of which are in the South, have taken steps to implement the expansion. As a result, people with incomes below the poverty line in these states continue to have no access to health coverage. Black, Hispanic, Asian, Pacific Islander, and Native American individuals make up over 60 percent of the 2.2 million people who remain uninsured without a pathway to accessing health care coverage.[3] Providing Medicaid coverage now would be a huge step toward making health equity a reality for these communities.

Medicaid expansion has narrowed racial and ethnic disparities in both coverage and access to care in the states where it has been expanded, and it has saved lives.[4] But these 2.2 million adults have experienced none of these gains, solely because of where they live. Without additional federal action for a comprehensive and permanent solution in the upcoming reconciliation package this year, people in most of these states will likely continue to suffer from a lack of access to health care for many more years, a lack of access that is costing people’s lives.

Access to health care is a civil and human right and it is imperative that no one is left behind. The COVID-19 pandemic amplified systemic pre-existing inequities in health care, with deadly consequences for many Black, Latino, Asian, Pacific Islander, and Native American people. We believe these racial disparities must be remedied by a comprehensive and permanent solution to close the Medicaid coverage gap, as included in the package adopted by the House Committee on Energy and Commerce earlier this month. We are urging the Senate to adopt this proposal to help advance a racially equitable recovery by creating access to permanent and comprehensive coverage for those who have been left out solely because of where they live. We cannot do anything less. Please contact June Zeitlin, senior advisor, at [email protected] with any questions.


The Leadership Conference on Civil and Human Rights
African American Health Alliance
American Association of People with Disabilities
Association of Asian Pacific Community Health Organizations (AAPCHO)
Autistic Self Advocacy Network
Bayard Rustin Liberation Initiative
Black Women’s Health Imperative
Center for Law and Social Policy
Community Catalyst
Disability Rights Education and Defense Fund (DREDF)
Eating Disorders Coalition for Research, Policy & Action
Epilepsy Foundation
Families USA
Friends Committee on National Legislation
Human Rights Campaign
National Disability Rights Network (NDRN)
National Education Association
National Employment Law Project
National Health Care for the Homeless Council
National Urban League
Network Lobby for Catholic Social Justice
Planned Parenthood Federation of America
REDC Consortium
The Arc of the United States
The United Methodist Church – General Board of Church and Society
Union for Reform Judaism


[2] Alabama, Florida, Georgia, Kansas, Mississippi, North Carolina, South Carolina, South Dakota, Tennessee, Texas, Wisconsin and Wyoming.