Economic Reconciliation Legislation Must Close the Medicaid Coverage Gap
Dear Speaker Pelosi and Majority Leader Schumer,
The Leadership Conference on Civil and Human Rights, along with the NAACP, National Action Network, National Urban League, and UnidosUS, appreciate your leadership in working to secure an economic package to help reduce our country’s economic and racial disparities and make health equity a reality for all communities.
As we have previously urged, any economic reconciliation legislation should close the Medicaid coverage gap, even temporarily, so that the more than 2.2 million adults, 60 percent of whom are people of color, living in states that have not adopted the Affordable Care Act (ACA) Medicaid expansion can finally access health care under the ACA. That is reason alone to ensure that a provision closing the coverage gap is part of forthcoming legislation. But now with the unconscionable U.S. Supreme Court decision in Dobbs v. Jackson Women’s Health Organization, it is even more urgent to close the coverage gap. Many of the states with the most restrictive abortion laws also have failed to extend Medicaid to low-income adults. There are more than 800,000 women of reproductive age with income under 100 percent of poverty living in states that haven’t expanded Medicaid, leaving them without access to comprehensive health coverage. Many of these people live in the South, a region where more than half of the country’s Black population lives and which already ranks low on many maternal health outcome measures.
Access to health coverage is not a substitute for abortion access and closing the coverage gap will not address the lack of abortion in these states. But closing the coverage gap will help ensure that low-income people have a regular source of health care, making it more likely that they can obtain contraception if desired as well as important preconception care. Access to these services can improve the odds of a healthy pregnancy for those who become pregnant. Maternal mortality rates in the United States are already too high and have risen during the pandemic, particularly for Black and Hispanic women. There are many factors driving health disparities and no single solution, but one thing is clear: closing the Medicaid coverage gap is a critical step that Congress can take to address longstanding disparities in access to care.
We recognize the significant challenges you face in reaching an agreement on this legislation. Failing to close the coverage gap isn’t a matter of missing an opportunity to improve a program; instead, it is about ending the current situation in which more than 2 million poor people, mostly people of color, lack any pathway to affordable coverage.
We appreciate your time and consideration of ways to reduce economic and racial disparities in health care as you work to come to an agreement on this legislation. If you have questions or need additional information, please contact Peggy Ramin, policy counsel for health/poverty, at [email protected].
Sincerely,
The Leadership Conference on Civil and Human Rights
NAACP
National Action Network
National Urban League
UnidosUS