Letter to Speaker Pelosi, Majority Leader Schumer, Minority Leader McCarthy, and Minority Leader McConnell - Inclusion of Medicaid Expansion in Reconciliation Package


Dear Speaker Pelosi, Minority Leader McCarthy, Majority Leader Schumer, Minority Leader McConnell,

As discussions continue around a budget reconciliation package, we urge you to prioritize the inclusion of a permanent, comprehensive fix for the Medicaid coverage gap in non-expansion states.

Closing the Medicaid coverage gap is a moral imperative, and Congress must ensure that Americans of all backgrounds have access to quality, affordable health care. Despite significant financial incentives provided by the Affordable Care Act (ACA) and the American Rescue Plan Act (ARPA), there are still 12 non-expansion states that prioritize politics over people and continue to deny low-income Americans health care coverage. This has left 4.4 million low-income Americans unable to access to the free or affordable care that is available in 38 other states and DC.[1] Geography should not determine whether people in this country have access to affordable health insurance and therefore access to our health care system.

Americans in the Medicaid gap are unable to access the preventative and primary care crucial to staying healthy. They are more likely to wind up requiring and receiving care only when disease is already advanced, acute, or life-threatening. This results in preventable suffering, death, and tragedy, and the costs of care when it's too late are inevitably born by the public. It is bad public health policy and it is bad fiscal policy.

The choice not to expand Medicaid has a very real and human cost. It is estimated that between 2014 and 2017, 15,600 older adults died prematurely due to states' decisions not to expand Medicaid. [2] Further, the Americans who are most harmed by this inaction from state leaders are people of color: 60 percent of people in the coverage gap are Black, Hispanic, Asian, or Pacific Islander.[3]

Medicaid expansion ensures low-income individuals have better access to preventative health services improving health outcomes and preventing premature deaths. Medicaid expansion also improves the economic mobility that would enable low-income individuals to work.[4]

Now is the time for action. We must finally fulfill the promise we made 12 years ago when we passed the ACA and ensure that all individuals and families, in all 50 states have access to health care. To that end, as a reconciliation package is being negotiated, we urge you to include provisions to close the Medicaid coverage gap and provide free and affordable health coverage to all those who would otherwise be eligible for this safety net program.

Thank you for your attention to this matter. We look forward to working together to deliver health care for millions of Americans.