Implementing the ACA’s Medicaid expansion for people with low incomes is an urgent moral imperative. Nevertheless, policymakers in twelve states refuse to do so. The result is the Medicaid coverage gap: an estimated 4.4 million people—nearly all Black, Latinx, or other people of color in the South—are uninsured because of non-expansion.
Emerging proposals to close the Medicaid coverage gap center on establishing a federally administered Medicaid program or fully subsidizing Marketplace coverage in lieu of Medicaid coverage. Any federal coverage gap solution must include access to Medicaid’s robust protections, as the ACA intended. Otherwise, it could enshrine in federal law a separate and unequal system of health coverage that furthers structural racism in U.S. health policy.
NHeLP’s new paper describes foundational principles for equitably solving the Medicaid coverage gap. The principles provide policymakers and advocates with a framework for developing, evaluating, and responding to proposals.”
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