Build Back Better Policies Must Close the Medicaid Coverage Gap to Address Health Equity

Two-thirds of people who would gain coverage in non-expansion states are people of color

RALEIGH (June 21, 2021) – Action NC and the NC Justice Center released a new issue brief highlighting racial equity in health care policies as the nation commemorated Juneteenth this past weekend, marking the emancipation of people who were enslaved in the United States.

The report describes how U.S. Congress and the Biden Administration can reduce racial disparities that result in worse health outcomes and diminished economic security for Black and Brown people by prioritizing policies that make healthcare affordable and expanding coverage.

Specifically, the report details how closing the Medicaid coverage gap in 12 states that have not yet expanded Medicaid would increase health equity. About 4 million people with low incomes could gain coverage under Medicaid if these states expand Medicaid, including 2.2 million adults with incomes below the poverty line. Of this number, 28 percent are Black and another 28 percent are Latino. In the state, 328,000 would gain coverage, including 68,000 Black and Brown people.

Three-fourths of states that have not expanded Medicaid, despite increased incentives under the American Rescue Plan (ARPA), are in the South, including Alabama, Florida, Georgia, Mississippi, North Carolina, South Carolina, Tennessee, and Texas. Three of these states (Texas, Georgia, Florida) also have the largest number of non-Hispanic Black people in the country. Texas and Florida are also among the top five states with the largest populations of Hispanic Blacks.

“The ACA made huge strides in improving health care for Black and Brown people, but the job isn’t finished as long as partisan opponents of the ACA can continue to block the implementation of Medicaid expansion,” said Naomi Randolph Hwesuhunu, Senior Advisor, Action NC. “We’ve been trying for many years to cover the remaining uninsured, but each time lawmakers put their politics ahead of healthcare for the people with the lowest incomes in our state. Even with increased incentives in the American Rescue Plan Act and with thousands of people falling sick with COVID, they continue to deny people coverage.”

Georgia Senators Warnock and Ossoff wrote a recent letter urging Congress and the Biden Administration to take action to create a federal solution for people denied Medicaid coverage because of political gridlock that would allow people in non-expansion states to access affordable healthcare.

Doing so would build on other improvements that emerged in ARPA that expanded premium tax credits and gave millions more people access to quality, affordable healthcare with lower premiums. More than one-third of enrollees have a plan that costs $10 or less per month including 4 in 10 new enrollees. ARPA increased funding to address maternal health by extending health coverage for new mothers, gave states the option to expand home-based and community services, and provided subsidized COBRA coverage for laid-off and unemployed workers. The rescue plan also increased funding for Medicaid expansion as an incentive to states to finally expand coverage to the uninsured but none of the dozen states took up the funding.

Members of the Black, Hispanic, and Asian Congressional Caucuses are now working together to advance closing the coverage gap as a key strategy to address racial health disparities, starting with a Tri Caucus sign-on letter. State advocates are urging the federal government to join the effort to finally ensure everyone has access to Medicaid.

“Health equity is not a blue state or a red state issue,” said Nicole Dozier, Director of the Health Advocacy Project at the NC Justice Center. “No matter where someone lives or what they look like, they should never be denied access to any human right including quality healthcare and certainly not based on political grudges. Many other states, Democratic and Republican-led, have put the interests and needs of their constituents ahead of their own partisanship. Politicians in the remaining states will not be allowed to hold people with low incomes, Black people, and Brown people hostage to their own agenda. President Biden and Congress must intervene and there’s never been a better time.”

FOR MORE INFORMATION CONTACT Pat McCoy, email/phone: pat@actoinnc.org. (919) 883-7120