November 11, 2022 

The Medicaid and health edition.  Health care was on the ballot in several states this past Tuesday. In South Dakota, 42,500 additional people will eventually be eligible for Medicaid benefits after voters approved Medicaid expansion. In Oregon, voters approved an historic measure that amends the state’s constitution to mandate that all residents have access to “cost-effective, clinically appropriate and affordable health care.” And in Arizona, voters overwhelmingly approved Proposition 209, which reduces the amount of interest creditors can charge for health debt from 10 percent to 3 percent. 

Meanwhile, on the federal level, there are urgent health care issues that Congress must address when members return later this month. Most urgently: it faces a December 16 deadline for protecting Puerto Ricans and U.S. residents in other territories from drastic cuts to Medicaid; in Puerto Rico, more than one million people could be affected. 

Also at risk: Between 5 million and 14 million Americans who could lose access to Medicaid once the COVID-19 public health emergency ends. A provision included in a 2020 COVID-19 relief bill required that states keep people continuously enrolled in Medicaid through the end of the month in which the public health emergency ends in exchange for more federal funding. The provision contributed to a 25 percent enrollment surge during the pandemic, but will end when the public health emergency does. 

Among those likely to lose coverage: 383,000 people in the 12 states that so far have declined to expand Medicaid under the Affordable Care Act. These people will fall into the Medicaid “coverage gap” — they’re part of a group of 2.2 million people living in non-expansion states who despite falling below the federal poverty level make too much to qualify for their state’s Medicaid but too little to qualify for subsidized marketplace coverage. 

“There are going to be a lot of low-income families in the coverage gap after the public health emergency ends,” Jane Adams, Campaign Director at the Cover Alabama Coalition, told Roll Call. “And it doesn’t have to be this way…It’s just bad governance.” 

There are several measures Congress should pass. Congress must provide continuous and expanded Medicaid and Children’s Health Insurance Program (CHIP) coverage, including 12 months of continuous eligibility for adults and children, 12 months postpartum coverage and other provisions to improve maternal and child health outcomes. 

Postpartum coverage is an issue of racial equity. Maternal mortality disproportionally affects Blacks and other women of color. And there is an issue of gender equity, which is why Congress should pass the Pregnant Women’s Fairness Act, which would ensure that pregnant women are not forced to choose between their health and the health of their pregnancy and their economic security. 

Congress has much to do before year’s end. Now with the election (mostly) behind us, it is time for members to get back to work. Click here and tell Congress it must protect Medicaid and prevent millions of Americans from losing health care.