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Coverage Now: Doggett Leads Effort to Build Back Better by Closing Medicaid Coverage Gap

***Press Release***

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FOR IMMEDIATE RELEASE

September 24, 2021

Contact: Kate Stotesbery

202-494-4620

Coverage Now: Doggett Leads Effort to Build Back Better by Closing Medicaid Coverage Gap

Washington, D.C. – U.S. Representative Lloyd Doggett (D-TX), Chair of the House Ways and Means Health Subcommittee, just led three dozen Democratic House Members from States with Republican leaders who have refused federal dollars to expand Medicaid coverage in a letter to leadership pressing for action on the Medicaid coverage gap in the final Build Back Better package. Specifically, the letter presses for a solution to ensure that uninsured people are no longer left behind and left out, and that they do not face a coverage cliff after a few years.

The members write: “Closing the coverage gap is the most significant step this Congress can take to promote health equity, protect public health, and better secure the health and economic security of these Americans.”

To close the gap, beginning next year, Build Back Better provides free ACA Marketplace coverage to those who have been excluded from Medicaid in recalcitrant States. After three years, a new federal Medicaid program would take effect and eligible consumers in States that have not expanded would be transitioned into this federal program. To assure there is no coverage cliff in 2025 leaving patients uninsured again, the Members urged leadership to assure free Marketplace coverage will remain available if the federal Medicaid program is delayed for any reason.

“Nearly six million Americans, primarily from communities of color, remain uninsured due to Republican ideological obstruction and indifference. To Build Back Better, we need to ensure that this legislation provides immediate coverage for those who have fallen into the Medicaid coverage gap, and we need to ensure that they do not face a coverage cliff that could leave our most vulnerable neighbors uninsured once again,” said Congressman Doggett. “It is long past time to assure access to a family physician, necessary medicine, and other essential coverage for our economically disadvantaged citizens.”

You can read the Members’ full letter here or below.

Dear Speaker Pelosi:

As negotiations continue with the Senate and our House Rules Committee prepares the Build Back Better Act for floor consideration, we write to reiterate the importance of permanently closing the Medicaid coverage gap.  We appreciate your strong commitment to fulfilling the ACA’s promise for the estimated 6 million uninsured Americans who have been denied any of its benefits by a few Republican state leaders.  Closing the coverage gap is the most significant step this Congress can take to promote health equity, protect public health, and better secure the health and economic security of these Americans.

The House Ways & Means and House Energy & Commerce Committees included strong policies to correct this wrong for our most vulnerable neighbors.  To assure the many benefits, consumer protections, and social services coordination offered by Medicaid, the Energy & Commerce Committee approved legislation to establish federal Medicaid plans operating in the non-expansion states. 

Recognizing such a program will take some number of years to establish, the Ways & Means Committee legislation provides immediate relief with zero-premium and deductible, year-long Marketplace coverage.  To better meet this vulnerable population’s needs, Marketplace coverage would include year-round enrollment opportunities and some additional benefits, including non-emergency medical transportation and family planning services.

Together, the two committees’ policies offer a path forward to close the coverage gap.  To ensure there are no interruptions in coverage, the Ways & Means Committee included an important sentence providing continuous zero-premium Marketplace coverage until the HHS Secretary certifies the federal Medicaid program is fully implemented and ready to enroll beneficiaries.  We draw your attention to this essential one-line provision, which assures there is no coverage cliff should the new federal Medicaid program be for any reason delayed.  Economically disadvantaged Americans, who have already been left behind for over a decade, must not again be suddenly left uninsured. 

We remain committed to ensuring CMS establishes a federal Medicaid program by the statutory deadline of January 1, 2025, but patients’ health security should not be left hanging in the balance.  CMS is already overburdened with the enormous work of undoing Trump’s sabotage of our health care system and the COVID-19 pandemic.  The agency will be implementing several new programs upon passage of the Build Back Better Act, increasing the possibility of delays. 

To ensure health care access is not disrupted, we respectfully ask that you preserve the continuous zero-premium coverage provision included in the Ways & Means bill and expand this protection to include the cost-sharing reductions under the Energy & Commerce Committee’s jurisdiction.  This provision is essential to genuinely fulfilling the promise of permanently closing the Medicaid coverage gap.

Thank you for your strong leadership and commitment to health equity during this unique moment in history.  We stand ready to assist you in getting this landmark policy to President Biden’s desk.

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