38 House Members Urge Congress to Close the Coverage Gap in States that Block Medicaid Expansion

As the White House and Congressional leaders head into the home stretch of negotiating a slimmed down "budget reconciliation bill," pressure is ramping up for them to include a health coverage solution for uninsured adults in Texas and other states that are blocking Medicaid expansion. The reconciliation bill is designed to circumvent the filibuster, allowing Senate Democrats to pass the bill without Republican votes.

The original Build Back Better bill, which passed the U.S. House but not the U.S. Senate, included a plan to offer a health insurance option to uninsured adults below the poverty line in these 12 states. The historic Affordable Care Act passed during the Obama administration offered HealthCare.Gov subsidies to adults above the poverty line and intended to expand Medicaid to cover adults near or below the poverty line, but these states have so far refused to implement Medicaid expansion.

In a recent letter to congressional leaders, 38 members of the U.S. House — including most Texas Democrats in Congress as well as representatives of other non-Medicaid expansion states — called for including a solution to the coverage gap in the reconciliation bill. The letter says:

For too long, politicians in our states have prevented 2.2 million people who would qualify for Medicaid expansion from gaining access to high-quality coverage. As Congressional members from the 12 non-expansion states, we strongly urge you to include language to close the Medicaid coverage gap in reconciliation....

As negotiations continue on reconciliation legislation, we want to once again reiterate the importance of closing the Medicaid coverage gap. It would help advance racial health equity in our nation, as nearly 60% of people in the coverage gap are Black, Hispanic, Asian, or Pacific Islander.

Additionally, health care advocates from Texas and across the south recently sent a letter to Congress pleading for action. Here's an excerpt from that letter:

We represent the 12 states that have refused to expand Medicaid, and today we write to implore you to express your strong and active support to ensure that any final agreement on a reconciliation package includes a provision to close the Medicaid coverage gap. In the wake of the Dobbs decision, Congress must take immediate action to ensure all women and birthing people across this country have at minimum access to basic health care.

Failing to close the coverage gap would be a moral failure and an unconscionable abandonment of over two million of the poorest Americans who still have no pathway to affordable health coverage, including more than one million predominately Black and Latino people of color, and 800,000 women of reproductive age.

In the coming days, Texans will continue to urge Congress to take this critical health care step.