17 Texas Groups Urge Congress to Close the Medicaid Coverage Gap

Seventeen Texas organizations are calling on Congress to support the proposal in President Joe Biden’s budget to close the Medicaid coverage gap. 

Their letter to Congress notes that an estimated 726,000 Texans with low incomes are in the coverage gap — meaning they do not qualify for affordable health insurance through Medicaid or through HealthCare.gov subsidies — because state leaders continue to block Medicaid expansion. 

The letter was signed by Every Texan, Children’s Defense Fund, Texans Care for Children, and other organizations.

The full text of the letter is available below:

April 1, 2024

Dear Members of Congress,

We are thrilled to see that President Biden’s recently released FY25 budget once again proposes to close the Medicaid coverage gap. Given your dedication to ensuring the health and well-being of Texans, we ask you to actively support President Biden’s proposal to create a pathway to affordable coverage for the 1.6 million low-income people — including an estimated 726,000 Texans — who are currently stuck in the coverage gap in the 10 states that have not implemented Medicaid expansion.

We urge you to actively support this proposal, starting with highlighting the importance of this policy for Democratic Congressional leaders as well as Democratic health committee leaders. Specifically, we ask you to underscore that a federal fix to the Medicaid coverage gap for states who have not expanded must remain a central part of the Congressional health care agenda going forward. It is a health care, moral, and racial equity imperative. Next year, the enhanced ACA Premium Tax Credits (PTC) must be renewed — hopefully permanently, as proposed by President Biden. As part of that Congressional effort to make health coverage more accessible and affordable, Congress should also close the coverage gap. In the meantime, it is important that we continue to highlight the need to prioritize a fix so we do not leave behind the 1.6 million people currently in the coverage gap. 

We encourage the Texas delegation to lead these efforts in Congress since our state has both the highest uninsured rate in the nation and the highest number of people in the coverage gap. Although the Texas Legislature and Governor continue to block Medicaid expansion, polls consistently show a high level of support for expansion among Texas voters. For example, an April 2023 poll conducted by the Texas Politics Project at UT-Austin found that 73 percent of Texans support Medicaid expansion, with only 17 percent opposed.

Studies repeatedly show that uninsured people are less likely to receive care or treatment, including preventive services. Delaying health services leads to increased risk of serious disease and illness and can cause chronic conditions to worsen. As a result, uninsured adults face a significantly compromised quality of life and higher mortality rates compared to those with health insurance. Furthermore, not only do higher uninsured rates mean increased costs for patients, but our state and local communities are left with higher levels of uncompensated care and other health costs.  

Closing the coverage gap would play a vital role in addressing racial and ethnic equity in Texas and the nation as a whole. The majority of the 1.6 million people in the coverage gap – 65 percent – are people of color. Research has shown that states that expanded Medicaid have successfully narrowed the gap in uninsured rates between Black and Latino populations and white populations, and it is well documented that those with health coverage have more financial security relative to those who don’t. For those reasons, as organizations that are committed to advancing health and racial justice for Texans, we strongly believe that closing the Medicaid coverage gap must remain a top priority for policymakers.  

We encourage you to speak out about the need to close the Medicaid coverage gap and help educate your congressional colleagues about why we cannot have a true conversation on health care affordability without addressing the needs of people, including more than 700,000 people in Texas, who have been left without any access to health coverage at all.

Sincerely,

Every Texan

Texans Care for Children

Children’s Defense Fund Texas

Every Body Texas

Latino Texas Policy Center

Mental Health America of Greater Houston

Methodist Healthcare Ministries

National Alliance on Mental Illness (NAMI) Texas

National Association of Social Workers-Texas

Network of Behavioral Health Providers

PrognosUS

Texas Chapter, American College of Physicians Services

Texas Chapter of Doctors for America

UnidosUS (formerly National Council of La Raza)

United Way of Metropolitan Dallas

Woori Juntos

Young Invincibles