Patient Advocates Urge Congress and Administration to Permanently Close Medicaid Coverage Gap

Media Contact

Caitlin Donovan
Senior Director, Outreach and Communications

Citing the health disparities experienced by millions of Americans, National Patient Advocate Foundation (NPAF) is urging Congress and the Administration to permanently close the Medicaid coverage gap.

An estimated 2.2 million adults nationwide are now in the “coverage gap,” which means that they live in poverty but still earn too much to qualify for Medicaid coverage in their state. Congress is considering a new provision in the current reconciliation bill that would develop a new health care option  for people affected by the coverage gap.

When Congress passed the Affordable Care Act, they intended all adults living at 138% of poverty to be covered by the Medicaid program. However, after a Supreme Court decision ruling that this provision was optional, many states chose not to expand their Medicaid programs.

“There are families living in the United States today earning less than $9000 annually who are being told that they are too wealthy to qualify for the Medicaid program,” said NPAF CEO Alan Balch, PhD. “In the mean time, if they lived in the next state over, they would have complete coverage. Congress has the ability to stop this disparity, and we are urging them to act quickly.”

Extensive research shows that uninsured individuals are more likely to delay treatment and to experience medical debt than people with insurance coverage. Medicaid expansion helps improve outcomes by offering access to prevention services and covering the financial costs of care.

“Ultimately, closing the Medicaid coverage gap is about health equity,” said Balch. “Sixty percent of those in the coverage gap are people of color, which means that expanding Medicaid will help eliminate the disparities experienced by communities of color and other populations who traditionally have little access to these resources.”

NPAF joined with the Partnership to Protect Coverage coalition, organizations that represent millions of patients facing serious, acute and chronic health conditions, to send a letter to congressional leadership stating support for a permanent federal Medicaid fix.