This is an ongoing injustice and must be rectified as soon as possible. Fortunately, Congress has an incredible opportunity to do so now. The House and Senate have passed a framework of $3.5 trillion budget resolutions for Fiscal Year 2022 that has the potential to dramatically reshape the healthcare landscape in the United States. As Congress finalizes this framework in the coming weeks, permanently closing the Medicaid coverage gap should be at the top of the priority list.
Past
Medicaid was established in 1965 and is jointly funded and administered by the federal government in all 50 states. At its inception, the program provided health insurance to those who qualified for other forms of government cash assistance. Over the years, the program has expanded to serve not only low-income families but also pregnant women, people with disabilities, and those in need of long-term care.
Under the Affordable Care Act originally enacted in 2010, states are required to extend their Medicaid programs to any resident whose income is up to 138% of the federal poverty line. (in 2021, the federal poverty threshold is $26,500 for a family of four); Substantial federal funding has been incorporated into the law to cover the majority (currently 90%) of the states’ expansion costs. However, a 2012 Supreme Court decision removed the mandate and instead expanded the decision up to each state. Countries have had the option to do so since 2014.
Present
Numerous studies have shown that Medicaid expansion under the ACA was a disqualifying success. In states that have taken this step, uninsured rates have fallen dramatically, particularly in communities of color and those with low incomes; participants had improved health outcomes, including reduced early mortality and fewer maternal deaths; and state economies have seen lower healthcare costs along with increased economic activity due to a healthier population. And thanks to the next law, there are additional federal funding incentives for states to take this step.
Therefore, there is no economic or health reason for holding states to repeatedly refuse to expand. Ultimately, the question is whose lives do we value in our country and who do we not, and right now policymakers in 12 states have decided that the lives of more than two million people are worthless. It should come as no surprise, then, that the populations most affected by the countries’ refusal to expand are the same populations that have been disproportionately affected by COVID-19 and its distribution. Racism and structural discrimination have been introduced into our country for the last century. People of color represent more than 60 percent of the coverage gap population, and compared to their overall percentage of the population in the United States, both Blacks and Hispanics are disproportionately counted in this group: For example, blacks in the US represent 14 percent of the US population but 28 percent of the population gap covers. And while more than 60% of those in the coverage gap are employed, many in low-wage jobs are more likely to not offer health insurance. For the working poor, there is often no other health care coverage than Medicaid, and that option is being offered to them in too many places.
As a Black woman and Black mother, I am also particularly pleased with our nation’s incredibly high maternal mortality rate, and Medicaid’s potential to change the trajectory for families. Black family. According to the Center for Budget and Policy Priorities, more than 800,000 people in the coverage gap are women of childbearing age. The United States has the highest maternal mortality rate of any developed country in the world, with Black women having the highest risk of dying before, during, or after the birth of a child. Expanding Medicaid coverage will make it easier and safer for Black women to have healthy pregnancies that help deliver healthy babies and healthy babies.
