On Thursday, the Joint Economic Committee, led by Congressman Don Beyer (D-VA), released a new report examining the economy- and society-wide benefits of closing the Medicaid coverage gap. In 11 states that have not expanded Medicaid under the Affordable Care Act, 2.2 million workers who earn above their state’s Medicaid eligibility threshold but below the poverty line are rendered ineligible for both Medicaid and for ACA tax credits to buy insurance. This leaves them with few options for affordable healthcare. 

Today, JEC Chairman Don Beyer (D-VA), Senator Reverend Raphael Warnock (D-GA), House Energy and Commerce Committee Chairman Frank Pallone, Jr. (D-NJ) and Congresswoman Carolyn Bourdeaux (D-GA) highlighted the critical need to address the Medicaid coverage gap, which is the result of Republican state officials’ refusal to accept generous federal funding to expand their state Medicaid programs.

In addition to providing health coverage for over 2.2 million low-income adults who are currently ineligible for any federal health insurance supports, closing the Medicaid gap would narrow racial gaps in health access and deliver benefits to a broad and diverse low-income population.

Analyses of recent and historical coverage expansions for low-income families show that the policy saves lives, improves people’s health, supports local hospital systems and is a strong investment in long-run socioeconomic well-being. For example, Medicaid expansion under the ACA saved nearly 20,000 lives in just the four years after enactment, reduced medical debt sent to collections by $6 billion and increased the number of preventative care visits in expansion states by 41%.

JEC Chairman Don Beyer said:

“The Medicaid coverage gap should never have existed, but because some Republican lawmakers have refused to accept generous federal support, millions of low-income families are currently blocked from accessing affordable health insurance because of the state where they live. Closing the Medicaid coverage gap through congressional action, like the Build Back Better Act, would expand access to affordable health insurance to millions of families and address pervasive racial health and economic disparities that threaten the foundation of our economy and our society. These are the kinds of investments in families that save lives, boost household economic security and strengthen local communities.”

Senator Reverend Raphael Warnock, who introduced the Medicaid Saves Lives Act in the Senate and serves on the Joint Economic Committee, said:

“Dr. King once said that of all the forms of inequality, injustice in health care is the most shocking and inhumane. This new report shines a bright light not just on how the refusal of state leaders in Georgia to expand Medicaid is exacerbating inequality and hurting people in need of access to vital health care coverage, but also how it is a missed opportunity to create good paying jobs in our state, bolster our hospitals and health systems, and help improve Georgians’ financial security. I’ve been fighting for years as an activist, and for months as a Senator, to get a federal fix to address this issue over the finish line, and I'm going to keep doing everything I can to close the coverage gap and ensure that all eligible Georgians can access free and affordable health care coverage.”

Congressman Pallone, Chairman of the House Energy and Commerce Committee, said:

“The Medicaid coverage gap has left millions of vulnerable Americans without access to health care through no fault of their own. One of the most important provisions in the Build Back Better Act would ensure that Americans who are currently stuck in the coverage gap have access to quality, affordable health care. It’s one of the most commonsense, transformative actions we can take to dramatically improve the health and wellbeing of hardworking Americans and one of the many reasons why we cannot give up on the fight to pass the Build Back Better Act.”

Congresswoman Bourdeaux, who introduced the Medicaid Saves Lives Act in the House, said:

“The state you live in should not determine whether or not you have access to health care, yet Georgians are being hung out to dry due to inaction. Closing the Medicaid coverage gap has the potential to provide health care coverage to over two million Americans, including 275,000 Georgians. Not only is refusing to expand Medicaid morally wrong, but it’s also fiscally irresponsible. We must expand Medicaid and ensure everyone has access to quality, affordable health care.” 

In particular, the report highlights how:

• Sixty percent of people in the coverage gap are people of color, so closing it will narrow racial disparities in coverage and health outcomes. Expansion states saw their average uninsured rates fall for Black, Hispanic, and American Indian and Alaskan Native populations at faster rates than in non-expansion states.
• Expanding coverage will support economic growth by creating an estimated 1 million new jobs, increasing financial stability, and shoring up vital local hospital systems 
• According to evidence from past Medicaid expansions, the upfront investment in health coverage more than pays for itself through better health outcomes, reduced rates of incarceration and crime, higher lifetime earnings, higher tax revenues and less spending on adult hospitalizations.

This report builds on a prior JEC issue brief  that highlights the important role that expanded health insurance subsidies under the American Rescue Plan played in increasing health coverage and financial security for many low to middle-income Americans. The previous brief also presented new data on the number of people in each congressional district who are estimated to gain coverage if these subsidies are extended under a bill like the Build Back Better Act passed by the House. Passing both of these policy fixes would fill significant gaps in the U.S. health system that put affordable healthcare out of reach for millions of Americans.