August 13, 2021
Media contact: National Consumers League – Carol McKay, firstname.lastname@example.org, (412) 945-3242
Washington, DC—The National Consumers League (NCL) has long supported increased access to health coverage for all consumers, regardless of ability to pay. Among other provisions within the American Rescue Plan Act (ARPA) that aim to make health coverage more accessible, the law provides states that have not yet adopted Medicaid expansion with significant financial incentives to do so.
Beginning April 2022, ARPA would extend enhanced federal matching funds past the public health emergency for five years. This incentive is particularly critical to addressing maternal mortality in the United States, ensuring birthing people have access to health coverage in the most vulnerable stage of their lives. Currently, states can extend Medicaid coverage for up to 12 months postpartum following pregnancy for the duration of the pandemic. But once that period ends, states will have to file a section 1115 waiver to continue to extend those benefits through April 1, 2022 when the new law kicks in. To date, three states have approved 1115 waivers expanding Medicaid for up to one year postpartum.
NCL remains concerned that uninsured rates are still high in the states that have not expanded Medicaid. Even under the new law, 37 percent of nonelderly individuals living in the 12 states that have not expanded Medicaid are left uninsured. Ballot initiatives may be an avenue to enhance coverage for uninsured adults in states left to expand Medicaid. Of the states that have expanded Medicaid thus far, Idaho, Maine, Nebraska, Oklahoma, Utah, and Missouri have expanded it as a result of a ballot initiative, while the rest achieved Medicaid expansion either through their governors or state legislatures. Missouri and Oklahoma were able to secure Medicaid expansion by taking the decision straight to the polls, allowing state residents to decide. These victories at the ballot box show that Medicaid expansion is incredibly popular amongst voters in all states, despite the actions of some elected officials. In most cases, it’s largely within the power of the state governor to expand Medicaid to all residents.
Another way states are expanding Medicaid is through Section 1115 Demonstration Waivers, approved by the Centers for Medicare and Medicaid Services (CMS), which allow states to test new approaches to Medicaid in their states. Arizona, Arkansas, Indiana, Iowa, Michigan, Montana, Nebraska, New Hampshire, New Mexico, Ohio, and Utah all have approved Section 1115 waivers to operate their Medicaid expansion programs in ways not otherwise mandated under federal law. Other than New Mexico and Iowa, these Section 1115 waivers impose work requirements as a condition to qualify for Medicaid benefits. Tying health benefits to having a job is problematic in and of itself, but clearly inappropriate to enforce during a pandemic. NCL is encouraged that the Biden Administration has begun the process of withdrawing Section 1115 Demonstration Waivers that include work requirements.
Medicaid expansion is a critical element in achieving health equity, as BIPOC populations are more likely to fall in the Medicaid coverage gap. ARPA includes two years of full federal funding for Medicaid services provided by urban Indian and Native Hawaiian Health Centers. The new law also increases federal Medicaid funding for home- and community-based services (HCBS). Expanding Medicaid would yield economic benefits, as state economies are projected to increase by $350 billion in the span of three years, while also creating 1 million jobs nationwide. NCL supports all efforts leading to Medicaid expansion, which increases access to health care for more Americans.
About the National Consumers League
The National Consumers League, founded in 1899, is America’s pioneer consumer organization. Our mission is to protect and promote social and economic justice for consumers and workers in the United States and abroad. For more information, visit www.nclnet.org.