Along with making the Affordable Care Act work better to help the millions struggling with health insurance coverage as a result of the pandemic, President Joe Biden and Democrats are strengthening Medicaid. They're working to extend that access to coverage to even more people, especially those in the 14 hold-out states that have continued to refuse the expansion of the program under Obamacare.
The House Energy and Commerce Committee is including a 5% increase in the federal share of Medicaid spending for two years to any of those states that might expand. In North Carolina, for example, it could bring in $2.4 billion for the next two years. The increase in federal matching dollars wouldn't just be for the new enrollees in expansion, but for the states' entire Medicaid populations. The ACA already covers 90% of the costs for a state expanding, but the extra 5% on regular Medicaid could pay for the entire expansion, and then some. States could end up with surplus to help pay for other health and pandemic services.
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The Center on Budget and Policy Priorities estimates that this, combined with increases in ACA subsidy eligibility for lower-income people, would mean nearly 4 million currently uninsured people could get coverage. That would include about 640,000 low-income essential and front-line workers.
That's all great, though those Republican states are so dug in to their opposition to Obamacare that even an influx of cash might not be enough to do it. Congress and Biden can do no more than try on that front. But what they're doing, which can be much for impactful, is giving the states the ability to lengthen coverage duration to 12 full months for new moms. That extension would last for states for five years, and again would have a particular impact in the non-expansion states, where some programs kick mothers out of coverage 60 days after giving birth, though their infants retain coverage for a year. This would give new mothers a huge boost, being able to have pregnancy-related health complications, like postpartum depression or recovery from a C section treated for a full year with consistent coverage.
In the states that expanded Medicaid, most of these women are able to maintain coverage under Medicaid because their income still qualifies. The non-expansion states, however, kick them off at 60 days. And because the non-expansion states are primarily in the southeast of the U.S., that means a lot of women of color don't have that coverage. The option to extend coverage for 12 months exists, but states wanting to do it have to obtain a waiver from the federal government. This legislation would allow states to do it without that application process.
This would provide a sliver of the assistance Democratic lawmakers are seeking to provide to Black mothers with their Black Maternal Health Momnibus Act of 2021. According to the Centers for Disease Control, black mothers are more three times more likely to die from pregnancy-related complications than white women. There's a lot more to that problem than just access to coverage under Medicaid, but it would still be a key component in addressing the issue, particularly now.
"During COVID-19, we've seen Black, Hispanic, Indigenous and Asian Americans face higher rates of exposure to the virus and suffer more severe health consequences upon infection. These disparities are unacceptable," Rep. Lauren Underwood, one of the momnibus' sponsors, said. "The hour for bold action has arrived and bold action is what the momnibus represents."