Closing the Medicaid coverage gap is the single biggest action the country can take to reduce the number of uninsured.

Despite massive reductions in the number of uninsured Americans as a result of states expanding their Medicaid programs under the Affordable Care Act, 10 states have not expanded eligibility, denying health coverage to nearly 2 million people. These people disproportionately come from communities of color and fall into what is known as the Medicaid “coverage gap.”

Although many people in the coverage gap are employed, they are less likely to have jobs that offer health insurance—this includes more than half a million essential workers. Many make too much money to be eligible for traditional Medicaid, but not enough to afford the cost of health insurance they purchase themselves. As an example, a single person in Texas who makes $10,000 a year doesn’t qualify for Medicaid, even though purchasing health insurance would cost more than half their salary.

The refusal of some states to expand their Medicaid programs means that political considerations are being prioritized over healthcare, even in the midst of the ongoing COVID-19 pandemic where health insurance can be the difference between life and death.

The expanded Medicaid program has been around for more than a decade and has brought the number of uninsured people in America to historic lows. Rolling back Medicaid expansion would imperil the health of millions while crippling state budgets and economies.

Katherine Hempstead, RWJF Senior Policy Adviser

Editor's Pick

Joint Statement Strongly Supports Congress Permanently Closing the Medicaid Coverage Gap

RWJF and public health and racial justice advocates state that, "in a country as wealthy as the United States, it is unconscionable that a person’s access to healthcare often comes down to skin color, gender, income, geography, disability, and employment or immigration status."

READ THE STATEMENT

The case for closing the Medicaid coverage gap:

  • Nearly 2 million adults across 10 states fall into the Medicaid coverage gap and are unable to access affordable, comprehensive health insurance because those states have refused to expand their Medicaid programs.
  • 60 percent of individuals in the coverage gap are people of color.
  • More than 550,000 essential workers fall into the Medicaid coverage gap.
  • Expanded Medicaid coverage has saved lives, reduced out-of-pocket costs, narrowed racial disparities, and provided peace of mind to those who would otherwise be living without insurance.
  • The average reduction in medical debt among people gaining coverage through Medicaid expansion is approximately $1,140.
  • Healthcare providers in states that expanded Medicaid saw a 45 percent drop in the cost of uncompensated care, which benefits their local economies.

 

 

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Learn more on Center on Budget and Policy Priorities