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Critical Time for Medicaid Expansion and Health Care in Congress.

Last month, Congress began the process of drafting and passing its Build Back Better reconciliation bill. An initial agreement between leaders in the House and the Senate created a general framework for a $3.5 trillion spending plan. Committees in each chamber were then tasked with drafting the specific policies for long-term investments in health care including:

  • Paid Family and Medical Leave

  • ACA expansion extension and filling the Medicaid Coverage Gap

  • Expanding Medicare to include dental, vision, hearing benefits and lowering the eligibility age

  • Long-term care for seniors and persons with disabilities (HCBS)

  • Health equity (maternal, behavioral, and racial justice health investments)

The House is making progress on putting together its version of the reconciliation bill but there are no exact details on what kind of Medicaid Expansion plan, if any, will be in the final version. Earlier this month, the House Energy and Commerce committee released a very good bill that includes a permanent and comprehensive solution to Medicaid expansion. However, there is now strong pressure to trim the bill back. Much of the current discussion, and discord, is about how extensive efforts to lower prescription drugs should be. (The savings from this will be used to pay for new health care initiatives.)

Negotiations are ongoing, and the version that leaves the House will likely reflect whatever compromises have been made with the Senate and White House. Speaker Pelosi promised that the infrastructure bill and this reconciliation bill would be brought to the floor at the same time for a vote by the 27th, but we will see.

What now?

It’s a critical time to push our priorities. Supporters of Medicaid expansion must keep up the drumbeat despite the unpredictable timeline. Tag members on social, write the letters, call your elected officials, and maintain constituent pressure on members to do the right thing. There is a lot to sort out – but we need to keep encouraging all stakeholders to stay in the game. Millions of Americans, including 425,000 Floridians are counting on us (and Congress).


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