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Federal Options to Address Health Care Coverage Gap in Non-Expansion States Emerge

Sen. Warnock Releases Framework for Federal Fix


Last month, the New York Times reported that in places where jobless benefits were cut, workers still seem to be choosy about reentering the workforce. According to the Times, “many economists are skeptical that enhanced jobless benefits have played an outsize role in the hiring squeeze. They are more likely to point to childcare and continuing health fears with less than half the population fully vaccinated. The labor market’s deeper problem, said Francine D. Blau, an economist at Cornell University, is the proliferation of low-paid jobs with few prospects for advancement and too little income to cover essential expenses like housing, food and health care.

This analysis comes as a new report by Georgetown University Center for Children and Families found that almost half of all adults working in Florida without health insurance are employed in the hospitality, retail, and administrative/support/waste management service industries. These include cashiers, cooks, waiters and waitresses, retail salespersons, and construction workers, all essential jobs during the pandemic.


If Florida expanded Medicaid, approximately 789,800 uninsured workers, or 33 percent of the state’s uninsured adult population, would gain health insurance. The state’s budget would also see a net gain of $1.8 billion over a two-year period. Still, despite the great need in our state, Florida legislators refused to consider expansion during the 2021 legislative session.


Without any of the non-expansion states passing legislation, advocates in these states are looking to the federal government for solutions on how to extend health insurance coverage to people who need it the most. This June, over 200 other advocacy organizations from the 12 non-expansion states signed onto a letter pleading Congress to bypass resistant state legislatures and provide coverage.


Calls are also growing within Congress itself. Senator Rev. Raphael Warnock will be releasing new legislation in the coming week to address the Medicaid coverage gap.

Senator Warnock’s legislation does the following:

  • Establishes a Medicaid Fall Back Program. Directs Secretary of Health and Human Services (HHS) to establish a program so eligible individuals can enroll in health coverage. This program must include all the Medicaid benefits that the ACA created for those newly eligible in expansion states. There are no premiums. Deductibles and cost sharing are aligned with the requirements as if State Medicaid programs.

  • Increases and extends the temporary enhanced federal matching rate in the American Rescue Plan Act (ARPA) to 10 percentage points over ten years. The legislation would adjust the ARPA enhanced match from 2 years to 10 years and increases the matching rate by 5 percent.

Now is the moment to act. Urge members of the House Committee on the Budget to include closing the coverage gap in the House budget resolution.



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