In a Pandemic, Medicaid Expansion Cannot Be Optional

By Sr. Mary Haddad, RSM, President and CEO, Catholic Health Association of the United States

As Congress continues to debate what will be included in the final reconciliation package, it’s incredible to think that two years into the COVID-19 pandemic, we are still debating whether health insurance coverage is necessary. As we work toward policy solutions to health care challenges, Medicaid expansion cannot be optional.

Medicaid was originally intended to close the health insurance gap for Americans in poverty. For those in the lowest income brackets, and for many mothers, Medicaid is a crucial way to ensure that families can both access health care and afford it. But far too many are either unable to do so, or their coverage doesn’t last long enough to provide the care they desperately need.

What does the data look like? Currently, more than 2 million Americans in 12 states making less than $12,500 a year are uninsured. They make too much to be eligible for Medicaid, but they also can’t qualify for subsidies under the Affordable Care Act. Those who fall into this gap tend to be the essential workers who have carried us through the pandemic thus far. Even as we celebrate these workers as heroes, without essential health insurance coverage, they are one medical issue away from tragedy.

They also are expectant and new mothers. Many women rely on the support of Medicaid during and after pregnancy, with more than 4 out of 10 new mothers covered by Medicaid for postpartum care. However, this coverage only lasts for 60 days after birth. Several severe health complications can happen weeks or months after giving birth, including nearly one-third of maternal deaths. It’s no wonder that the U.S. has some of the highest rates of maternal and infant mortality in the industrialized world. Expanding Medicaid coverage to a year would help ensure new mothers have coverage when they need it most.

Provisions to expand Medicaid are in the current reconciliation package, but there is far too much uncertainty about whether they will remain. To close the Medicaid coverage gap for low-income Americans, Congress must allow ACA subsidies to cover those who are currently ineligible for Medicaid based on their income. It must also extend care for mothers in need by requiring comprehensive Medicaid coverage for one year postpartum, instead of only 60 days. Without these provisions, far too many will be at risk - especially during a global pandemic. As conversations about the costs and value of the reconciliation package continue, this is no longer a question of politics; saving the lives of our most vulnerable Americans is what is at stake.

As president and CEO of the Catholic health Association of the United States, I represent health care organizations that are committed to following Catholic social teaching that calls us to care for the sick and suffering. We are all too aware of the disproportionate impact that many diseases have had on communities of color, low-income groups, and other historically and medically disadvantaged groups; the most recent being COVID-19.

As we focus on our duty to provide the best health care possible for the most vulnerable populations, we ask Congress to pass Medicaid expansion policies that will provide critical health care coverage for low-income Americans and new moms.