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Partnership for Medicaid supports States Achieve Medicaid Expansion Act

Policy experts estimate 4 million people could gain coverage if bill is enacted

April 27, 2021

By Jennifer Garvin

Washington — The Partnership for Medicaid, of which the ADA is a member, is supporting new legislation to incentivize states to expand Medicaid.

The partnership sent an April 27 letter to Sens. Mark Warner, D-Va., and Raphael Warnock, D-Ga., thanking the lawmakers for introducing the States Achieve Medicaid Expansion Act. The States Achieve Medicaid Expansion Act, or SAME Act, would allow states that did not immediately expand Medicaid under the Affordable Care Act access to the same level of increased federal financial support offered to states that chose to expand immediately.

The coalition said that “since 2014, nearly 16 million individuals have enrolled in Medicaid coverage as part of the ACA’s Medicaid expansion, which allows individuals with incomes up to 138% of the federal poverty level the chance to acquire Medicaid coverage for the first time,” and noted that states that chose to immediately expand eligibility to this population received three years of full federal funding beginning in 2014 before declining to a 90% federal matching assistance percentage after six years and every year thereafter. States that expanded after Jan. 1, 2014, were not eligible for the same federal financial support and lost hundreds of millions of dollars in federal assistance.

The SAME Act addresses this financial disparity by allowing all states the opportunity to secure the same level of federal financial support for their Medicaid expansion population, no matter when they expand, the organizations said. By doing so, it provides an additional incentive for states to expand their Medicaid programs.

“The consequences of not expanding are dire,” the partnership said. “Patients may not seek care or head straight to the emergency department, placing further pressure on a health care system already strained by the COVID-19 pandemic. Many health care providers may struggle to keep their doors open; hospitals in states that expanded Medicaid saw their closure rates decrease since 2014, while those in states that did not expand saw increased rates in closures.”

Under the terms of the SAME Act, nearly 4 million “nonelderly, currently uninsured individuals” would gain coverage. The coalition noted that Medicaid expansion has led to increased access to care and a decreased reliance on uninsured emergency department utilization and uncompensated care overall.

“This legislation builds on existing efforts to incentivize states to expand Medicaid found in the American Rescue Plan, which allows states that have yet to expand the opportunity to do so at a 95% federal matching assistance percentage for two years,” the letter concluded. “The SAME Act takes this one step further by treating states that have yet to expand no differently than those who did so in 2014.”

The Partnership for Medicaid is a nonpartisan, nationwide coalition made up of organizations representing clinicians, safety net health plans and counties.

Follow all of the ADA’s advocacy efforts at ADA.org/advocacy.