Implications of the Lapse in Federal COVID-19 Funding on Access to COVID-19 Testing, Treatment, and Vaccines
A current impasse in Congress threatens continued funding for COVID-19 testing, treatment, and vaccines. The lack of additional federal COVID-19 funding has broad implications for access to these services, particularly for the uninsured, and could undermine efforts to ensure equitable access to these resources.
Continuous enrollment in Medicaid and enhanced premium assistance have helped millions afford and maintain coverage, but those gains could be reversed as the public emergency ends and if the provisions like those in the Build Back Better Act fail to pass.
- Under the ARPA, the majority of uninsured people (63%) are now eligible for financial assistance through the Marketplaces, Medicaid, or Basic Health Plans. In fact, more than 4 out of 10 uninsured people are eligible for a free or nearly free health plan through one of these programs.
Federal Policy May Temporarily Close the Coverage Gap, But Long-term Coverage May Fall Back to StatesThe Build Back Better Act would close the Medicaid coverage gap for three years, providing subsidized ACA marketplace coverage to 2.2 million uninsured people in the 12 states that have not expanded Medicaid under the Affordable Care Act. But providing a permanent pathway to coverage may fall back to states in the long-term. Our Policy Watch explains the latest developments.
- Data on demographics; health coverage, access, and utilization; and health status by race and ethnicity provides insight into the status of health disparities and changes since implementation of the ACA.
- This issue brief describes how coverage has changed in recent years, examines the characteristics of the uninsured population, and summarizes the access and financial implications of not having coverage.
- Nationally, 2.2 million poor uninsured adults were in the ACA “coverage gap” in 2019 in states that had not expanded Medicaid. They earned too much to be eligible for Medicaid but not enough to qualify for Marketplace premium tax credits. Three-quarters of them reside in just four states: Texas, Florida, Georgia and North Carolina.
- Twelve states have not adopted the ACA Medicaid expansion, leaving 2.2 million people in the coverage gap. Understanding the characteristics of this group can help inform policy decisions.