Last month, Health and Human Services Secretary Xavier Becerra extended the COVID-19 public health emergency through mid-July, a decision that helped maintain access for some of the 86 million Americans currently relying on Medicaid.
The secretary knows that while two-thirds of the U.S. population has been fully vaccinated, the pandemic is not yet over. Cases are continuing to rise this week, and more than 160,000 Latinos have died from the virus, including more than 1,900 since the beginning of March alone. Higher uninsured rates and greater workplace exposure are only two of the reasons Latinos have suffered disproportionately. Given that 1 in 5 Latinos was uninsured prior to the pandemic (including more than 9 percent of Latino kids) Congress must do everything it can to ensure this number does not rise.
Congress continues to debate a new reconciliation package focused on economic and tax policies. But any new congressional deal must also include policies that expand and protect health coverage for more Americans. When the public health emergency ends, millions of people will be at risk of losing Medicaid coverage. In 2020, Congress prevented states from disenrolling people on Medicaid during the emergency in exchange for additional federal support. Latinos and other people of color disproportionately rely on Medicaid for their health coverage, putting these communities at even greater risk of becoming uninsured.
While the public health emergency is presently slated to end in July, it is likely to be extended again. In the meantime, there are three key priorities for Congress as the Medicaid coverage cliff looms.
First, no working family should be at risk of losing coverage entirely because their wages and earnings increased slightly over the previous year. For some, income increases or changed life circumstances during the pandemic will mean they are no longer eligible for traditional Medicaid. The risk of coverage loss is particularly high in states that did not expand Medicaid under the Affordable Care Act. For years, 2.2 million people who would qualify for coverage if they lived in any other state instead fell into the “coverage gap,” including more than 610,000 Latinos. Closing the Medicaid “coverage gap” is a commonsense policy that can protect more people from coverage loss.
Second, it makes no sense to allow the cost of coverage to dramatically increase for working families just as the price for daily essentials like groceries, gas and other living expenses are rising to record levels. As a result of the American Rescue Plan Act, more than 2.5 million uninsured Latinos can now access zero-premium plans. The enhanced financial assistance will allow the ACA marketplace to act as a bridge for many to maintain coverage when the public health emergency ends, but these subsidies are scheduled to expire after this year. (In many states, premiums could increase by more than 50 percent.) Even if the public health emergency lasts through the end of the year, the expiration of the enhanced subsidies will create a cliff after which premiums will skyrocket for families who buy their own health insurance.
Finally, the end of the public health emergency is connected to numerous ongoing benefits that working families still rely on to make ends meet. Families are already experiencing unprecedented levels of anxiety and stress. While the Department of Health and Human Services has taken steps to help states manage the unwinding process, Congress can further protect families by establishing clear parameters for the process to preserve coverage for those still eligible for Medicaid and to transition newly ineligible people to new sources of coverage.
Despite many states’ assurances that they will take ample time to process renewals and redeterminations, some will face both fiscal and political pressure to act as quickly as possible. Individuals could lose coverage from things as simple as a family missing a renewal notice or the state sending a notice to the wrong address. As many as 2.4 million Latino children could lose coverage when the disenrollment freeze is lifted. Based on past experience, the vast majority of children will lose coverage not because they are ineligible, but because of red tape and missing paperwork.
Given the systemic failures we witnessed throughout the pandemic, congressional Democrats and the Biden administration have made health equity a top priority. But the reconciliation package may be one of the last opportunities for Congress to demonstrate the seriousness of its commitment before the looming coverage cliff.
Congress must act preemptively, without further delay, to help avoid this outcome when the public health emergency ends.
Matthew Snider is a senior health policy analyst at UnidosUS, formerly the National Council of La Raza, a Latino civil rights and advocacy organization.