Summary
Senate Majority Leader Chuck Schumer (D-NY), Senate Budget Committee Chair Bernie Sanders (I-VT), and other Senate Democrats have asserted that their forthcoming $3.5 trillion budget reconciliation package will include provisions addressing the Medicaid expansion coverage gap. Obstinate refusal by holdout states to expand Medicaid, despite the availability of new financial incentives provided by the American Rescue Plan Act of 2021 (ARPA) (P.L. 117-2), has put pressure on lawmakers to pursue a more direct approach.
In the attached memo, we compare several bills introduced in the 117th Congress that address the coverage gap through policies that go beyond increasing federal support. Our memo focuses on three legislative options currently deliberated by Congress:
- Medicaid Save Lives Act (S. 2315), introduced by Sen. Raphael Warnock (D-GA) that would establish a new Medicaid-like coverage program;
- Medicaid REACH Act (H.R. 1784), introduced by Rep. Lloyd Doggett (D-TX) that would establish increased reporting burden for non-expansion states with a reduction in federal support for noncompliance; and
- COVER Now Act (H.R. 3961), introduced by Rep. Doggett, that would establish new demonstration authority for county-level Medicaid expansion.
The Senate is expected to take a procedural vote this evening on the $579 billion bipartisan infrastructure deal, which is seen as critical to securing moderate Democrats’ support for the $3.5 trillion budget reconciliation package. Whether there are 60 votes to clear the package remains to be seen. If the bipartisan infrastructure package is advanced, the Senate is likely to turn its attention to the fiscal year (FY) 2022 budget resolution. Senate Majority Leader Schumer has insisted that the Senate will vote on the budget resolution before adjourning for recess at the end of next week, though a vote has not yet been scheduled.