Democratic lawmakers are grappling with how to extend health insurance to millions of poor Americans in states that have refused Obamacare’s Medicaid expansion
, believing their upcoming party-line “human infrastructure” package represents the best chance to plug the health law’s biggest gap.
Tackling the Medicaid gap would fulfill President Joe Biden’s pledge to extend coverage to the 2.2 million low-income adults in the 12 states where Republican officials have resisted the program for nearly a decade.
Yet, momentum for plugging the coverage gap has grown in recent weeks, after key Democratic leaders have embraced the effort. Congressional staff are still hashing out thorny policy questions over how to expand coverage to poor adults in the Medicaid expansion holdout states, but no clear preferred policy has emerged amid concerns over potential drawbacks.
— Allowing low-income adults to get free private coverage through Obamacare’s insurance marketplaces. Financial assistance for the marketplaces has been closed off to people earning below the poverty line, about $13,000 for an individual, because Obamacare’s drafters expected they would be covered by Medicaid expansion. However, a 2012 Supreme Court decision made the expansion optional for states, creating the coverage gap Democrats are trying to close.
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