Need new health insurance NOW?

If you experience certain life changes, you don’t have to wait for Open Enrollment in November to enroll in affordable health coverage on or your state’s marketplace. You have 60 days after the following events to apply for a Special Enrollment Period and enroll:

• Moving to a new zip code or county
• Getting married or divorced
• Having a baby, adopting or becoming a foster parent
• Becoming a U.S. citizen or getting a green card

You have 60 days before or after the following to enroll: 

• Losing your health insurance from your job
• Turning 26 and aging off your parent’s health plan

And if you are experiencing domestic violence and want to apply for your own health plan, you can do so at any time.

Learn more about Special Enrollment Periods at or call 1-800-318-2596.


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Medicaid work requirements not really about work

Medicaid work requirements not really about work

This week, our last article for Medicaid Awareness Month highlights the ways that conservatives are using bureaucratic red tape to dismantle Medicaid from within by making coverage impossible to retain.

In 2017, congressional Republicans tried to gut long-standing coverage guarantees in traditional Medicaid under the pretense of repealing the Affordable Care Act. When thatfailed, the Trump administration quickly switched to encouraging states to load up their Medicaid programs with so much red tape that eligible people would lose coverage.

Dressed up in rhetoric like “improv[ing] Medicaid enrollee health and well-being through incentivizing work and community engagement,” the true intent of these efforts is to make compliance with the rules so cumbersome that few can do it.

Making Medicaid coverage conditional on meeting work requirements is a particularly compelling example because there are very few Medicaid beneficiaries who could be working but aren’t. As the Center on Budget and Policy Priorities notes, the overwhelming majority of adults with Medicaid already work, are too sick to work, are going to school, are taking care of family members, or are already actively looking for work and can’t find it.

Work requirements won’t change those circumstances, but the red tape associated with trying to prove compliance will cause many of those people to lose coverage. As the New York Times reported last year, “a large body of social science suggests that the mere requirement of documenting work hours is likely to cause many eligible people to lose coverage.” As the article notes, “these [administrative hurdles] may be especially daunting for the poor, who tend to have less stable work schedules and less access to resources that can simplify compliance: reliable transportation, a bank account, internet access.”

That means that hundreds of thousands of eligible low-income women—including those who are already working, who are serving as an unpaid care-giver, who are disabled, or who should qualify for an exemption—will lose their coverage anyway simply because they can’t keep jumping through all of the right hoops.

But for the Trump administration, that’s a feature, not a bug. In Arkansas, for example, the Center for Medicare and Medicaid Services (CMS)—led by Vice President Mike Pence’s close ally Seema Verma—approved a waiver designed to make it as difficult for working Arkansans to report their work hours as possible. In Kentucky, state health officials boastedthat their waiver would save the state money because 95,000 eligible Kentuckians would lose coverage.

While the Obama-led CMS rejected work requirements, Trump’s CMS has approved them under the guise of “demonstration projects” in 9 states: Arkansas, Kentucky, Indiana, New Hampshire, Arizona, Michigan, Ohio, Utah, and Wisconsin. An additional 6 states—Alabama, Mississippi, Oklahoma, South Dakota, Tennessee, and Virginia—have work requirement proposals pending with CMS. But because the law doesn’t give CMS this authority, these state waivers are subject to litigation. Last year, we quoted former CMS official Eliot Fishman explaining why:

"[W]aivers must meet a legal requirement that they try to strengthen the Medicaid program: by expanding coverage, improving care delivery, or help safety net hospitals and other providers. But CMS’s recent announcement is directly opposed to the central Medicaid goal of covering low-income people. This is the first time in the 52-year history of the program that Medicaid waivers have been approved to reduce coverage instead of to expand it."

Thus far, the courts have agreed. After more than 18,000 people lost coverage in Arkansas, the only state to have had a work requirement go into effect thus far, federal district court Judge James E. Boasberg ruled that CMS “had not adequately considered whether the program ‘would in fact help the state furnish medical assistance to its citizens, a central objective of Medicaid’” and concluded that the agency’s “approval cannot stand.” The same judge delayed implementation of Kentucky’s work requirement before it could begin, pending the outcome of litigation. New Hampshire is currently scheduled to start taking away coverage from people who fail to meet its work requirements on August 1, though a lawsuit filed against that waiver is also headed to Judge Boasberg’s court. The cases may ultimately end up before the Supreme Court.

Even in states that haven’t expanded Medicaid or initiated work requirements yet, thousands of low-income women, children, and families have lost their coverage because they couldn’t keep up with the bureaucratic paperwork demands. In Tennessee, 1 out of 8 children lost coverage in a two-year period because of paperwork. In Texas, repeated, unnecessary income checks have “led to thousands of kids being abruptly kicked off the program — and data shows that many of those removals were in error,” according to the Texas Tribune.

Having successfully fought to save Medicaid from congressional attacks and proved the popularity of Medicaid expansion through ballot initiatives, advocates must not lose sight of the ways that conservatives are seeking to hollow out Medicaid from the inside out.

Just as the onslaught of anti-abortion state laws have made the Constitutional right to an abortion a right in name only for millions of women, so too do conservatives hope to make Medicaid coverage exist in name only, turning it into a health care program for the poor so riddled with bureaucratic red tape that even wealthy households would struggle to cut through.


Medicaid expansion is a women’s health issue!

Medicaid expansion helps women and our families

In this week’s installment of our series of articles recognizing April as Medicaid Awareness Month, we’re highlighting the importance of the Affordable Care Act’s Medicaid expansion and what it means to women and families.

Prior to enactment of the ACA in 2010, many parents with dependent children were eligible for Medicaid only if they had incomes well below the poverty line. Most adults without dependent children weren’t eligible at all, although the rules varied state to state. As a result, contrary to popular belief, millions of even the poorest Americans weren’t eligible for coverage.

Congress’s remedy, enacted as part of the ACA, was to extend Medicaid eligibility to individuals with incomes up to 138% of the federal poverty level (FPL) -- regardless of whether they fit into one of the pre-existing eligibility categories, which were for pregnant people, people with disabilities, children and seniors.

For millions of low-income Americans, that meant qualifying for high quality health coverage for the first time in their lives. But the Medicaid expansion as envisioned by the ACA wasn’t just a huge leap forward in public health and women’s health. It also addressed the institutional racism that was original Medicaid’s original sin.

Writing for the Women’s Health Activist, RWV co-founder Cindy Pearson explains:

“But while the same congressional act created Medicaid and Medicare, only Medicaid was built on the foundation of earlier public assistance programs, with all of their existing racist, distorted, and discriminatory aspects. … Ceding coverage decisions to the states let the Jim Crow South drag its feet; 32 other states adopted [original] Medicaid before even one former Confederate state did, and Southern resistance continued for decades. The federal government mandated that parents of dependent children be covered but, in reality, coverage was almost unobtainable in Southern states, which capped eligibility at income levels as low as 10% FPL. Even when the federal government offered matching funds to encourage states to cover pregnant women, working parents, and certain low-income children, Southern states rejected most of these opportunities.

The ACA sought to fix this unequal, unjust system by requiring states to participate in Medicaid and by equalizing eligibility in all states. For the first time, low-income American adults would be guaranteed access to health care coverage under the law no matter where they lived in the U.S. and states couldn’t play games with their eligibility requirements to deny coverage to people of color. If a state denied someone coverage under the old rules, she would still qualify under the new expansion.”

But as we know, the story doesn’t end there. In 2012, a group of conservative states led by Florida challenged the ACA’s Medicaid expansion in court. The Supreme Court upheld the expansion’s constitutionality, but made it optional for states. With one decision, the Court took the potential opportunity for health care away from millions of vulnerable women and restored a decades-old structure built to appease Jim Crow segregationists.

While 25 states and Washington, DC, expanded Medicaid as envisioned by the ACA on January 1, 2014, the fight to expand in the remaining 25 states and to protect the expansion in the original 26 must now be waged state by state.

For the last five years, expanding Medicaid nationwide and fixing the Court’s mistake has been one of RWV’s most important missions. Our regional coordinators have successfully helped push for Medicaid expansion in Pennsylvania, Montana, Louisiana, and Maine. But given Medicaid’s history, it’s no surprise that of the remaining 14-17 states without expansions, 7 are in the Deep South and 4 are Southern border states. (While Utah, Idaho and Nebraska have officially “adopted” Medicaid expansion and are included in official counts, GOP lawmakers in those three states have taken action to roll back coverage.) As Cindy notes, “the remaining opposition isn’t rational, it’s rooted in deeply held prejudices.” But there’s hope. RWV starts at the grassroots, and organizes across race and class. Join us in working to make Medicaid a true safety net for all.

New state reports on Medicaid and rural communities

Medicaid is vital to the health and wellbeing of rural areas across the country. For Medicaid Awareness Month, the national Protect Our Care coalition has created state-by-state reports on how threats to Medicaid affect rural residents.  You can find the one for your state here.

What do we learn from these reports? Well, for example, an estimated 726,000 Georgians would gain health coverage if that state were to finally expand its Medicaid program. Currently, 26 percent of Georgia adults living in rural areas are uninsured, compared to 19 percent in non-rural regions of the state. The state’s refusal to expand Medicaid has placed 26 rural hospitals at great financial risk. Severn rural hospitals have already closed in Georgia since 2010, when Georgia lawmakers turned down Medicaid expansion.



It’s Black Maternal Health Week!

Why Black maternal health must be a priority

Today is the start of Black Maternal Health Week, which runs through April 17. The Black Mamas Matter Alliance (BMMA) has organized this week’s activities, and Raising Women’s Voices is proud to be a co-sponsor. Several RWV regional coordinators are active in BMMA and have been working in their own states to address maternal health disparities through establishment of state Maternal Mortality Review Boards, Medicaid funding for doulas and extension of Medicaid coverage for pregnant women for up to a year following childbirth. We present highlights of their work below.

The United States is the only developed country where the maternal mortality rate has increased over the last two decades. This problem is especially acute for Black women, who are dying in childbirth, or the immediate post-partum period, at rates three to four times higher than for white women. In some parts of the country, the problem is even worse. In New York City, for example, Black maternal mortality is 12 times higher than for white women.

Poor maternal health also has a severe impact on Black infant health. Black infants die at rates 2.4 times higher than for white infants, primarily because Black women have high rates of preterm births. While pre-term births are typically associated with low-income women, Black women from all socio- economic backgrounds experience higher rates of preterm births and infant mortality than other women, suggesting that income is not the sole driving factor.

Factors contributing to Black maternal and infant mortality include lack of access to quality, culturally-sensitive health care services. One area of focus is implicit bias on the part of health providers, who may unconsciously discount the concerns and reported symptoms of Black pregnant women. Studies are also showing that Black women who deliver at hospitals that primarily serve the Black population are much more likely to experience complications and death during and after delivery. Black women are also disproportionately experiencing health conditions that can increase maternal mortality risks, including hypertension, diabetes and obesity.

Congressional action is underway

Sen. Kamala Harris (D-CA) and Rep. Alma Adams (D-NC) are introducing a resolution today officially recognizing Black Maternal Health Week, in order to bring national attention to the maternal health crisis in the Black community. Reps. Adams and Lauren Underwood (D-IL) this week officially launched the first-ever Black Maternal Health Caucus.  Meanwhile, Sen. Doug Jones (D-AL) and Sen. Martha McSally (R-AZ) are circulating for Senate co-signers a bipartisan Dear Colleague letter that urges funding for programs at the Health Resources and Services Administration (HRSA), the Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH) that seek to prevent maternal mortality, improve maternal health and eliminate disparities in maternal health outcomes.

There have also been several bills introduced in Congress addressing maternal mortality. Incremental progress has been made with the passage of the Preventing Maternal Deaths Act of 2018, which was sponsored by Rep. Jaime Herrera Beutler (WA-3). It established a program under which HHS may make grants to states for such actions asestablishing maternal mortality review committees to investigate the causes of maternal deaths and improving the quality of maternity care through provider education.

Recently, Rep. Robin Kelly (D-IL) and Senators Dick Durbin (D-IL) and Tammy Duckworth (D-IL) reintroduced the Mothers and Offspring Mortality & Morbidity Awareness (MOMMA) Act (H.R. 1897 and S. 916.) This measure would (1) expand Medicaid coverage to the full postpartum period (one year) for mothers; (2) standardize data collection and empower a designated federal agency to collect uniform data; (3) ensure the sharing of best practices between practitioners and hospital systems (4) establish and enforce national and emergency obstetric protocols; and (5) improve access to culturally competent care. 

Rep. Adams and Sen. Harris have introduced the Maternal Care Access and Reducing Emergencies (CARE) Act. This bill focuses on increasing comprehensive and quality health care access by creating two grants: (1) implicit bias training program grants to support specific training programs in medical, nursing and other training schools; (2) Pregnancy Medical Home Demonstration Project to establish a demonstration project to assist up to 10 states with developing and sustaining pregnancy medical home (PMH) programs.

State action: Maternal mortality review boards, post-partum Medicaid coverage, doulas!

One of the most important things states can do is to establish and support Maternal Mortality Review Boards, with confidential protections for providers that require a review for every pregnancy-related death, and which can develop recommendations to prevent future deaths.

Colorado Organization for Latina Opportunity and Reproductive Rights (COLOR),our Denver-based regional coordinator, is advocating for the inclusion of funding that would give the state’s Maternal Mortality Review Committee the authority and resources needed to ensure robust participation and strong, timely recommendations to the legislature to prevent future maternal deaths. COLOR notes that Colorado’s maternal mortality rate roughly doubled between 2008 and 2013, and is urging its members to call on the state to treat this as a public health crisis.  Raising Women’s Voices - New York is applauding the state Legislature, which overwhelming passed a bill to create a maternal death review board, and included funding in the state budget to support it.

The Afiya Centerour Dallas-based regional coordinator and an active member of theBlack Mamas Matter Alliance, has been a leader on maternal mortality work, successfully advocating for the passage of a 2017 bill to address the maternal mortality crisis in Texas.The Texas Moms Matter Act created a Maternal Mortality and Morbidity Task Force within the Department of State Health Services to review cases of pregnancy-related deaths and trends in severe maternal morbidity, which has disproportionately affected Black women.

In the last month of the Texas state legislative session, the Afiya Center has been working with Rep. Toni Rose, Rep. Shawn Thierry and Rep. Victoria Neave on maternal mortality-related legislation. They worked with Rep. Rose to provide language on how to extend Medicaid for pregnant mothers from 60 days to one year post partum (HB744). Afiya Center Policy Director Deneen Robinson testified at the hearing (photo below) on the bill, which is still pending.

With support from RWV, the The Afiya Center has been working to train doulas – hosting a Full Spectrum Doula Training presented by Ancient Song Doula Services, which honored the legacy and traditions of Southern midwives and birth doulas. Doulas are trained professionals that serve as a physical and emotional support to women before, during, and after pregnancy, and also help to connect them with other social supports. Patients with doulas for pre-natal, labor and post-partum support have better birth outcomes and are less likely to have cesarean births.

Currently, doulas are mainly affordable only for upper middle-class or affluent women and families who can pay out-of-pocket for these services. Advocates hope that making doulas more accessible to low-income women and women of color could help address maternal health disparities. In Rhode Island, our RWV coordinator – Planned Parenthood of Southern New England is advocating for legislation ensuring that doulas are covered by Medicaid in that state. Under H5609, qualified, trained doulas would be eligible for reimbursement through private insurance and Medicaid for up to $1,500 per pregnancy. If this legislation passes, Rhode Island would join Oregon, Minnesota, and a pilot program in New York allowing Medicaid coverage for doula services.

According to an article in Uprise RI, the bill was announced at “what may have been the first press conference held at the Rhode Island State House in which all of the speakers were women of color.” Speaking at the press conference, Kavelle Christie, Public Policy and Organizing Specialist of Planned Parenthood of Southern New England (pictured above in a photo from Uprise RI), said “Planned Parenthood of Southern New England believes that carrying a pregnancy to term should not put women’s lives at risk. As a member of the Rhode Island Coalition for Reproductive Freedom, we will fight to ensure black women receive the high-quality care they deserve, and perinatal doulas are fairly compensated for the care they provide. Maternal mortality in the United States is a public health crisis and its severe impact on black women is unacceptable.” Click here to see Kavelle’s full speech.

New Jersey Citizen Action, our regional coordinator in that state, recently joined other health care advocates for a roundtable hosted by New Jersey First Lady Tammy Murphy. The roundtable highlighted the $1 million in funding in Governor Murphy’s proposed 2020 budget to provide coverage for doula care services to expectant mothers on Medicaid to help combat New Jersey’s Black infant and maternal health crisis. In the program’s initial phase, community doulas will be trained to provide services in Newark, Trenton, Camden and Atlantic City.  So far, 50 community doulas have been trained, and another 50 are in the pipeline.  This is just one of several initiatives the First Lady is actively promoting as part of her push to address maternal health inequities for women of color in New Jersey.  Other proposals pending include a bill to extend Medicaid coverage for 12 months post-partum. Currently, pregnant women with incomes under 200% of the federal poverty limit can qualify for Medicaid, but that coverage expires 60 days post-partum. 

As part of New Jersey Citizen Action’s advocacy efforts in support of the First Lady’s initiative, Maura Collinsgru, Health Care Program Director at New Jersey Citizen Action, included these proposed maternal health bills in her budget hearing testimony. In her testimony on behalf of New Jersey Citizen Action, Collingsru cited the alarming statistic that Black women in New Jersey are five times more likely than their white counterparts to die from pregnancy-related complications. “Providing support to moms during and after pregnancy is vital if we are to turn around this unacceptable statistic,” she said.


Protect Medicaid to protect women and families!

Highlighting the importance of Medicaid for women and families

April is Medicaid Awareness month! Every week this month we’ll highlight the importance of Medicaid to women and our families and provide updates on the continuing fight to save Medicaid from conservative efforts to dismantle it.

First enacted in 1965, with expansions over time, Medicaid has become a lifeline for women and families. Women live in poverty at higher rates than men do and are much less likely than men to have employer-sponsored insurance in their own names. Women with private health insurance are at greater risk than men of losing it following divorce or changes in the family coverage offered by their spouse’s employer.Unsurprisingly, then, women make up a majority of the adult Medicaid population, and it is especially important for women of color. 

As of 2014 (the most recent year for national enrollment data), Medicaid covered 25 million women age 19 and older. (The number is likely higher now that additional states have used the Affordable Care Act to expand their Medicaid programs to cover more adults since then.)

Medicaid and reproductive health

Approximately two-thirds of women with Medicaid are in their reproductive years (age 19 to 49). Medicaid covers critical reproductive health care services, such as family planning and contraception, prenatal care, childbirth, and postpartum care. Women cannot be charged out of pocket costs for reproductive health services and the law guarantees them “free choice of provider” to see the qualified health care provider of their choosing.

Nearly half of all pregnant people get their prenatal care through Medicaid, which also covers almost half of all births in the U.S. Medicaid also helps new parents struggling with postpartum depression. However, in those 14 states that haven’t expanded Medicaid  under the authority of the Affordable Care Act (ACA), many women lose their Medicaid coverage 60 days after giving birth. In DC and the 36 states that have expanded their Medicaid programs, most women are able to retain their coverage, ensuring better access to care.

Recently, WV FREE, our Charleston-based RWV regional coordinator, helped successfully advocate for the passage of SB 564, which expands Medicaid and CHIP coverage for pregnant women between 185 percent and 300 percent of the federal poverty level, and includes prenatal care, delivery and 60 days postpartum care.  According to the West Virginia Center on Budget and Policy, over 24,000 women age 19 to 44 in the state did not have health insurance in 2017. Among new mothers in that age range, an estimated 3 percent did not have health insurance, making the cost of childbirth out of reach for many. The average cost of childbirth in West Virginia ranges from $10,000 for a vaginal birth, and $14,000 for a C-section, combined with $20,000 for pre- and postnatal care, West Virginia Center on Budget and Policy reports.

Recognizing the importance of postpartum Medicaid coverage to the health and well-being of mothers and babies, some of our RWV regional coordinators – including New Jersey Citizen Action, EverThrive Illinois and Northwest Health Law Advocates  – have been supporting state efforts to extend postpartum full-scope Medicaid coverage to 12 months in their states. 

Medicaid and the Children’s Health Insurance Program (CHIP) together cover 35 million children. Almost half of all young children, ages three and below, are covered by Medicaid.

Who else needs Medicaid? Older women

Another 16% of women with Medicaid coverage are 65 and older. Women live longer than men and enter their senior years with fewer financial resources. While Medicare and most private health insurance does not cover the cost of long-term care, including nursing home care, Medicaid does, making it particularly critical for older women. 

Perhaps most importantly, Medicaid works! As the Kaiser Family Foundation noted, “A large body of research shows that Medicaid beneficiaries have far better access to care than the uninsured and are less likely to postpone or go without needed care due to cost. Moreover, rates of access to care and satisfaction with care among Medicaid enrollees are comparable to rates for people with private insurance.” 

Finally, while Medicaid is essential for public health, it also helps lift millions of families out of poverty by lowering their health care costs, reducing their debt burden, and keeping them healthy for work and school. A 2017 study published in Health Affairs concluded that Medicaid is one of the most effective anti-poverty programs.


Trump’s ACA shocker; Pelosi’s ACA rescue plan

Health care back at center of national stage

Two diametrically opposed approaches to health care were on display this week. On Monday, the Trump administration shocked legal observers—and even members of the GOP—by announcing that it would not defend any part of the Affordable Care Act (ACA) in court. On Tuesday, House Democrats unveiled sweeping new legislation to significantly expand and improve upon the ACA.  Then on Wednesday, a federal judge struck down a core part of the administration’s attacks on Medicaid, its promotion of work requirements.

On Monday, the Trump Justice Department announced that it is no longer asking the courts to uphold any part of the ACA in the Texas lawsuit challenging the constitutionality of the health care law.  Previously, the Trump administration had surprised legal observers by declining to defend the ACA’s protections for people with pre-existing conditions, even as it defended the rest of the law. (The department’s refusal to fully defend the law was so controversial that several Justice attorneys ultimately removed themselves from the case.) 
Then in December, federal court Judge Reed O’Connor (hand-picked by the GOP plaintiffs) issued a ruling to overturn the entire ACA that was so shocking even prominent conservatives called it “bananas” and “an exercise of raw judicial power.” Now, under DOJ’s new filing, the administration has abandoned its previous position without explanation, arguing that O’Connor’s decision striking down the entire law should be upheld by the Fifth Circuit Court of Appeals.
Behind-the-scenes reporting makes clear that the White House is attempting a cynical, if politically dubious, ploy to force Democrats to support a Trumpcare alternative by blowing up the current system. But University of Michigan law professor and former Justice official Nicholas Bagley points out that it’s actually far more sinister.
Calling the move “far beyond the pale” and a “serious threat to the rule of law,” he writes: “The duty [to defend the law] is a close cousin to the president’s constitutional duty to enforce the law. If the Justice Department really thinks that Obamacare is so blatantly unconstitutional that it can’t be defended, that implies that the president is violating the Constitution whenever he applies it. It’s not hard to see that as an incipient justification for refusing to enforce any law that the president believes to be unconstitutional, however ridiculous or partisan that belief might be.”
While the case is still considered a long-shot despite the Trump administration’s new stance, it’s worth considering what’s at stake if the ACA is overturned. More than 12 million people who gained coverage through the ACA’s Medicaid expansion would immediately lose their care. Another 9.2 million people who receive federal subsidies to buy insurance through ACA marketplaces could find their care unaffordable without help. An estimated 133 million Americans have pre-existing conditions that could disqualify them from buying health insurance if the law falls, 171 million people could see annual and lifetime caps on coverage return, 60 million Medicare recipients would face higher costs, and 2 million young people currently on their parents’ health plans could be kicked off of coverage.

Women live in poverty at higher rates than men do, live longer than men, and are much less likely than men to have employer-provided insurance in their own names, making them particularly vulnerable to attacks on Medicaid, Medicare, and the ACA. At the same time, all of the law’s protections against discrimination and benefits for women—including contraceptive coverage, maternity care, breastfeeding support, well-woman visits and more—would fall. 
Downplaying these real-world harms, Trump told reporters, “If the Supreme Court rules that Obamacare is out, we’ll have a plan that is far better than Obamacare,” he said. Despite making similar promises during the campaign, the Trump White House has never put out its own health care plan and has no realistic path forward.

Pelosi and House Dems propose plan to expand, improve on the ACA

While congressional Republicans groused anonymously about the possibility of ripping health care away from 21 million Americans and affecting millions more without any idea of how to help them, House Democrats, led by Speaker Nancy Pelosi, put on a united front on Tuesday in rolling out sweeping new legislation to significantly expand and improve upon the ACA.

The new bill would unwind Trump administration sabotage of the ACA by blocking “junk” health plans and other Trump-exploited loopholes that circumvent protections for people with pre-existing conditions. It would also end Trump efforts to weaken the ACA’s essential health benefit coverage requirements and would restore funding outreach for open enrollment, among other steps. It would also fix long-standing problems with the current law, like eliminating the “family glitch,” which bases affordability on an individual’s premiums even when the family needs coverage.
But most importantly, the bill comes closer to fulfilling the promise of the ACA by making coverage far more affordable for working and middle class families. The bill takes important steps that we have long called for, such as making existing financial assistance much more generous for people with incomes below 400 percent of the federal poverty level (FPL) and eliminating the current cap on assistance for people with incomes above that threshold.
For middle class families with incomes above 400 percent FPL, the bill would make them eligible for premium support if the premiums for the benchmark plans in their area would cost more than 8.5 percent of their incomes. For example, a typical 60-year-old making $50,000 would see her premiums cut significantly. Where she now pays a monthly premium of $1,016, she would pay $354 per month under the new bill, or 8.5 percent of income. All together, the bill would lower premiums for 13 million people and extend coverage to millions more who are currently uninsured.
The lead sponsor of the House’s Medicare for All bill, Rep. Pramila Jayapal (D-WA), told reporters that “We are completely united, as I’ve said for a while, on shoring up the ACA” even as their long-term goal is moving to a single payer system.

Judge throws out Medicaid work requirements in KY, AR

In a huge win for health care, on Wednesday, a federal district court judge threw out Medicaid work requirements in Kentucky and Arkansas, arguing that they violate the law. The Trump administration has encouraged states to seek waivers to Medicaid’s existing coverage rules in order to impose a host of new bureaucratic obstacles designed to block eligible people from getting covered through the program. Thus far, Arizona, Indiana, Michigan, New Hampshire, Ohio and Wisconsin have been given approval by the administration to start imposing work requirements, and several others have sought or are weighing approval.

As we wrote last year, the Medicaid statute is clear: waivers must help improve access to care and any waiver that seeks to block coverage is in violation of the law. Judge James E. Boasberg agreed, writing “The Court cannot concur that the Medicaid Act leaves the [HHS] Secretary so unconstrained, nor that the states are so armed to refashion the program Congress designed in any way they choose.”

In April, we will be focusing on the Medicaid program, what it means for women, and what these bureaucratic red tape requirements are really intended to do. Stay tuned!

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