Today, Congresswoman Lizzie Fletcher (TX-07) introduced the Affordable Care Coverage Expansion and Support for States (ACCESS) Act to establish a program at the Department of Health and Human Services to create a federal Medicaid program for adults in the coverage gap in non-expansion states, like Texas. 

“Texas is home to world-leading, innovative health care and medical research, and at the same time, Texas has the highest rate of uninsured people in the country, and is ranked lowest in access to care,” said Congresswoman Lizzie Fletcher.  “We can make major advancements in access to care by expanding Medicaid.  That is why I have introduced this legislation to create a federal Medicaid plan to close the coverage gap and expand access to quality, affordable health care for Texans and Americans who need it.”

In the United States, more than 1.9 million adults have incomes above their state’s eligibility for Medicaid but below the poverty line, which puts them in the coverage gap.  These individuals are unable to afford health insurance through the Affordable Care Act (ACA) marketplace and are ineligible for Medicaid because their states have not enacted ACA Medicaid expansion.  There are currently 10 states in the U.S. that have not enacted ACA Medicaid expansion, including Texas, leaving vulnerable residents without affordable coverage options.  Closing the coverage gap would increase health insurance coverage, reduce racial health disparities, and improve health care access, health outcomes, and financial security.  

The ACCESS Act establishes a federal Medicaid program to provide a coverage option for individuals in the coverage gap.  If enacted, an estimated 771,000 Texans who currently have no access to health insurance without Medicaid expansion would qualify for a federal Medicaid plan. 

In 2021, Congresswoman Fletcher’s bill, the Expand Medicaid Now Act, was signed into law as part of the American Rescue Plan Act, H.R. 1319.  Her bill increased the amount of federal funding for states to expand Medicaid.  North Carolina and South Dakota expanded Medicaid as a result of Congresswoman Fletcher’s bill, but Texas chose not to expand Medicaid and close the coverage gap.

To read the full text of the ACCESS Act, click here.