October 21, 2021

ICYMI: At Hearing, Warren Calls on Congress to Close Medicaid and Medicare Coverage Gaps in Reconciliation Bill To Meet Americans’ Health Care Needs

Warren on Medicaid Coverage Gap: “Congress has already paid to insure this population. And it’s time for the federal government to deliver these individuals the coverage that they have long been promised.”

Video of Hearing Exchange

Washington, D.C. — In case you missed it, at yesterday's United States Senate Committee on Finance hearing, United States Senator Elizabeth Warren (D-Mass.) called for robust health care investments in the reconciliation bill, including proposals to close the Medicaid coverage gap and expand Medicare to include dental, vision, and hearing benefits. Millions of Americans in the 12 states without Medicaid expansion – 60% of whom are people of color – have been boxed out of affordable health care because they are too poor while federal funding to close the coverage gap sits on the table. Additionally, many Medicare beneficiaries are unable to afford the out-of-pocket costs for the dental, vision, and hearing care they need. Senator Warren highlighted the importance of expanding health care access for millions of Americans, especially low income families and communities of color.

Transcript: Health Insurance Coverage in America: Current and Future Role of Federal Programs
United States Committee on Finance 
Hearing Exchange From U.S. Senator Elizabeth Warren
Wednesday, October 20, 2021 

Senator Warren: Thank you very much, Mr. Chairman.

As many people have talked about today, health care coverage continues to be out of reach for millions of Americans. And right now Congress has this historic opportunity to take a big step in the right direction by passing the Build Back Better agenda to close the Medicaid coverage gap, to expand Medicare coverage for dental, vision, and hearing, to tackle affordability, and more.

So let me start with you, Dr. Blumberg. You have written about many of these proposals. Now, if all of the remaining states expanded their Medicaid programs, how many of the uninsured people who would become eligible for health care coverage have incomes below the poverty line? 

Dr. Blumberg: My colleagues estimate about 3 million of the newly eligible uninsured in those twelve states will be-- currently have incomes below poverty.  

Senator Warren: Okay. And unless a person in this coverage gap gets a job that offers them health insurance – or unless they move to another state that has already expanded Medicaid – do these people have any other coverage opportunities? 

Dr. Blumberg: They don't have adequate and affordable other opportunities. No.

Senator Warren: Okay. Alright, so 3.2 million people below the poverty line. They don't have any other coverage options. The people caught in the Medicaid coverage gap are not boxed out of care because they’re too wealthy or because they have some other option available to them. Instead, these individuals – 60 percent of whom are people of color – have no health care coverage because they are poor. That shouldn't happen in America.

So Dr. Blumberg, if the twelve states that have not taken up the Medicaid expansion decided to do so tomorrow, how much new federal money would the federal government be expected to find to finance these expansions?

Dr. Blumberg: It would cause no increase in the need for revenue because it was already covered by the Affordable Care Act that was passed in 2010. 

Senator Warren: So this has already been budgeted for? 

Dr. Blumberg: Correct. There's a lot of money left on the table that has not been used by those states since 2014.

Senator Warren: Okay. Money left on the table. If Congress passed a bill to close the coverage gap and found new money to cover the costs, would Congress be paying twice to cover this same population? 

Dr. Blumberg: Essentially, yes. That's the truth since it was already funded. The same people. The same benefits. 

Senator Warren: Alright. Thank you.

You know, this is important to focus on, especially in light of the CBO estimates that were released yesterday. To anyone saying that it is too expensive to cover the Medicaid coverage gap or that we can only afford to cover this gap for a few years, I have some good news for you: Congress has already paid to insure this population. And it’s time for the federal government to deliver these individuals the coverage that they have long been promised. And there’s no reason to pay for it a second time.

No, Mr. Isasi, last year, 9.5 million Medicare beneficiaries said that they could not access dental, vision, or hearing services that they needed. Can you just give us a little bit of a description about who those people were?    

Mr. Isasi: Absolutely. Thank you for the question. So we're talking about -- it's really important to say this-- 3 times as many folks are having trouble who are below-- who have incomes below $10,000 and the people who have higher income. These are -- lar-- large, large part we're talking about -- the most vulnerable Medicare recipients. Also, it's many, many people of color compared to white Medicare beneficiaries. Twice as many Black beneficiaries can't see a dentist, and one-third as many Hispanics. Twice as many Black adults have lost all their teeth as compared to the national average. And three times as many Mexican-American older adults have untreated tooth decay. So this is very much an issue for some of our most poor, vulnerable, and beneficiaries of color. 

Senator Warren: And they are the ones who would benefit most if Medicare were expanded to cover vision, dental, and hearing. 

Mr. Isasi: Without a question. Without a question. 

Senator Warren: You know, thank you very much for this. Low-income Americans and people of color will disproportionately benefit from Medicare dental, vision, and hearing coverage. Of the millions of Medicare beneficiaries who don’t have access to these services, about 70 percent have said it’s just because they can’t afford it.

The best approach to getting universal coverage is through a single-payer system.  But we should not overlook how powerfully important the provisions in the Build Back Better agenda are. We have an historic opportunity to make a real difference in people's lives. And we should do that. 

Mr. Isasi: Couldn't agree more.