ACA survives, but coverage gap remains

ACA survives, but coverage gap remains

The U.S. Supreme Court has once again upheld the Affordable Care Act, ruling 7-2 against a challenge by Republican attorneys general who sought to overturn the landmark 2010 health care law. It marks the latest failed challenge by the law’s opponents, who have tried repeatedly to undermine widespread coverage gains across the country, particularly among low-income adults on Medicaid. Adam Liptak of the New York Times has the details on what was at stake:

Striking down the Affordable Care Act would have expanded the ranks of the uninsured in the United States by about 21 million people — a nearly 70 percent increase — according to recent estimates from the Urban Institute. The biggest loss of coverage would have been among low-income adults who became eligible for Medicaid under the law after most states expanded the program to include them. 

Though the Affordable Care Act originally intended to expand Medicaid eligibility across the country, a previous Supreme Court ruling left expansion decisions to the states. Twelve states remain that have not expanded the program – refusals that perpetuate racial disparities in access to care. As many as 2.2 million adults in non-expansion states fall into the “coverage gap,” with incomes that are too low to qualify for subsidized marketplace coverage, yet too high to qualify for Medicaid coverage. A new report from Center on Budget Policy and Priorities explains

The ACA helped reduce disparities in health insurance coverage among states that expanded, but the coverage gap worsens these disparities by disproportionately denying coverage to people of color. While people of color comprised 41 percent of the adult, non-elderly population in non-expansion states, they made up 60 percent of people in the coverage gap, including 28 percent who are Latino and 28 percent who are Black.

A new reconstruction
As we emerge from the Covid-19 pandemic, Black mayors from five Southern cities – Birmingham, Jackson, Little Rock, Montgomery and Shreveport – are calling for a new Reconstruction to address entrenched structural inequities in America. Historic disinvestment in many Southern cities has led to a critical need for federally funded infrastructure improvements – programs that would also help create well-paying new jobs. The mayors make their case for infrastructure spending in The Washington Post:

While the pandemic exposed these woes, it did not create them. … They stem from decades of divestment in our communities as Washington sat idly by. Politicians at the national level have watched roads and bridges crumble; allowed subterranean infrastructure to fall into disrepair, leaving millions without clean, reliable drinking water; forced citizens to keep pace with utility rate increases to finance unaffordable, federally mandated consent decree projects; and failed to act as extreme weather resulting from climate change has exacerbated infrastructure problems.

Black voters matter
A coalition of national civil rights and grassroots groups are hitting the road across Deep South cities to rally for federal action to protect voting rights. The Freedom Ride for Voting Rights was spurred by state efforts to restrict ballot access, which would have a disproportionate effect on Black voters, and to call on elected officials to continue to fight for full access to the right to vote. Benjamin Barber of Facing South has the story:

The initiative was announced last month on the 60th anniversary of the original Freedom Rides “to show voters, communities, and elected officials of how far we’ve come and remind them what Black power can do,” as (LaTosha) Brown and (Cliff) Albright (of Black Voters Matter) said. Also involving local and national partners, the bus tour seeks to raise public awareness about voter suppression and to pressure lawmakers to support the two pieces of federal legislation: the For the People Act, which has been called the “the next great civil rights bill,” and the John R. Lewis Voting Rights Act.

Attacks on food assistance
After federal food assistance programs for low-income Americans expanded to meet skyrocketing need during the pandemic, some Republican controlled state legislatures have started to impose additional barriers to access. Republican lawmakers in Ohio, Arizona, Arkansas, Missouri, Montana and others have proposed policies that would make it harder for people who use SNAP for their household food budget to maintain their benefits, or would punish them for trying to get ahead. Laura Reiley in the Washington Post has the story

The federal SNAP program, which serves an average of 40.3 million people per month, is often misunderstood by state legislatures, according to Ed Bolen, senior policy analyst at the Center on Budget and Policy Priorities. “Some states jump in and offer state bills that require the agency to do something. It’s often not from a place of understanding, more cookie-cutter or template bills that don’t really address specific needs, but they can sound like they are dealing with program integrity”…Requiring participants to report every tiny change in income, Bolen said, has been shown to be “useless work — and a lot of it — a death by a thousand paper cuts,” and work requirements have been proven mostly to dramatically cut participation in the program.

Correction: Thursday’s Daily Dime incorrectly reported that the increase in Louisiana Unemployment Insurance benefits is $28 per month. The maximum benefit will increase $28 per week in 2022.

Number of the Day
7,500 – Estimated new jobs that could be created if Louisiana captured 10% of the projected offshore wind generation market. (Source: National Renewable Energy Laboratory via The Advocate