Skip to Main

June 17, 2021

Bourdeaux, 40+ Members Of Congress, Introduce Legislation Empowering Local Governments To Expand Medicaid

WASHINGTON — Today, Congresswoman Carolyn Bourdeaux joined over 40 members of Congress, representing states which have refused to expand Medicaid coverage, in introducing the Cover Outstanding Vulnerable Expansion-Eligible Residents Now (COVER) Now Act. The COVER Now Act would authorize the Centers for Medicare and Medicaid Services (CMS) to work directly with counties, cities, and other political subdivisions to expand Medicaid coverage.

The COVER Now Act is based on previous successful demonstration projects in Cuyahoga County, Ohio; Cook County, Illinois; and several counties in California. These demonstration projects were established by State application through 1115 waivers and served as the glidepath to statewide expansion. Under the COVER Now Act, local entities would be empowered to apply directly to CMS without the State’s involvement.

“It’s time to expand Medicaid and if our states won’t act, we need to let our counties take action — not just because it’s the right thing to do, but because it’s good policy. We all pay for uncompensated care through our own rising premiums. The COVER Now Act will empower counties to work directly with the Centers for Medicare and Medicaid Services to offer health insurance coverage to those who would have been eligible if our states had chosen to expand Medicaid. I thank Congressman Doggett and all of my colleagues for supporting this critical measure,” said Congresswoman Bourdeaux.

“Over four million Americans, primarily from communities of color, remain uninsured due to ideological obstruction and indifference. Our homegrown solution, the COVER Now Act, enables willing local leaders to accept directly federal resources to achieve both the public health and financial benefits of Medicaid expansion. For many of our most disadvantaged citizens this bill offers a pathway to access a family physician, necessary medicine, and other essential coverage that thirteen States continue to deny. The COVER Now Act empowers local leaders to assure that the obstructionists at the top can no longer harm the most at-risk living at the bottom,” said Congressman Doggett.

“UnidosUS is deeply committed to ensuring all Americans have access to quality, affordable health coverage and care. Latinos and their children have long been overrepresented among the uninsured and the pandemic has only exacerbated such long-standing inequities in our health care system, especially in nonexpansion states like Texas and Florida. As we continue to push for Medicaid expansion for all residents in the remaining states, we applaud the sponsors of this bill for their leadership in addressing coverage gaps, and for their commitment to reduce racial and ethnic health disparities. Making sure each and every American has access to coverage under the Affordable Care Act protects public health and is morally the right thing to do,” said Eric Rodriguez, Senior Vice President of Policy and Advocacy, UnidosUS.

“Catholic values affirm that health care is a sacred human right for every person. Already more than 600,000 people in the U.S. have died from COVID-19, with the pandemic revealing long-standing health disparities particularly for Black, brown, and Native American communities. These disparities are the result of a long history of systemic racism and racial exclusion often manifested in our country’s laws. Closing the Medicaid gap for people living in non-Medicaid expansion states is an important step towards eliminating these unjust and immoral racial health disparities. We urge all Members of Congress to heed the call to prioritize health equity for all,” said Mary J. Novak, Executive Director, NETWORK Lobby for Catholic Social Justice. 

“Millions of people have gained access to health care, thanks to the Affordable Care Act. But despite these advancements there are still 2.2 million people who have been shut out due in large part to 12 states refusing to expand Medicaid. The majority of those impacted are people of color. In order to fix this, the American Rescue Plan provided a sizable financial incentive to states to finally take up Medicaid expansion. Still, these states — many with a deep legacy of racism and racist health policies — will likely continue to refuse these incentives at great detriment to the health outcomes, lives, and maternal health of their residents. The National Partnership commends these members for working to find ways to address the coverage gap in states that have not expanded Medicaid coverage, and we urge Congress to work towards a solution,” said Debra L. Ness, President, National Partnership for Women & Families.

“The American Diabetes Association strongly supports the COVER Now Act to expand access to Medicaid coverage for uninsured and under-insured Americans, especially the 122 million people living with diabetes and prediabetes. Health insurance coverage through Medicaid can empower individuals and families to be more proactive in seeking preventive care, early diagnosis and diabetes management through affordable prescription drugs and devices. Health care costs for the diabetes community are 2.5 times higher than those for Americans without diabetes, and the COVER Now Act is an important step toward addressing cost barriers to life-saving health care,” said Tracey Brown, CEO, American Diabetes Association.

“As a Federally Qualified Health Center, our mission is to improve the health of the communities that we serve maximizing our resources to reach as many people as possible.  The COVER Now Act would allow us to expand our reach by providing healthcare coverage to those individuals who are currently unable to access the system due to their financial circumstances.  By providing these families and individuals with high quality preventative healthcare, we will not only improve upon the wellbeing of our community, but also preserve scarce resources by reducing unnecessary emergency room visits.  The Act would provide the opportunity for us to work with our local hospital district to transform the health of those individuals that are currently slipping through the safety net.  As such, I wish to express our whole-hearted support of the COVER Now Act,” said Paul M. Nguyen, President and CEO, CommuniCare Health Centers.

The COVER Now Act would: 

  • Authorize CMS to contract directly with counties and other political subdivisions to establish demonstration projects expanding Medicaid coverage to their residents
  • Participating entities will receive the same deal previously made available to States: 100% federal funding for the first 3 years and a gradual reduction to 90% federal funding by year 7 and thereafter
  • Participating entities may apply individually or jointly if they wish to establish a regional expansion project
  • Existing Medicaid rules and systems would remain in place and apply to the local expansion programs
  • States would be required to cooperate and authorize access to State Medicaid systems for participating entities, with additional federal administrative Medicaid funding for cooperation and subject to federal penalties for non-cooperation
  • Should a state expand, eligible beneficiaries enrolled in a local expansion program would be automatically enrolled into the State Medicaid program

Endorsing organizations include: UnidosUS, American Diabetes Association, National Alliance on Mental Illness, National Multiple Sclerosis Society.


Rep. Carolyn Bourdeaux lives with her family in Suwanee, Georgia and represents Georgia’s 7th Congressional District in the 117th Congress. Carolyn is a strong advocate for affordable health care, an economic recovery that puts workers and small businesses first, and investing in her district’s world-class public education system and transportation infrastructure. 

Georgia’s fast-changing 7th Congressional District includes portions of the northeast Atlanta metropolitan area, including portions of Forsyth and Gwinnett counties and cities Peachtree Corners, Berkeley Lake, Sugar Hill, Norcross, Cumming, Lawrenceville, Duluth, Snellville, Lilburn, Suwanee, Grayson, and Buford.