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Local Medicaid Expansion: Health Coverage for Vulnerable Residents in Non-Expansion States.

This bill establishes a demonstration project allowing local governments (counties, cities) in states that have not expanded Medicaid to independently provide health assistance to low-income residents. This means citizens in these areas can gain access to health insurance even if their state does not offer it. The federal government will cover most costs, and states attempting to obstruct these local initiatives face penalties on their administrative funding.
Key points
Local political subdivisions can launch their own Medicaid programs for individuals who would qualify for expansion but reside in non-expansion states.
The federal government will cover 100% of the medical assistance costs for the first three years of the project, gradually decreasing the share thereafter (down to 90% in later years).
The demonstration project lasts for seven years, with a potential five-year extension, unless the state opts for full Medicaid expansion sooner.
The bill imposes financial penalties on states that take punitive actions against local governments for establishing these health coverage projects, such as reducing local funding or blocking provider participation.
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Status: Introduced
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Additional Information
Print number: 119_HR_608
Sponsor: Rep. Doggett, Lloyd [D-TX-37]
Process start date: 2025-01-22