Congresswoman Terri Sewell

Representing the 7th District of Alabama

Rep. Sewell Votes in Favor of the Patient Protection and Affordable Care Enhancement Act, with Renewed Medicaid Expansion Incentives

Jun 29, 2020
Press Release
H.R. 1425 would build on the success of the Affordable Care Act, increasing health insurance coverage and reducing health inequities

Washington, D.C. – Today, Rep. Terri Sewell (AL-07) voted in favor of H.R. 1425, the Patient Protection and Affordable Care Enhancement Act, which will lower American’s health coverage costs, combat inequity in health coverage in communities of color, crack down on junk plans, strengthen protections for people with pre-existing conditions, and incentivize hold-out states like Alabama to expand Medicaid. This bill includes the Incentivizing Medicaid Expansion Act (H.R. 584), legislation that Rep. Sewell sponsored to renew the Affordable Care Act’s (ACA) original expanded federal match for states adopting Medicaid expansion, regardless of when they expand, providing critical federal funds to uncovered Alabamians in the wake of the coronavirus pandemic.


“As COVID-19 cases continue to spike across the state of Alabama without any indication of flattening or decreasing, I am deeply concerned for residents across my district and particularly throughout the rural Black Belt who lack access to health insurance and coverage,” said Rep. Sewell. “The state’s refusal to expand Medicaid, which would provide much needed coverage to these communities, is particularly irresponsible in the face of this ongoing pandemic. The public health emergency and subsequent economic crisis currently facing our nation have made these uninsured and unemployed more vulnerable, our health care systems more fragile, and our state Medicaid programs more susceptible to budget cuts due to plummeting state revenues. The need for Medicaid expansion is as clear today as it has ever been. The Patient Protection and Affordable Care Enhancement Act would once again provide the state with an opportunity to expand Medicaid with the original expanded federal match.”

Research shows Medicaid expansion is associated with improvements in health outcomes and stronger financials for hospitals and health care providers. In Alabama alone, it is estimated that 314,000 more Alabamians would have access to health coverage if the state expanded Medicaid. A recent analysis found that Alabama would see a decrease of 43% in the uninsured rate if it expanded Medicaid, which is the largest decrease among states that haven’t yet expanded. It is estimated that between 2014 and 2020, Alabama left $12 billion in federal funding on the table by refusing Medicaid expansion.

The Patient Protection and Affordable Care Enhancement Act is part of Democrats’ continued efforts to broaden healthcare access, making coverage and prescription drugs available and affordable for all Americans. As Republicans sue to declare the ACA invalid, removing coverage from millions of Americans, the Patient Protection and Affordable Care Enhancement Act seeks to fortify the ACA, expanding coverage and ensuring that every American gets the health care they need, particularly in the wake of the coronavirus pandemic.


Details on the Patient Protection and Affordable Care Enhancement Act:

Lowers Americans’ health coverage costs 

  • Expands tax credits to lower Americans’ Marketplace health insurance premiums and allow more middle-class individuals and families to qualify for subsidies – for the first time, no person will pay more than 8.5 percent of their income on a silver plan in the Marketplaces
    • An adult earning $19,140 would see premiums cut to zero, saving $800 dollars a year. 
    • A family of four earning $40,000 would save nearly $1,600 in premiums each year.
    • A single adult with income of $31,900 would see premiums cut in half. 
    • A 64-year-old earning $57,420 would save more than $8,700 in premiums each year.    
  • Ensures that families who don’t have an offer of affordable family coverage from an employer can qualify for subsidies in the Marketplaces.
  • Provides funding for reinsurance initiatives to further lower premiums, deductibles, and other out-of-pocket costs.  

Expands coverage & pushes hold-out states to adopt Medicaid expansion 

  • Presses Medicaid expansion hold-out states to reconsider by renewing the ACA’s original expanded federal matching for states that adopt the Medicaid expansion and progressively reducing administrative FMAP for those who continue to refuse.  More than 4.8 million Americans have been cruelly excluded from coverage because states have refused to expand Medicaid.    
  • Funds critical federal and state efforts to increase health coverage enrollment, educate consumers of their health care rights, and help individuals navigate the health insurance system.
  • Delivers funding for states who want to establish their own state-based Marketplaces. 

Combats inequity in health coverage faced by communities of color

  • Fights the maternal mortality epidemic by requiring states to extend Medicaid or CHIP coverage to new mothers for 1-year post-partum.
  • Protects vulnerable populations from losing health coverage by ensuring that Medicaid and CHIP beneficiaries receive a full 12 months of coverage once enrolled, protecting them from interruptions due to fluctuations in their income throughout the year.
  • Improves Medicaid beneficiaries’ access to primary care physicians, by reauthorizing the ACA’s increased payments to primary care physicians who treat Medicaid recipients. 

Cracks down on junk plans & strengthens protections for people with pre-existing conditions

  • Reverses the Trump Administration’s expansion of junk health insurance plans that do not provide coverage for essential medical treatments and drugs, and that are allowed to discriminate against people with pre-existing medical conditions.
  • Curtails the Trump Administration’s efforts to give states waivers to undermine protections for people with pre-existing conditions and weaken standards for essential health benefits.