America Can’t Recover if the South Isn’t Covered


The Southerners for Medicaid Expansion continues to urge federal leaders to take immediate action to expand healthcare coverage to nearly seven million people across the South.


May 18, 2022 - Urging Majority Leader Schumer to close the Medicaid coverage gap as a necessary step for economic and racial justice.

Read our past Letters


September 17, 2021

Dear Democratic Senators,

We, the Southerners for Medicaid Expansion coalition, lead health equity movements across the Southern states that have not expanded Medicaid. We are joined by nearly 400 organizations: advocates from non-expansion states and leaders for health and racial equity across the nation.

We are urging you to prioritize the permanent and comprehensive Medicaid “coverage gap” policy outlined in the House Energy and Commerce Committee reconciliation bill.

Closing the coverage gap would mean that over two million uninsured Americans—most of them Black, Latino, Indigenous, and Asian, all of whom live below the poverty line—could finally get health coverage. This is the only health care policy in the Build Back Better Act that directs resources specifically to low-income Americans, 60% of whom are people of color, who have no other pathway to coverage. We ask you to count it among your highest health care priorities.

We cannot ask Americans to keep waiting for this basic human right—nor can we settle for a solution that will lapse in a few years or leave some Americans behind. That is why our organizations urge you to support the House’s permanent and comprehensive policy.

This is not just about health care. It is a matter of racial justice.

The legacy of slavery has always been reflected in the design of Medicaid—in who has received it, and who hasn’t. While its sister program, Medicare, was created at the federal level to reach every senior in America, Medicaid was a concession made to former slave states.[1] Instead of being universal, it let states decide whether to participate and who could and could not get coverage. Southern states went out of their way to disqualify as many Black Americans as they could, an agenda reflected in their Medicaid policies to this day. It is no coincidence that eight of the twelve non-expansion states are former slave states.

This is why the Leadership Conference on Civil and Human Rights has called the coverage gap a “test of [Congress’] commitment to racial equity.” It’s why leaders of the Congressional Black Caucus and Congressional Hispanic Caucus wrote that closing the coverage gap quickly, permanently, and comprehensively is “one of the single most important steps” we can take to address racial inequities in health care. And it’s why Black leaders from Stacey Abrams to Rev. Barber of the Poor People’s Campaign have joined our call.

The Affordable Care Act—championed by so many Democratic leaders—intended to correct this injustice by expanding Medicaid to every low-income American regardless of where they lived. But since Southern states successfully brought NFIB v. Sebelius to the Supreme Court, Medicaid expansion has been left up to the states.

After nearly a decade of fighting for Medicaid expansion, we know the political landscapes of our states all too well. We know that to finally fulfill the promise of the ACA, we will need bold action from Congress.

That is why we are urging you to correct this deep, historic injustice by closing the coverage gap once and for all. Congress may not have another chance to do so for years, if not decades. In that time, tens of thousands more low-income people of color will die from treatable illnesses and millions more will suffer. The risk is too great.

We are grateful to you and your colleagues for your leadership on this bill, and we are eager to work with you in the coming weeks to close the Medicaid gap once and for all.


[1] David Barton Smith, "Civil Rights and Medicare: Historical Convergence and Continuing Legacy," in Medicare and Medicaid at 50: America's Entitlement Programs in the Age of Affordable Care, ed. by Cohen, Colby, Wailoo, and Zelizer, Oxford: Oxford University Press, 2015.



Southerners for Medicaid Expansion Coalition
1199SEIU United Healthcare Workers East
A VOICE for the Reduction of Poverty in Nashville and Beyond AARP
ABC for Health Inc.
ACA Consumer Advocacy
Action NC
ADAPT of Texas
Advocates for Responsible Care (ARxC)
African Communities Together
AIDS Alabama
AIDS Foundation Chicago
AIDS Services Coalition
Alabama Academy of Family Physicians
Alabama Arise
Alabama League of Women Voters
Alabama Primary Health Care Association
Alabama Solutions
Alianza for Progess
Alianza for Progress
Allegany Franciscan Ministries
Allergy & Asthma Network
Alliance for a Healthy Kansas
Alliance for Eating Disorders Awarness
American Association for the Treatment of Opioid Dependence American Association on Health & Disability
American Civil Liberties Union of Mississippi
American Medical Student Association
Appleseed Foundation

Arab Community Center for Economic and Social Services (ACCESS) Arkansas Advocates for Children and Families
Autism Society of Texas
Bay Area Women Coalition, Inc. Be a Hero
Bend the Arc South Florida Better Wyoming
BirthWell Partners Community Doula Project Black Children‘s Institute of Tennessee Bradbury-Sullivan LGBT Community Center Brevard County FL Leadership Action Team Broward for Progress
Broward Healthy Start Coalition
C4 Innovations
C4 Recovery Foundation
California Black Women's Health Project California Pan-Ethnic Health Network California School-Based Health Alliance Castleberry Development Rec. Center Catalyst Miami
Center for Civic and Public Policy Improvement (CCPPI) Center for Health Progress
Center for Independence of the Disabled, NY
Center for Law and Social Policy
Center on Halsted
Centering Healthcare Institute
CenterLink: The Community of LGBT Centers
Central Florida Jobs with Justice
Centro de Comunidad y Justicia
Children First
Children's Action Alliance
Children's Defense Fund - Texas
Children’s Defense Fund’s Southern Regional Office
Children’s Services Council of Broward County
Church & Society, Anniston First United Methodist Church
Church Women United Chapel Hill-Carrboro Unit
Church Women United, Raleigh-Wake Unit
Circular Congregational Church, Charleston, SC
Citizen Action of Wisconsin
City of Leland / Leland Southern Rural Black Women Initiative, LLC CitySquare
Coalition for Health Care of NC

Coalition of Texans with Disabilities Coalition on Human Needs Colorado Center on Law and Policy Colorado Consumer Health Initiative Colors+

Community Catalyst
Community Education Group
Community Foundation of Northeast Alabama Consumers for Affordable Health Care
Cover Texas Now
Democratic Disabilty Caucus of Florida
Dillon Joyce Ltd
Disability Rights and Resources
Diversity Collective Ventura County
Doctors for America
Down Home North Carolina
Drug Policy Alliance
East Texas Human Needs Network
Eating Disorders Coalition for Research, Policy & Action El Pueblo
Elite Lindenite Organization, Inc.
Equality State Policy Center
Every Texan, (formerly CPPP)
Faith in Florida
Faith in New Jersey
Faith in New York
Faith in Public Life
Families USA
Family to Family Network
Family Voices NJ
Farmworker Association of Florida
Farmworker Justice
Fayetteville Police Accountability Community Taskforce Feeding Texas
Feminist Women's Health Center
FLARA (Florida Alliance for Retired Americans)
Florida Center for Fiscal and Economic Policy
Florida Coalition on Black Civic Participation
Florida Council of Churches
Florida Health Justice Project
Florida Mental Health Advocacy Coalition
Florida People’s Advocacy Center
Florida Policy Institute
Florida Voices for Health
Floridians For Health Care; Florida Policy Institute Fortaleza
Fresh Start Global Outreach Ministries
Georgia Budget and Policy Institute
Georgia Equality
Georgia Interfaith Public Policy Center
Georgia Women (And Those Who Stand With Us) Georgians for a Healthy Future
Grace Presbyterian Church
Greater Birmingham Ministries
Greater WI Agency on Aging Resources, Inc. Green Careers Dallas
Greensboro Housing Coalition
Health Access CA
Health Care For All (Massachusetts)
Health Care Voices
Healthcare For All - South Carolina

Healthy Florida
Healthy Schools Campaign
Healthy Wyoming
Helping Hands Community Outreach Services Hispanic Federation
Hispanic Services Council, Inc.
HIV Medicine Association
Homeless and Housing Coalition of Kentucky Hometown Action
Hoosier Action
Houston Area Women’s Center
IDid Creations, Inc.
Independent Living Center of Mobile
Indivisible Austin
Indivisible Georgia Coalition
Indivisible Marching Buddies of Atlanta
Institute for the Advancement of Minority Health Interfaith Children's Movement
International Museum of Muslim Cultures International Valley Health Institute
Jackson District WHOMS AME Zion Church Jackson State University
Jefferson District CED
Jersey City Connections DBA Hudson Pride Center Jewish Community Relations Council
Jewish Democratic Womens Salon

Jewish Family Service Houston
Jolt Action
Kansas Action for Children
Kansas Appleseed Center for Law and Justice, Inc. Kansas Breastfeeding Coalition
Kansas Interfaith Action
Kentucky Equal Justice Center
Kids Forward
La Fe Policy Research and Education Center
La Union del Pueblo Entero (LUPE)
Latina Institute for Reproductive Justice Florida
Latino Leadership, Inc.
LatinosAgainstAlzheimer's Network
League of Women Voters of N.C.
Legal Action Center
Legal Aid Service of Broward County, Inc.
Legal Council for Health Justice
Louisiana Budget Projet
Lupus and Allied Diseases Association, Inc.
Lutherans Engaging in Asvocacy Minisrty
Maine Equal Justice
Marengo County Retired Education Employees Association Maryland Citizens' Health Initiative
Massachussets ME/CFS and FM Association
Medicaid Matters New York
Medical Advocacy & Outreach
Mental Health America of Greater Dallas
Mercy Care
Metro New York Health Care for All
Miami Dade League of Women Voters
Miami Workers Center
Michigan Disability Rights Coalition
Michigan League for Public Policy
Mississippi Center for Justice
Mississippi Families for Kids
Mississippi Health Advocacy Program
Mississippi Human Services Coalition
Mississippi Low Income Child Care Initiative
Mississippi State Conference NAACP
Mississippi United Methodist Conference CUIR
Missouri Health Care for All
Mobile District AME Zion Church WHOMS
Mobile District AMEZ Church
Montana Women Vote
Morehouse School of Medicine
MS Black Women's Roundtable
Multicultural Development Institute, Inc.
NAMI Central Texas
NAMI Kansas
NAMI Texas of Palestine
NARAL Pro-Choice North Carolina
Nashville Jewish Social Justice Roundtable
National Alliance on Mental Illness (NAMI) Texas
National Association for Rural Mental Health
National Association of County Behavioral Health & Developmental Disability Directors National Association of Social Workers
National Association of Social Workers - Florida
National Association of Social Workers - Mississippi Chapter
National Association of Social Workers - Texas Chapter
National Council of Urban Indian Health
National Latina Institute for Reproductive Justice
National MS Society
National Network for Arab American Communities
National Partnership for Women & Families
NBB Mentoring
NC Child
NC Coalition Against Domestic Violence
NC National Organization for Women
NC Poor People’s Campaign
Network Lobby for Catholic Social Justice
New Haven Pride Center
New Hope Housing
New Jersey Appleseed Public Interest Law Center
New Jersey Citizen Action
New Jersey Policy Perspective
New Virginia Majority
No More Silence Foundation
North Carolina AIDS Action Network
North Carolina Asian Americans Together
North Carolina Justice Center
North Texas Area Community Health Center
Northwest Health Law Advocates
Nurse Practitioner Alliance of Alabama
Office of the County Judge - Dallas County
Oklahoma Policy Institute
One Health Literacy Organization
OutFront Kalamazoo
Outstanding Kids
Palm Beach Groves
Panhandle Community Services
Partnership to End Addiction
Pasadena Health Center
Pennsylvania Health Access Network
People First Of Alabama
Personal Attendant Coalition of Texas
PGH Equality Center
Police, Treatment, and Community Collaborative Pride Center of Staten Island
Pride Community Center, Inc
Protect Our Care
Protect Our Healthcare Coalition RI Proyecto Azteca
Proyecto Juan Diego Inc.,
Resource Center
Restored Citizens

Root & Rebound
Sacramento LGBT Community Center Salavtion and Social Justice
Sant La, Haitian Neighborhood Center SC Appleseed Legal Justice Center Shriver Center on Poverty Law
Sick Of It Texas Campaign
SIsters 2 Sisters of Wilcox County Inc
Sisters of Charity Foundation of South Carolina
Sisters of Mercy of the Americas
South Carolina Small Business Chamber of Commerce
South Florida Zioness
Southeast Alabama AHEC
Southern Echo Inc.
Southern Economic Advancement Project
Southern Rural Black Women's Initiative
Southern Rural Black Women’s Initiative for Economic and Social Justice Southern Vermont Area Health Education Center
Southern Vision Alliance
SPAN Parent Advocacy Network
Spirit in Action
SRBW Human Rights Commission Voices for Arcola
St. Johns County Legal Aid
Step Up Savannah
Susan G. Komen
Tahirih Justice Center - Houston
TASC (Treatment Alternatives for Safe Communities)
Tennessee Disability Coalition
Tennessee Health Care Campaign
Tennessee Hemophilia & Bleeding Disorders Foundation
Tennessee Justice Center
Texans Care for Children
Texas Academy of Family Physicians
Texas Alliance for Retired Americans
Texas Association of Community Health Plans
Texas Data Quality Coalition

Texas Impact
Texas Organizing Project
Texas Parent to Parent
Texas Pediatric Society, the Texas Chapter of the American Academy of Pediatricians The Afiya Center
The AIDS Institute
The Arc of Alabama
The Arc of the United States
The Center: 7 Rivers LGBTQ Connection
The Common Ground Project
The Commonwealth Institute for Fiscal Analysis
The Connecticut Oral Health Initiative, Inc.
The Family Healthcare Foundation
The Good Life Outcomes program, at Change Happens! (Houston, TX)
The Kennedy Forum
The Knights & Orchids Society
The Leadership Conference on Civil and Human Rights
Thrive Allen County
Through the Archway
Union for Reform Judaism
Unitarian Universalist Congregation of Columbia, SC
United Community Services of Johnson County
United for Respect
United Way for Greater Austin
United Way of Greenville County
United Way of Metropolitan Dallas
United Way of Southern Cameron County
United Way of Tarrant County
United Way Suncoast
United Ways of Texas
Universal Health Care Action Network of Ohio
URGE: Unite for Reproductive & Gender Equity
Utah Health Policy Project
Virginia Interfaith Center for Public Policy
Virginia Organizing
VOA Southeast
Wellness Pointe
West Virginians for Affordable Health Care
WestCare Foundation
WH&OM Society
Wisconsin Faith Voices for Justice
Women for Kansas
Women for Progress of MS, Inc.
Women of Purpose Global Ministries
Women's Alliance of SWFL
Wyoming Community Foundation Wyoming Education Association - Retired Wyoming Medical Society
Wyoming Rising
Wyoming Women's Action Network YMCA of Birmingham
Young Invincibles



Additional signatories after letter officially sent on September 17, 2021:

Alabama Poor People's Campaign
Asian Resources, Inc
Children's Action Alliance
Coalicion de Lideres Latinos-CLILA
Coalition for a Strong Tennessee
Disability Rights and Resources
Greater Birmingham Ministries
Houston Area Women's Center
Jacksonville Urban League
Kennedy-Satcher Center for Mental Health Equity
Magnolia Medical Foundation
Mississippi Urban League
Mississippi Votes
North Carolina Council of Churches
Nurture the Next
One Voice, Inc.
Oral Health Progress and Equity Network (OPEN, Inc.)
Palmetto Project
Restaurant Opportunities Center MS
Six Dimensions
The Jolley Foundation, Greenville SC
United Methodist Health Ministry Fund
Youth OUTright WNC

Read our past Letters
  • February 12, 2021
    • Urging Congress to take immediate action to expand healthcare coverage. Southern states are battling COVID-19 on sinking ground.
  • June 24, 2021
    • Urging Congress to pursue a direct coverage option for low-income individuals in non-expansion states in the forthcoming recovery legislation.
  • September 10, 2021
    • Urging Congress to ensure the Build Back Better reconciliation bill includes a coverage gap policy solution that is comprehensive and permanent.
  • September 17, 2021
    • Urging Democratic Senators to prioritize the permanent and comprehensive Medicaid “coverage gap” policy outlined in the House Energy and Commerce Committee reconciliation bill.
  • October 19, 2021
    • Urging Congress to secure progressive investments in Build Back Better legislation to close the federal Medicaid coverage gap.
  • December 21, 2021
    • Urging Congress to work to ensure any final BBB package includes the federal coverage gap fix.
  • May 18, 2022
    • Urging Majority Leader Schumer to close the Medicaid coverage gap as a necessary step for economic and racial justice.
  • May 19, 2022
    • Urging Speaker Pelosi to ensure moves a fix to the Medicaid coverage together with an extension of enhanced APTCs.
Take Action

Contact Your Officials

Our communities have suffered far too long in the coverage gap. They are parents and youth, cooks and teachers, caretakers and essential workers. For too many, this is a matter of life and death. The White House included a coverage gap fix through 2025 in the Build Back Better framework - now we need to raise our voices to ensure the coverage gap fix becomes law. Contact your member of Congress now!


Click below to send a tweet to the President & Congressional leaders demanding that they provide a coverage solution now!