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

Dear President Biden, Speaker Pelosi, Majority Leader Schumer, Chairman Pallone, Chairman Wyden, and Members of the United States House of Representatives and United States Senate:

We, the Southerners for Medicaid Expansion Coalition, urge Congress and the Biden Administration to take immediate action to expand healthcare coverage to nearly seven million people across the South.

The undersigned organizations lead Medicaid expansion efforts across Alabama, Florida, Georgia, Mississippi, North Carolina, South Carolina, Tennessee, and Texas.

There has never been a more dire time for your leadership on healthcare expansion. Southern states are battling COVID-19 on sinking ground. Thousands have died prematurely. Our uninsured rates remain the highest in the nation. Our residents face overwhelming rates of poverty, chronic illness, and racial health inequities. Representing about 56% of uninsured in the Medicaid expansion group, Black and Latino Southerners continue to be locked out of preventive care, mental health services, and chronic care management. These intertwined, long-standing inequities have led to devastating losses in our Black, Latino, and immigrant communities during the ongoing pandemic.

With our shared commitment to racial justice, healthcare expansion, and a strategic, equitable COVID-19 response, we request immediate action on the following priorities:

  1. Enact fiscal incentives for holdout states to expand Medicaid. This may include offering 100% FMAP for three years for the Medicaid expansion population and/or increased FMAP for traditional Medicaid to new states that expand. We recognize the leadership of 39 expansion states including D.C., and support additional federal incentives for them, including states that recently took up expansion. Still, we must emphasize that millions of Southerners may continue to suffer without federal action.
  2. Leverage the 1115 waiver process to foster coverage expansion and meet critical health system needs. We support the Biden administration’s recent Executive Order and further efforts to (a) re-examine Medicaid policies that undermine coverage, (b) revisit last-minute waivers approved by the Trump administration, and (c) revoke waivers that radically alter Medicaid’s financing structure (e.g. block grants) or eligibility criteria (e.g. work requirements). In future negotiations, we urge that all waivers designed to finance uncompensated care pools in non-expansion states also include strong stipulations to also expand coverage to adults made eligible for Medicaid under the ACA.

In addition to these pressing items, we see great need in our states for reforms that include fixing the family glitch, ensuring continuous eligibility for children on Medicaid, extending postpartum Medicaid eligibility to 12 months after the last day of pregnancy, boosting outreach funding for ACA marketplace, Medicaid, and CHIP enrollment, and dismantling recent public charge regulations that intimidate eligible residents from enrolling.

It’s no coincidence that the majority of holdout states are in the South, and that a majority of our residents in the Medicaid expansion group are Black and Latino. Our fight for healthcare is a fight for race equity. Our coalition applauds your commitment to both, and we urge you to help us tackle the unique challenges our states face.

We stand ready to work with you to ensure all Americans have access to affordable, quality healthcare, and would be eager to meet to continue this discussion.


A VOICE for the Reduction of Poverty
AAUW of Georgia
AAUW Talladega County Branch
AAUW Raleigh-Wake Co. Branch
Action NC
AIDS Alabama
Alabama Arise
Alabama Coalition for Immigrant Justice
Alabama Institute for Social Justice
Alabama Solutions, a grassroots movement
Allergy & Asthma Network
American Association of University Women- North Carolina
American Diabetes Association
Asheville NOW
Association of Mexicans in North Carolina, Inc. (AMEXCAN)
Birmingham Islamic Society
Cape Fear Indivisible
Carolina Jews for Justice
Catalyst Miami
Center for Civic and Public Policy Improvement 
Center for Pan Asian Community Services (CPACS)
Chapel Hill NOW
Charlotte Center for Legal Advocacy
Children’s Defense Fund Southern Regional Office
Children’s Defense Fund - Texas
Southern Rural Black Women’s Initiative
Church Women United
Church Women United Chapel-Carrboro Unit, North Carolina
Church Women United North Carolina
Circular Congregational Church, UCC, Charleston SC
Claiborne County Board of Supervisors
Coalition for Health Care of NC
Coalition of Texans with Disabilities
Community Enabler
Community Foundation of Northeast Alabama
Community Health Choice
Community Health & Wellness Center, Inc. Mississippi
Converge: Partners in Access
Cover Alabama
Dallas Chapter, Texas Alliance for Retired Americans
Dependable Source Corp Center for Community & Workforce Development
Disability Rights & Resources
Doctors for America
Down Home North Carolina
Durham NC NOW—Pauli Murray Chapter
East Lake United Methodist Church
East Texas Human Needs Network
Emancipate NC
Epilepsy Foundation Alabama
Epilepsy Foundation Mississippi
Equality North Carolina
Etowah Democrat Club
Every Texan
Farmworker Association of Florida
Farmworker’s Self-Help
First Presbyterian Church of Auburn, Alabama
Florida Health Justice Project
Florida People’s Advocacy Center
Florida Policy Institute
Florida Voices for Health
Fresh Start Global Outreach Ministries, Georgia
Fresh Start Apostolic Fellowship, Georgia
GASP- Georgians Against Smoking Pollution
Greater Birmingham Ministries
Georgia Advancing Communities Together, Inc.
Georgia AFL-CIO
Georgia Budget and Policy Institute
Georgia Equality
Georgia Interfaith Public Policy Center

Georgians for a Healthy Future
Greene County Human Rights Commission
Health Care for All NC
Health Care for All UNC
Health Care Justice – NC
Healthy and Free Tennessee
Henry Brewster, LLC
Hispanic Interest Coalition of Alabama
Historic Mound Bayou Foundation
Hope Community
Houston Women March On
Indivisible Asheville WNC
Indivisible Georgia Coalition
Indivisible Guilford County
Interfaith Children’s Movement
International Children March
Jewish Community Relations Council
Jewish Democratic Women’s Salon
La Union del Pueblo Entero-LUPE
Latham United Methodist Church
League of Women Voters Lower Cape Fear
League of Women Voters of Alabama
Mayor Willie White
Medical Advocacy & Outreach
Mental Health America of Greater Dallas
Miami Workers Center
Mississippi Center for Justice
Mississippi Human Services Coalition
Mississippi Low Income Child Care Initiative
Mississippi Regional Housing Authority V1
Montevallo Progressive Alliance
Moore Community House
Mound Bayou Area Human Rights Commission
Mississippi AFL-CIO
Mississippi Black Women’s Roundtable
My Style Matters, Inc.
NAACP Cookeville/Putnam Tennessee
NARAL Pro-Choice North Carolina
Nashville Jewish Social Justice Roundtable
National Black Worker Center
National Association of Pediatric Nurse Practitioners, Georgia Chapter
National Association of Social Workers- Texas Chapter
National Association of Social Workers- North Carolina Chapter
National Association of Social Workers- Mississippi Chapter
National MS Society
NC Climate Justice Collective
NC MomsRising
NC National Organization for Women
NC Poor People’s Campaign
North Alabama Presbytery Peacemaking Committee
North Carolina AIDS Action Network
North Carolina Asian Americans Together
North Carolina Council of Churches
North Carolina Harm Reduction Coalition
North Carolina Justice Center
North Florida Educational Development Corporation
Old North State Medical Foundation
One Health Literacy Organization
Open Table UCC
Pediatrics Plus
Planned Parenthood South Atlantic
Planned Parenthood Southeast
Protect Each Other NC
Protect Our Care Georgia
Raleigh NOW
Raleigh- Wake Church Women United

SC Appleseed Legal Justice Center
Service Employees International Union- Texas
South Carolina Small Business Chamber of Commerce
South Carolina State Conference of the NAACP
Southern Christian Coalition
Southern Echo Inc.
Southern Economic Advancement Project (SEAP)
Southern Rural Black Women’s Initiative
Southerners On New Ground
Southwest Georgia Project
Southwest Georgia Project for Community Education, Inc.
SPLC Action Fund
Tennessee Disability Coalition
Tennessee Health Care Campaign
Tennessee Hemophilia & Bleeding Disorders Foundation
Tennessee Justice Center
Tennessee Mental Health Consumers Association
Tennessee Valley Progressive Alliance
Texas Alliance for Retired Americans
Texas Alliance for Retired Americans, Austin Chapter
Texas Equal Access Fund
Texas Organizing Project
Texas Parent to Parent
The Afiya Center
The Center for Education Innovation
The Charleston Area Justice Ministry
The Common Ground Project
The E.WE Foundation
The Equity Alliance
The United Church of Cookeville
The Vestry Board of the Unitarian Church in Charleston
The Women’s Fund of Greater Birmingham
TN United Methodist Conference Board of Church & Society
Unitarian Universalist Church of Birmingham
United Ways of Tennessee
United Way of Tarrant County
VOA Southeast, Inc.
Western North Carolina AIDS Project
Women for Progress of MS, Inc.
Women’s March Florida
Women of Purpose Global Ministries
Working America
Young Invincibles
YWCA Central Alabama
YWCA Nashville & Middle Tennessee


Meaningful incentives for Southern states to #ExpandMedicaid are currently being considered in both chambers of Congress. 

We know Medicaid expansion is already a great deal for the South. New legislation will bring even more money into our states, helping us recover in a time of economic recession. 

Join our #South4MedEx tweetstorm

Please use the hashtag #South4MedEx and join us in amplifying the message: America can’t recover if the South isn’t covered.  

Our next tweetstorm will be Wednesday, February 17 at 2 p.m. ET, 3 p.m. CT. 

[CLICK HERE for Sample tweets]
Take Action

Sign our Petition

Join Southerners from Alabama, Florida, Georgia, Mississippi, North Carolina, Tennessee, Texas and South Carolina who are uniting to expand Medicaid for our essential workers, our communities of color and our uninsured families and children!