Medicaid End-of-Year Sign-On Letter

December 6, 2022


The Honorable Nancy Pelosi
Speaker of the House of Representatives
1236 Longworth House Office Building
Washington, DC 20515
The Honorable Charles Schumer
Majority Leader of the Senate
322 Hart Senate Office Building
Washington, DC 20510


Dear Speaker Pelosi and Leader Schumer:

As organizations that believe everyone in our nation deserves health coverage that provides affordable access to high-quality care, we urge Congress to take action to reduce health care costs and improve health care access for low income families before the end of the year. While Congress made an important investment in health coverage for higher income individuals with private insurance through the Inflation Reduction Act, and made short term efforts to bolster the Medicaid program through pandemic relief legislation, additional action is needed in this Congress on permanent health coverage solutions that specifically help our nation’s low income families and advance health equity. Especially as the temporary pandemic era investments in health coverage come closer to ending, there is a clear and urgent need for further action. As Congress develops its end of year spending package, our organizations urge lawmakers to prioritize the following actions to strengthen Medicaid and ensure its ability to meet the needs of our nation’s low income families:

Protect maternal and child health: Our nation urgently needs solutions to address our ongoing maternal mortality crisis while guaranteeing that children will have the health care they need to grow up healthy and strong. Medicaid and CHIP must provide 12 months of continuous postpartum coverage and coverage for low-income children to ensure the stability and health of families across the country. At the same time, the Children’s Health Insurance Program and state options for streamlined enrollment must be made permanent.

Strengthen guardrails for resumption of eligibility redeterminations: When the Public Health Emergency and Maintenance of Effort provisions end, states will resume Medicaid/CHIP redeterminations, and millions of people could unnecessarily lose health coverage they are eligible for simply due to problems with paperwork. Low income families need Congress to implement guardrails that give CMS an unambiguous and highly actionable basis for enforcing state obligations under the ACA to streamline redeterminations, and allow CMS to prevent states from rushing the redeterminations process.

Create sustainable Medicaid financing for U.S. territories: While Congress has provided a much needed patchwork of short-term, enhanced funding solutions for U.S. territories’ Medicaid programs in recent appropriation bills, this critical funding is now set to expire on December 16, 2022. It is time for Congress to create a permanent solution for equitable financing and access to health services for individuals living in U.S. territories.

Enable states to provide coverage to incarcerated individuals prior to their reentry to the community: Passing policy to allow incarcerated individuals to receive services covered by Medicaid 30-days prior to their release from jail or prison would take a necessary and important step toward improving health outcomes, reducing recidivism, preventing overdose deaths, and restoring the federal, state, and local partnership in delivering safety-net benefits.

Establish permanent solutions to allow older adults and people with disabilities to stay at home as they age: The Money Follows the Person (MFP) program and the HCBS Spousal Impoverishment Protections eligibility rule are critical supports to families, allowing hundreds of thousands of people to stay independent or move out of institutional care settings and back into their communities. Without action, both of these provisions will expire at the end of 2023. Making these proven initiatives permanent is long overdue.

We are grateful for everything Congress has done to help millions of struggling families in America obtain high-quality, affordable health care. We urge you to continue this important work by making Medicaid enhancements a central part of forthcoming legislation.




National Organizations

Allies for Independence
America’s Physician Groups (APG)
American Federation of Teachers
Asian & Pacific Islander American Health Forum (APIAHF)
Association for Community Affiliated Plans
Community Catalyst
First Focus Campaign for Children
Medicaid Health Plans of America
National Birth Equity Collaborative
National Education Association
National Hispanic Medical Association
National Immigration Law Center
National Partnership for Women & Families
Prevent Blindness
The Center for Black Health & Equity
Third Way
United States of Care


Please click here to download a copy of the letter.