Congresswoman Robin L. Kelly (IL-02), Vice-Chair of the House Energy and Commerce Committee and Chair of the Congressional Black Caucus Health Braintrust voted on September 15, 2021, in D.C. to favorably report the Build Back Better Act out of the Energy and Commerce committee. The legislation will soon advance to the House floor for final passage.
“The Build Back Better Act will be one of the most transformative pieces of legislation for Americans in generations, and I am proud to have ensured that this bill will include major steps forward in reducing health inequities,” said Congresswoman Kelly. “For too long, Black Americans, people of color, and low-income individuals have been left behind when it comes to healthcare access, leading to disproportionately higher rates of certain illnesses, maternal mortality, and death. No more. We must pass the Build Back Better Act to bring reliable, affordable healthcare coverage to all Americans regardless of where they live or what they look like.”
Congresswoman Kelly’s leadership on several key health equity provisions were key to their inclusion in the final bill text. Inclusion of the following priorities was based on legislation Congresswoman Kelly authored on Medicaid postpartum coverage, Medicare dental coverage and a solution to close the Medicaid coverage gap.
Extended Medicaid Postpartum Coverage
Rep. Kelly first introduced the MOMMAs Act in the 115th Congress and has continued to reintroduce this and other legislation to extend Medicaid postpartum coverage. The Build Back Better Act provision for extended Medicaid postpartum coverage is based on Rep. Kelly’s MOMMAs Act and builds on the state option for the extension she successfully included as part of the American Rescue Plan. While 25 states have extended Medicaid postpartum coverage through either the American Rescue Plan option or an 1115 waiver, this legislation will ensure that all women, regardless of their zip code, have access to the life-saving maternal health coverage they deserve.
The United States has the highest rate of maternal mortality among developed countries. Mortality rates for Black women are more than three times higher compared to the rate of white women, and women of color also experience more pregnancy complications and risk factors.
One in three maternal deaths and pregnancy-related complications occur between one week and one year of giving birth. The Build Back Better Act will improve maternal health outcomes for vulnerable populations by ensuring that all pregnant Medicaid beneficiaries will keep their health insurance for the first critical year postpartum, while also making significant public health investments to reduce inequities in maternal health outcomes and strengthen the maternal health workforce.
Medicare Dental Coverage
Based on Rep. Kelly’s Medicare Dental Coverage Act, the Build Back Better Act includes dental coverage for seniors using Medicare Part B. The legislation adds new dental benefits to Medicare Part B, including coverage for screening and preventative services, basic and major treatments, and dentures beginning in 2028.
Currently, nearly half of Medicare beneficiaries have no dental coverage. One in five Medicare beneficiaries who used dental services in 2018 spent more than $1,000 out of pocket on dental care, and many went without care due to cost. When oral disease goes untreated, people are at a higher risk for diabetes, stroke, COVID-19, and even death. People of color and low-income individuals are disproportionately impacted by Medicare’s gaps in dental coverage. 68 percent of Black and 61 percent of Latino Medicare beneficiaries did not visit a dentist in the past year compared to white beneficiaries.
Medicaid Coverage Gap Solution
Congresswoman Kelly has recently led the Congressional Black Caucus and Congressional Tri-Caucus in two letters to Congressional leadership and the White House, urging a permanent solution to close the Medicaid coverage gap.
The Build Back Better Act finally closes the Medicaid coverage gap and expands access to low-income individuals regardless of where they live, strengthening the health and financial security of beneficiaries and their communities. By closing the Medicaid coverage gap, the Build Back Better Act will expand coverage to up to 4 million uninsured individuals and finally enable them to enjoy the full benefits of Medicaid expansion.
People of color are overrepresented in the coverage gap. While they comprise 41 percent of the adult, non-elderly population in non-expansion states, they made up 60 percent of people in the coverage gap, including 28 percent who are Latino and 28 percent who are Black. Research shows that expanded Medicaid is associated with greater access to primary, preventative, and specialist care, and significantly decreased emergency room visits.
Medicaid expansion is associated with lower maternal mortality rates among Black women.
It is associated with better health outcomes and increased treatment of cancer. Medicaid expansion has saved thousands of premature deaths annually and saved the lives of at least 19,200 adults between 2014-2017.
Beginning in 2022 through 2024, the legislation expands the Affordable Care Act’s premium tax credits to below 100 percent of the federal poverty line and provides enhanced cost-sharing assistance.
Then beginning in 2025, the bill establishes a federal Medicaid program in the remaining non-expansion states.