Alabama Lawmakers Propose Bridge to Medicaid Act for Uninsured Residents

Alabama remains one of the ten U.S. states that have not expanded Medicaid under the Affordable Care Act (ACA), resulting in over 100,000 low-income residents being uninsured. Democratic lawmakers in Alabama, including U.S. Representatives Terri Sewell and Shomari Figures, have introduced the Bridge to Medicaid Act to address this coverage gap. The legislation aims to extend health insurance subsidies for individuals who earn between 100% and 138% of the federal poverty level, currently ineligible for Medicaid in non-expansion states, for a three-year period starting in 2026.

The proposed Act would enhance access to ACA premium subsidies and progressively reduce deductibles and cost-sharing for eligible individuals over its duration. It also allows year-round enrollment and increases the federal share of Medicaid spending from 90% to 93% in states with Medicaid expansion. In addition, Sewell and Figures support complementary legislation, the COVER Now Act, which permits local governments in non-expansion states to facilitate coverage for residents who would qualify under Medicaid expansion.

This legislative push comes amid ongoing national debates surrounding Medicaid's future. The Trump administration's tax cut and spending bill proposal includes significant Medicaid funding cuts, new work requirements for certain populations, increased eligibility verification, and restrictions on funding entities providing abortion services. The proposal has drawn scrutiny as it could potentially reduce health insurance coverage for millions.

Alabama's current Medicaid funding is partly supported via provider taxes on hospitals and other health services; the Republican plan includes freezing such provider taxes. The Energy and Commerce Committee, responsible for Medicaid oversight, is scheduled to review the proposed federal legislation.

Alabama's non-expansion status preserves a significant coverage gap, and the Bridge to Medicaid Act seeks to mitigate this by supplementing affordable insurance options, reflecting ongoing federal efforts to address disparities in health coverage resulting from state-level Medicaid policies. The outcome of these legislative actions will have direct implications on health insurance coverage accessibility and costs for low-income populations in states like Alabama.