Cost-share chart To incentivize holdout states to expand Medicaid, starting in 2023 the plan would permanently cut billions in special federal Medicaid funding to the non-expansion states.

At least 2.2 million low-income adults — nearly all in Texas and the Southeast — would be eligible for government-funded health insurance under the Democrats’ $1.75 trillion social spending and climate change plan.That’s the number of people who are eligible for Medicaid under the Affordable Care Act but have been left uninsured because they live in one of the dozen states that have not expanded coverage under the 2010 law. They are in the coverage gap — with incomes too high to qualify for Medicaid, but below the $12,880 annual federal income minimum for an individual to qualify for subsidized coverage in the insurance marketplaces created by the ACA.

An estimated 60% of those caught in that Medicaid coverage gap are Black or Hispanic, according to the Center on Budget and Policy Priorities. And nearly two-thirds of those in the gap live in one of three Republican-controlled states: Texas (771,000), Florida (415,000) and Georgia (269,000), according to a KFF analysis.

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