240 advocacy groups from 44 states ask Congress to protect Medicaid maintenance of effort

BOSTON, MA — Today, Community Catalyst and 239 state advocacy organizations from over 40 states (full list here) representing people and communities across the country, including children and families and people with chronic health conditions, called on Congress to maintain a provision of the Families First Coronavirus Response Act that is critical to increasing access to Coronavirus (COVID-19) testing and treatment and to preserving health and economic security for millions  across the country.

In a letter to House and Senate leadership, advocates outlined why Congress should preserve the maintenance-of-effort (MOE) provision that protects people who currently rely on Medicaid coverage from becoming uninsured. This is especially important for expanding testing and treatment, particularly for people of color who are disproportionately and more acutely impacted by COVID-19 disease because of longstanding, unjust barriers to economic security and health. Because of those barriers, people of color are also more likely have Medicaid, a federal-state health insurance program for people and families with low-incomes, as a primary insurer.

The MOE provision in the Families First Act requires states to maintain certain standards of coverage and care for people in order to receive an increase in their federal Medicaid funding (known has the federal medical assistance percentage, or FMAP). This includes maintaining eligibility standards and ensuring coverage of testing and treatment without cost-sharing; a prohibition of premium increases; and coverage for individuals enrolled during the pandemic. Unfortunately, some congressional Republicans sought to strike the MOE in the CARES Act, and some governors will likely push to weaken the requirement in a future COVID-19 response bill. 

The letter to Congress states:

“Medicaid is vital in combating the spread of the virus. It increases access to coverage and care for millions of people and provides a badly needed health care and financial safety net for millions of households when they need it most in the midst of an economic downturn.

“In past recessions, in the absence of maintenance-of-effort rules, states have used eligibility cuts as a way to balance state budgets, causing millions of people—including children—to lose coverage… If the maintenance-of-effort provision is repealed now, the number of low-income Americans cut off Medicaid and cast into the ranks of the uninsured will be devastating—both to our economy and long-term health.

“Undermining coverage and care for one sector of the population inevitably spills over to affect the health care system and the general population more broadly. We all have a stake in maintaining the broadest possible coverage in the midst of this crisis.”

“Protecting the MOE is only part of a larger Medicaid agenda Congress must adopt to preserve health coverage and address the unfolding state fiscal crisis,” said Emily Stewart, Community Catalyst executive director. “We also need to further boost federal Medicaid support to states and make sure it lasts for the duration of the economic downturn, which will extend beyond the state of emergency. And we should ensure that federal help applies to all beneficiaries, not just some.”

In addition, 14 states have still not expanded Medicaid to cover most low-income adults as provided for by the Affordable Care Act. State revenues are going to plummet as the demand for coverage goes up.


“Expanded Medicaid funding does triple duty – it preserves and helps expand access to health care, protects against cuts to other vital state services that would result from declining state revenue, and will help with our economic recovery,” Stewart said.



About Community Catalyst

Community Catalyst is a national, non-profit consumer advocacy organization founded in 1998 with the belief that affordable quality health care should be accessible to everyone. We work in partnership with national, state and local organizations, policymakers and philanthropic foundations to ensure consumer interests are represented wherever important decisions about health and the health system are made: in communities, statehouses and on Capitol Hill. For more information, visit www.communitycatalyst.org. Follow us on Twitter @HealthPolicyHub.