The COVER Now Act creates a way for cities and counties to help people get health insurance in states that haven't expanded Medicaid. Here's the situation: under the Affordable Care Act, states were supposed to expand Medicaid to cover more low-income adults, but some states chose not to. This left a gap where certain people earn too much for regular Medicaid but too little to afford private insurance. This bill lets local governments step in and provide health coverage to these people for up to 10 years, or until their state decides to expand Medicaid on its own.

The federal government makes this financially attractive by covering 100% of the costs for the first three years, meaning local governments don't have to pay anything out of pocket initially. After that, the cost-sharing arrangement isn't specified in this summary, but the program can continue for up to a decade. To protect participating cities and counties, the bill prevents states from punishing them—states can't cut their funding, raise their taxes, or prevent doctors and hospitals from participating in the local program. If a state tries these tactics anyway, it faces financial penalties from the federal government.

This bill essentially gives local communities a tool to cover their uninsured residents without waiting for their state government to act, while protecting those communities from state retaliation.

COVER Now Act

Doggett, Lloyd

Cover Outstanding Vulnerable Expansion-eligible Residents Now Act or the COVER Now Act This bill establishes a demonstration program to allow local governments to provide health benefits to the Medicaid expansion population in states that have not expanded Medicaid. Under the program, local governments may provide coverage for individuals who are newly eligible for Medicaid under the Patient Protection and Affordable Care Act (i.e., the Medicaid expansion population) for a maximum of 10 years, or until their respective states expand Medicaid. The bill provides a 100% federal matching rate for the first three years of program participation. The bill prohibits states from taking certain actions against participating localities, such as withholding funding, increasing taxes, or restricting provider participation. States that violate these requirements are subject to certain funding penalties.