After years of inaction from state legislatures, advocacy organizations from the remaining non-expansion states have united to urge Congress to guarantee access to affordable healthcare for over 2 million Americans in the coverage gap.

Over 200 advocacy organizations from the 12 non-expansion states have signed onto a letter pleading Congress to bypass resistant state legislatures and provide coverage during the worst pandemic in modern history.

"State leaders continue to block the path forward for expansion despite additional federal incentives, upholding deeply politicized tensions over the will of their constituents while exacerbating health inequities in our communities," said Hyun Namkoong, policy advocate with the N.C. Justice Center.

The many people living in these states, especially people of color--are being denied the right, benefits, and dignity of healthcare coverage granted to Americans in 38 other states, a right that Congress fully intended when it expanded Medicaid through the Affordable Care Act.

Millions of people have been left uninsured and unprotected during a global pandemic, many of them essential workers. Expansion states have made the greatest progress in narrowing racial gaps in health outcomes. They see fewer maternal deaths for Black and Hispanic women. And in rural communities, expansion has helped sustain struggling hospitals in areas that already experience sparse access to health care facilities.

"Communities in Alabama can wait no longer. Our people need health insurance. Thousands in Alabama continue to put off getting essential screenings for cancer, diabetes, heart disease, and behavioral health care, worrying about whether the next bill will bankrupt them," said Jane Adams, Campaign Director of Alabama Arise.

Even with a plethora of evidence showing the benefits of expansion, as well as billions of dollars in new federal incentives to expand Medicaid included in the American Rescue Plan, 12 states are still refusing to expand coverage.

Without any of the non-expansion states passing legislation to expand Medicaid, advocates in these states are looking to the federal government for solutions on how to extend health insurance coverage to people who need it the most.

"Thousands of Texans in the Medicaid coverage gap have died preventable deaths in just the last few years. And nearly 3 in 4 Texans in the coverage gap today are people of color. This is about racial justice. This is about our lives and our livelihoods. We can't wait any longer," said Dr. Laura Guerra-Cardus, Deputy Director of the Children's Defense Fund - Texas and Campaign Director for the #SickOfItTX campaign.