HR608119th CongressWALLET

COVER Now Act

Sponsored By: Representative Doggett

Introduced

Summary

Authorizes local governments to run Medicaid expansion demonstrations so counties, cities, and other political subdivisions in states that have not expanded Medicaid can provide coverage to the expansion population under a time‑limited, federally funded program. The law sets who can apply, how long demonstrations run, minimum coverage standards, funding rules, and limits on state interference.

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  • Residents eligible for the Medicaid expansion can get coverage through a participating political subdivision. Demonstrations last 7 years with up to a 5‑year extension, and enrollees automatically move to the State plan if the state later expands.
  • Local governments may apply alone or in partnerships, must hold public notice and comment, and must provide benefits comparable to essential health benefits. Federal funding uses a special matching schedule that includes 100% federal matching for administrative costs in the first 3 years and a phase down with a 90% match in year 8 and beyond.
  • States face penalties if they block or punish subdivisions, including up to 25% withholding of certain administrative payments. The Secretary may approve up to 100 demonstrations and may not require budget neutrality.

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Bill Overview

Analyzed Economic Effects

3 provisions identified: 3 benefits, 0 costs, 0 mixed.

High federal funding for local Medicaid coverage

If enacted, the federal government would pay 100% of medical costs for the first three years. In year four it would pay 100% if a rural area is included, otherwise 95%. Year five: 95% if rural, otherwise 94%; year six: 94% if rural, otherwise 93%; year seven: 93% if rural, otherwise 90%; year eight and later: 90%. The federal share for admin costs would also rise by 5 percentage points for each 100,000 people enrolled in a quarter. Example: 200,000 enrollees adds 10 percentage points.

Local Medicaid expansion by cities and counties

This bill would let cities or counties in non‑expansion States run their own Medicaid expansion. Eligible low‑income adults could get coverage similar to essential health benefits. Local governments would apply and hold public hearings, and they could partner with nearby areas. Demos could run up to 7 years, with up to 5 more on approval. If the State later expands Medicaid, the State would automatically enroll eligible people on day one. HHS would issue rules within 180 days, allow up to 100 projects, and not require budget neutrality.

Penalties for states that block local coverage

If a State punishes a local area for running a demo, HHS would withhold 25% of the State’s Medicaid admin payments for that time. Banned actions include shifting people off the State plan to the local demo, cutting local funding, raising local taxes because of the demo, blocking participation, or denying access to State Medicaid systems. This would protect local coverage efforts.

Sponsors & CoSponsors

Sponsor

Doggett

TX • D

Cosponsors

  • Bishop

    GA • D

    Sponsored 1/22/2025

  • Casar

    TX • D

    Sponsored 1/22/2025

  • Castor (FL)

    FL • D

    Sponsored 1/22/2025

  • Castro (TX)

    TX • D

    Sponsored 1/22/2025

  • Cohen

    TN • D

    Sponsored 1/22/2025

  • Clyburn

    SC • D

    Sponsored 1/22/2025

  • Cuellar

    TX • D

    Sponsored 1/22/2025

  • Escobar

    TX • D

    Sponsored 1/22/2025

  • Figures

    AL • D

    Sponsored 1/22/2025

  • Fletcher

    TX • D

    Sponsored 1/22/2025

  • Frankel, Lois

    FL • D

    Sponsored 1/22/2025

  • Garcia (TX)

    TX • D

    Sponsored 1/22/2025

  • Green, Al (TX)

    TX • D

    Sponsored 1/22/2025

  • Johnson (GA)

    GA • D

    Sponsored 1/22/2025

  • Johnson (TX)

    TX • D

    Sponsored 1/22/2025

  • McBath

    GA • D

    Sponsored 1/22/2025

  • Cherfilus-McCormick

    FL • D

    Sponsored 1/22/2025

  • Scott, David

    GA • D

    Sponsored 1/22/2025

  • Sewell

    AL • D

    Sponsored 1/22/2025

  • Soto

    FL • D

    Sponsored 1/22/2025

  • Thompson (MS)

    MS • D

    Sponsored 1/22/2025

  • Turner (TX)

    TX • D

    Sponsored 1/22/2025

  • Veasey

    TX • D

    Sponsored 1/22/2025

  • Wasserman Schultz

    FL • D

    Sponsored 1/22/2025

  • Williams (GA)

    GA • D

    Sponsored 1/22/2025

  • Wilson (FL)

    FL • D

    Sponsored 1/22/2025

  • Adams

    NC • D

    Sponsored 1/22/2025

  • Cleaver

    MO • D

    Sponsored 1/22/2025

  • Connolly

    VA • D

    Sponsored 1/22/2025

  • Del. Norton, Eleanor Holmes [D-DC-At Large]

    DC • D

    Sponsored 1/22/2025

  • Raskin

    MD • D

    Sponsored 1/22/2025

  • Crockett

    TX • D

    Sponsored 1/23/2025

  • Frost

    FL • D

    Sponsored 2/4/2025

  • DeSaulnier

    CA • D

    Sponsored 2/4/2025

  • Gonzalez, V.

    TX • D

    Sponsored 7/21/2025

Roll Call Votes

No roll call votes available for this bill.

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