COVER Now Act

Increased Medical Assistance Access: Qualifying political subdivisions can provide medical assistance to individuals in the expansion population (Section 2(a)(1)). This allows people in areas where the state has not expanded Medicaid to receive coverage.

Federal Support for Local Programs: The Secretary provides high federal matching percentages to participating subdivisions, starting at 100 percent for the first three years (Section 2(a)(5)(C)(i)). This helps ensure the programs are funded as they provide coverage to residents.

Inclusion of Rural Areas: The bill provides a higher federal matching percentage for participating political subdivisions that include a rural political subdivision compared to those that do not (Section 2(a)(5)(C)(ii-v)).

Public Input Requirements: To qualify, a political subdivision must undergo a process for public notice and comment, including public hearings, to ensure a meaningful level of public input (Section 2(a)(3)(A)(ii)).

Smooth Transitions for Coverage: If a state decides to provide medical assistance for the expansion population, individuals enrolled in a local demonstration project are automatically enrolled under the state plan (Section 2(a)(4)(C)).

Limited Number of Projects: The Secretary is prohibited from approving more than 100 demonstration projects (Section 2(a)(9)). This means coverage opportunities may be limited regardless of need.

Decreasing Federal Support Over Time: While the federal match starts high, it decreases over the years of the project (Section 2(a)(5)(C)). For example, in the seventh year, the match could drop to 95 percent for those including rural areas or 90 percent for those that do not.

Time-Limited Coverage: The demonstration project is scheduled for seven years or until the state adopts the expansion plan, whichever is shorter (Section 2(a)(4)(A)). This creates a potential end date for the specific local program.