Report: Funding Cuts and Red Tape Could Drive Historic Health Coverage Losses

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Civil rights and advocacy organizations call for restructuring Medicaid and the ACA

Leaders say actions to ease enrollment are urgently needed to protect civil rights and health of Americans

WASHINGTON, D.C.—A national coalition of nine leading civil rights and healthcare advocacy groups issued a stern warning that record cuts to public health insurance programs and new bureaucratic barriers to enrollment will likely cause historic coverage losses across the United States for years to come. 

The nine organizations released a report outlining comprehensive recommendations for legislators and federal agencies to safeguard civil rights and the health of the American people. The report, “Seamless, Accountable and Fair: A Civil Rights Agenda for Reconstructing Insurance Affordability Programs,” calls attention to the disproportionate harm that will fall on historically marginalized communities if policymakers do not act. The Congressional Budget Office projects that drastic healthcare cuts under the so-called “One Big Beautiful Bill” Act and the failure to extend Affordable Care Act (ACA) tax credits will cause nearly 15 million people to become uninsured by 2034. The report estimates that 60% of newly uninsured people will come from communities of color. 

While calling for the rescission of recent cuts, the report stresses the need to systematically rebuild Medicaid and the ACA marketplace in order to guarantee coverage to eligible families. The organizations say that current cuts to Medicaid and ACA health coverage are only part of what will drive record coverage losses in future years. They warn of new bureaucratic barriers, like more frequent eligibility checks and work requirements that terminate Medicaid when families don’t meet onerous new paperwork demands.

To bring quality, affordable insurance to everyone in America, without leaving behind people from marginalized communities, the coalition urges three core reforms:

Make healthcare significantly easier for hardworking families to navigate. 

  • Eliminate enrollment paperwork for the vast majority of eligible people by automatically qualifying families for health coverage based on their participation in the Supplemental Nutrition Assistance Program (SNAP) and on information already in their tax returns.
  • Create a single eligibility system in each state that includes all health programs, so families don’t have to go from agency to agency looking for insurance.
  • Fund independent consumer assistance programs to help families navigate healthcare complexities.

Hold public programs accountable to the public.

  • Give health agencies the resources needed to provide good customer service. And then set performance standards that limit coverage denials based on arbitrary, poorly understood, or onerous procedures.
  • When a state Medicaid agency violates federal law, or causes serious and unjustified harm based on race or ethnicity, let injured families go to court to stop the violation. 

Treat all people fairly, regardless of race, ethnicity, or ZIP code.

  • Offer ACA coverage to adults with incomes below the poverty line in states that still refuse to expand Medicaid. That will prevent poor adults from being uninsured simply because of the state where they happen to live.
  • Qualify lawfully present immigrants for health programs, without penalizing them when they seek healthcare for their families.

“As millions of Americans, including Latinos, struggle with high costs, our leaders must reverse recent cuts and then rebuild our health programs to ensure affordable health coverage for all, regardless of race, ethnicity, or ZIP code,” said Janet Murguía, president and CEO of UnidosUS, the nation’s largest Latino civil rights and advocacy organization. “Coverage protects family finances, improves health outcomes and saves lives. And in places where nearly everyone has health coverage, a better-funded provider infrastructure lowers costs while improving healthcare access and quality for the entire community.”

“On issue after issue—healthcare, SNAP, voting rights, and more—the administration and its Congressional allies are aggressively erecting unmanageable administrative barriers to deny over-burdened, under-resourced Americans access to critical programs and protections,” explained Marc Morial, president and CEO of the National Urban League. “When the time comes to restore and rebuild the country’s healthcare programs, an equally aggressive effort to eliminate administrative burdens will be essential to securing healthcare for families from all backgrounds—but it will be especially important to communities of color, which too often bear the greatest burden when essential services are put out of reach.”

“Healthcare coverage disparities have widened dramatically over the past year, leaving our nation’s most vulnerable communities further behind,” said Juliet K. Choi, president and CEO of the Asian & Pacific Islander American Health Forum. “Today, two-thirds of uninsured Americans come from historically underserved communities. Every increase in the coverage gap deepens existing inequities. We must act now to make healthcare more affordable and ensure that every family can access, afford, and navigate the care they need.”

“The attack on healthcare access is also an attack on civil rights,” said Derrick Johnson, president and CEO of the NAACP. “Black Americans are disproportionately harmed when policymakers create barriers that make it harder for eligible families to enroll in or keep health coverage. We have already seen millions lose coverage because of paperwork and bureaucratic obstacles rather than ineligibility. As lawmakers consider the future of our healthcare system, they must reject policies that widen racial disparities and instead build programs that are seamless, accountable, and fair for the communities that have too often been left behind.”

The coalition presenting the recommendations reflects the views of civil rights, healthcare, and consumer advocacy leaders. It includes the Asian & Pacific Islander American Health Forum, NAACP, the National Council of Negro Women, the National Urban League, the Southern Poverty Law Center (SPLC), UnidosUS, the Coalition on Human Needs, Community Catalyst, and Families USA.

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About NAACP

The NAACP advocates, agitates, and litigates for the civil rights due to Black America. Our legacy is built on the foundation of grassroots activism by the biggest civil rights pioneers of the 20th century and is sustained by 21st century activists. From classrooms and courtrooms to city halls and Congress, our network of members across the country works to secure the social and political power that will end race-based discrimination. That work is rooted in racial equity, civic engagement, and supportive policies and institutions for all marginalized people. We are committed to a world without racism where Black people enjoy equitable opportunities in thriving communities. For more information, visit naacp.org. 

NOTE: The Legal Defense Fund – also referred to as the NAACP-LDF – was founded in 1940 as a part of the NAACP, but now operates as a completely separate entity.