Rep. Cleaver Co-Introduces Legislation to Empower Local Governments to Overcome Obstruction and Expand Medicaid

Jun 17, 2021
Press Release

(Washington, D.C.) – Today, U.S. Representative Emanuel Cleaver, II (D-MO) joined over 40 Democratic House lawmakers from States which have refused to expand Medicaid coverage to introduce the Cover Outstanding Vulnerable Expansion-Eligible Residents (COVER) Now Act. This landmark legislation would authorize the Centers for Medicare and Medicaid Services (CMS) to work directly with counties, cities, and other political subdivisions to expand Medicaid coverage. For the first time, it would allow local leaders to help their vulnerable residents get insured in States that have refused to accept federal resources for Medicaid expansion.

“Today, I’m proud to stand with my Democratic colleagues and vulnerable Missourians who are sick and tired of political obstructionism standing in the way of access to quality healthcare,” said Congressman Cleaver. “When not even a free and fair election can convince the state legislature to listen to the will of the people of Missouri, it’s become abundantly clear that Congress must fill the void of inaction. The exceptional leadership demonstrated by local leaders throughout the pandemic gives me confidence that they can—and will—accept the federal resources necessary to provide Missouri families with the healthcare they need and deserve.”

“Over four million Americans, primarily from communities of color, remain uninsured due to Republican ideological obstruction and indifference. Our homegrown solution, the COVER Now Act, enables willing local leaders to accept directly federal resources to achieve both the public health and financial benefits of Medicaid expansion,” said Congressman Lloyd Doggett. “For many of our most disadvantaged citizens this bill offers a pathway to access a family physician, necessary medicine, and other essential coverage that thirteen States continue to deny. The COVER Now Act empowers local leaders to assure that the obstructionists at the top can no longer harm the most at-risk living at the bottom.”

The COVER Now Act would:

  • Authorize CMS to contract directly with counties and other political subdivisions to establish demonstration projects expanding Medicaid coverage to their residents;
  • Allow participating entities to receive the same deal previously made available to States—100% federal funding for the first three years and a gradual reduction to 90% federal funding by year seven and thereafter;
  • Allow participating entities to apply individually or jointly if they wish to establish a regional expansion project; • Keep existing Medicaid rules and systems in place for local expansion programs;
  • Require States to cooperate and authorize access to State Medicaid systems for participating entities, with additional federal administrative Medicaid funding for cooperation and subject to federal penalties for non-cooperation; and
  • Should a state expand Medicaid, eligible beneficiaries enrolled in a local expansion program would be automatically enrolled into the State Medicaid program.

Organizations endorsing the COVER Now Act include: Unidos US, American Diabetes Association, National Alliance on Mental Illness, National Multiple Sclerosis Society, CommuniCare Health Centers.


Emanuel Cleaver, II is the U.S. Representative for Missouri's Fifth Congressional District, which includes Kansas City, Independence, Lee's Summit, Raytown, Grandview, Sugar Creek, Blue Springs, Grain Valley, Oak Grove, North Kansas City, Gladstone, Claycomo, and all of Ray, Lafayette, and Saline Counties. He is a member of the exclusive House Financial Services Committee; Chairman of the House Subcommittee on Housing, Community Development, and Insurance; member of the Select Committee on the Modernization of Congress; member of the Committee on Homeland Security; and a Senior Whip of the Democratic Caucus. For more information, please contact Matt Helfant at 202-590-0175 or A high-resolution photo of Congressman Cleaver is available here.