A Prescription for Better Physical and Financial Health: Medicaid Expansion for North Carolina
ASHEVILLE, NC – February 1, 2022. The Republican-dominated North Carolina state legislature has formed a committee to study Medicaid expansion and access to health care as required by the 2022 state budget. Previous budgets had been vetoed by Governor Cooper, a Democrat, because they did not include expanding Medicaid coverage. The Governor signed the 2022 budget because it included a provision to study this issue. It has been estimated that hundreds of thousands of uninsured adults in North Carolina would be able to obtain access to medical care with Medicaid expansion. Medicaid currently covers over 2 million people in the state yet more than 1 million people (12.9% of the population) do not have health insurance including 30 thousand Buncombe County residents. In an interview on December 15, 2021, Governor Cooper said, “I’m still deeply disappointed that we have yet to expand Medicaid, particularly in the middle of a pandemic, particularly when you have more than a million of North Carolinians without health insurance.”
According to a recent University of Michigan study, the benefits of Medicaid expansion are:
- To improve the physical and financial health for low-income persons, including better health, increased life expectancy and lower debt
- To reduce the amount of uncompensated care for hospitals
- To stimulate the economy and create jobs
Medicaid expansion was originally included in the 2012 Affordable Care Act, by relaxing the program requirements defining the ‘very neediest,’ but the Supreme Court ruled that each state had the right to decide upon expansion rather than the federal government. Thirty-eight states and Washington D.C. have expanded Medicaid either through their state legislature or by voter referendum. All 6 voter-referendums have passed including in 3 Republican states. North Carolina is one of twelve non-expansion states. The legislature has resisted any attempt to pass Medicaid expansion, in spite of the strong support by the governor. Many years ago, the North Carolina state legislature had passed a law that does not allow for voter referendums negating any attempts to circumvent the legislature’s anti-expansion position.
This has become a political football with Republicans generally opposed to expansion for fear of rising taxes, increasing the state budget and a bigger government although the state costs for expansion have been shown to be covered by other health programs whose users gain coverage from Medicaid (like correctional health care and community mental health). Congress has voted to defray the cost of Medicaid expansion by 90% for each state although this is time-limited. North Carolina state hospitals and health-care systems have recently agreed to provide $758 million to help cover the state’s 10% share.
Listen to the full Healthy Asheville Report below: