12 States Refuse to Expand Medicaid. This Is How It Hurts Latinos.

A new study draws a direct correlation between healthcare inequalities, particularly for Latino families, and the refusal to expand Medicaid in states like North Carolina. (Image via Shutterstock)

By Araceli Cruz

July 7, 2021

Healthcare inequalities in North Carolina’s low-income communities are related to the state’s refusal to expand Medicaid. 

A recent study shows a correlation between the lack of Medicaid expansion and healthcare inequalities in low-income communities, particularly Black and Latino families. 

According to the US Census Bureau on health insurance coverage, at least half of the 1,157,000 remaining uninsured people in North Carolina in 2019 could gain coverage if the General Assembly accepted federal funds to close the Medicaid coverage gap. Out of that group, 51,000 are uninsured Latino children

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More than 3.88 million Latino parents and 1.83 million Latino children do not have health insurance in the US. Expanding Medicaid would help close the coverage gap for uninsured Latino families. However, Republican lawmakers are refusing to support Medicaid expansion. 

12 States Refuse to Expand Medicaid. This Is How It Hurts Latinos.
Graphic by Desirée Tapia for Cardinal & PIne

“We need a bill in our legislature right now that would expand Medicaid coverage,” Vikki Crouse, Project Director of NC KIDS COUNT, said to Cardinal & Pine. “Through the COVID response at the federal level — through the bills that were passed into law to provide relief to families —  those included some big billion-dollar incentives for states that have not expanded Medicaid coverage to do so. So, if we don’t get legislation passed this year we’re also walking away from over a billion dollars in incentives for our state to expand Medicaid.”

Medicaid is a federal and state program that provides healthcare coverage for some people with limited income and resources. But whether someone qualifies for Medicaid varies from state to state.  

For low-income Latino families, applying for any kind of health care plan is challenging because they face language barriers, they might not be able to because of their immigration status, and cost overall is one of the main reasons why they don’t apply for health insurance. Expanding Medicaid would help address those issues. 

Some states have expanded their Medicaid programs to cover all people with household incomes below a certain level. Others haven’t—and no law forces state officials to expand Medicaid to everyone. 

On June 26, the US Supreme Court ruled that the Affordable Care Act would remain intact and save healthcare coverage for millions of Americans. While this may have been a loss for Republicans, they are pushing to have their way by not expanding Medicaid coverage in several states, and that’s because, in 2012, the Supreme Court ruled that Medicaid eligibility would be optional for states. 

President Joe Biden’s way of helping states expand their Medicaid coverage to more low-income people was to include the expansion in his American Rescue Plan (ARP). However, as of now, 12 states are refusing to expand Medicaid. Those states are Alabama, Florida, Georgia, Kansas, Mississippi, North Carolina, North Dakota, South Carolina, South Dakota, Tennessee, Texas, and Wisconsin.

The Annie E. Casey Foundation released a report on June 21 that ranks children’s well-being in each state, from 1 to 50, with 50 being the lowest. The states that ranked the worst for Latino children’s education, health, economic well-being, family and community, and overall well-being are those states that refuse to expand Medicaid. Out of 50, North Carolina ranked at 34

Furthermore, the report shows that the COVID-19 crisis exacerbated the inequality among low-income families, with Black and Latino kids and families grappling the most.  

“In North Carolina, I think our weakness is that we don’t invest what we need to invest into our social safety nets,” Crouse said. “And, so that decline that has been due to budget cuts, loss in revenue due to corporate tax cuts, all of that is funding that is lost that could be going to support these programs and making them better and really that is important right now in this moment because the response to a crisis this big as the one that we’ve seen over the past year has to be at the same level. So we need more funding, more attention to these issues than ever before in order to get us back on track, in order to build back better after this pandemic.”

On June 11, Gov. Roy Cooper signed an Executive Order to extend a variety of measures currently in place to respond to the COVID-19 Pandemic including expanded access to healthcare and Medicaid services. But that order ends on July 30. 

Gov. Cooper has urged for the expansion of Medicaid. 

“We need to expand Medicaid.” Cooper said in Charlotte on June 21 during a ceremony for Centene Corporation, a provider of managed care services for Medicaid. “We need everyone out there talking to legislators about this critical moment in time. It’s really a moral issue for a person to be able to afford to see a doctor, and it’s time for that to happen.”

Some might think that states cannot afford to adopt a Medicaid expansion, but Biden’s new provision under the ARP provides the financial resources that each state needs in order to cover those costs. 

In other words, the funds for each state to cover a Medicaid expansion are already there—Republican lawmakers just need to say yes. 

An initial version of this article had an incorrect byline. It has been corrected to reflect Araceli Cruz is the author.


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