North Carolina Lawmakers Eye Path to Long-Awaited Medicaid Expansion

Senate Democratic Leader Dan Blue is seen in the Senate chamber in January 2021. Democrats have been pushing Republicans in both chambers to end their blockade of Medicaid expansion for a decade. A new committee signals there is some hope. (AP Photo/Gerry Broome)

By Sarah Ovaska

February 22, 2022

A new state legislative committee is raising hopes that North Carolina could expand healthcare options or its Medicaid program this year.

One in 10 people in North Carolina don’t have health insurance, leaving more than a million people without the means to navigate or prevent a medical emergency. 

But things could change later this year, if the Republican-led state legislature reverses years of refusal and accepts federal dollars to extend Medicaid coverage to an estimated 500,000 to 600,000 people. 

A committee exploring the issue met for the first time last week. 

“We are confident that by working together, we can create a solution that makes sense for our state’s needs and priorities,” said Erica Palmer Smith of Care4Carolina, a large coalition of NC-based hospitals, health provider groups and non-profit groups pushing for expansion. “And we look forward to making 2022 the year we close the coverage gap for all those without an affordable option for health insurance.”

North Carolina is one of 12 states that hasn’t expanded Medicaid to cover adults who can’t afford health insurance on their own. Studies have shown that people in states that have expanded health care coverage are living longer, experiencing fewer bankruptcies, giving birth to healthier babies, and having cancers detected earlier than people in non-expansion states like North Carolina. 

Holding Out On Coverage 

The expanded Medicaid program, a key part of the Affordable Care Act, has been available to states since 2013 with the federal government agreeing to pick up 90% of the price tag.

But lawmakers in control of North Carolina’s state legislature haven’t signed up for the program, even after the Biden administration sweetened the deal with an offer of $1.2 billion to the state if Medicaid were expanded. 

The new committee on health care access and Medicaid expansion met for the first time last week, and will keep meeting throughout the year to see if they can come up with a plan that would pass muster with conservatives who so far haven’t agreed to extend coverage to struggling North Carolinians.

Meanwhile, Democrats in the US Congress continue to push for passage of Biden’s Build Back Better plan, which would offer health coverage to people living in non-expansion states. 


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