What Expanding Medicaid Would Mean for North Carolina

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Expanding Medicaid would ensure access to affordable health insurance coverage for more than 600,000 North Carolinians.

It would also increase access to health care— including mental health and substance use services— across the state, particularly in rural communities.

Below are six reasons why Medicaid expansion would benefit North Carolina:

  1. Medicaid expansion saves lives. Research shows that when states expand Medicaid, it saves lives. A study found that Medicaid expansion was associated with nearly 12 fewer deaths per 100,000 adults each year in expansion states. That is because people with health coverage are more likely to get preventative care, more likely to catch and treat diseases like cancer and heart disease early, and less likely to skip medications because of the cost.
  2. Medicaid expansion increases access to mental health and substance use treatment. About 2 million of North Carolina’s more than 10 million residents will experience a mental illness and substance use disorder, but in 2019 more than 55% of people who needed it did not receive treatment because of cost. The COVID-19 pandemic has exacerbated the mental health crisis in this country. Untreated mental illness can lead to homelessness, involvement in the justice system, and trauma to children. Twenty-seven counties in NC don’t have a psychiatrist.
  3. Medicaid expansion helps working families. Expanding Medicaid in NC would bring affordable health coverage to more than 100,000 low-income parents with children at home, including thousands of parents of children with special needs. Having affordable health insurance helps families be able to go to the doctor, go to the hospital, and get prescription medicine. Research also shows that states that have expanded Medicaid have fewer families declaring bankruptcy because of medical bills.
  4. Medicaid expansion builds a healthier workforce for North Carolina. Access to affordable health care helps more people participate more fully in our labor force. Many small businesses can’t afford to offer health coverage to employees – even in the best of times. Medicaid expansion can build a healthier workforce for businesses like childcare, restaurants, and the service industry by helping more employees have access to affordable health insurance. Medicaid expansion also helps more people with disabilities enter the workforce because without it, many people with disabilities must live in poverty to maintain their Medicaid eligibility.
  5. Protecting more than 14,000 uninsured veterans and their families. Less than half of North Carolina’s veterans receive their health coverage through the Department of Veteran’s Affairs and a portion of those have family members who remain uninsured. Medicaid expansion provides health coverage for more North Carolina veterans who have served to protect our country.
  1. Boosting rural health care, hospitals, and families. Expansion will give hundreds of thousands of people in rural areas access to affordable health insurance, while creating jobs and strengthening the economy in rural communities. The additional funding that flows into rural communities with Medicaid expansion helps to retain providers, keep rural hospitals open, and recouping the previously uncompensated costs to health care providers of providing care for uninsured people.

Visit www.ncdhhs.gov for more information.

Prepared by the NC Department of Health and Human Services.