It’s been a long fight, but Medicaid expansion is finally coming to North Carolina, and with it, coverage to as many as 621,000 people across the state. It will be the 40th state (including D.C.) to adopt the expansion under the Affordable Care Act.
Citizen activists, community leaders, hospitals and health care providers have been fighting for this moment for years. Rev. William Barber and dozens of supporters got themselves arrested for it. Gov. Roy Cooper, a Democrat, put his reelection on the line fighting for it.
“An agreement by legislative leaders to expand Medicaid in North Carolina is a monumental step that will save lives and I commend the hard work that got us here,” Gov. Cooper said Thursday. “Since we all agree this is the right thing to do, we should make it effective now to make sure we leverage the money that will save our rural hospitals and invest in mental health. I look forward to reviewing the details of the bill.”
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It will help save rural hospitals, or what’s left of them. North Carolina has lost nearly a dozen rural hospitals since 2006, closures which don’t just deprive residents of vital, local care, but also cause job losses in communities. The loss of those hospitals was halted in the last few years with an influx of federal dollars in response to the COVID-19 pandemic, but saving the remaining facilities has been a key argument for expansion proponents.
The legislation hasn’t been drafted, but there’s agreement between House Speaker Tim Moore and Senate leader Phil Berger was reached as part of budget talks. It was driven in part by the federal changes in Medicaid, phasing out the continuous enrollment provision that’s been in effect throughout the pandemic. States were required to keep people enrolled with the federal government paying more for them.
That funding going away, and the potential loss of coverage for a big chunk of people helped drive the agreement. Even without the pandemic, North Carolina hospitals are providing about $1 billion in uncompensated care every year to uninsured people. Not only will most of that care be covered under Medicaid expansion, the state should see about 40,000 new jobs in health care created.
“This is our state finally investing in the health and well-being of the people of North Carolina, finally,” Dr. Robin Peace, the former president of medical at UNC Health Southeastern in Lumberton told WRAL. “[It’s been] frustrating,” Peace said. “It’s been frustrating because those of us that are in health care, we’ve known all along that Medicaid expansion would help everybody.”
“This funding will help the hospitals to provide that service,” Peace said. “There are hospitals in rural areas that are closing, that they are having to stop certain services because of lack of funding.”
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