Medicaid Expansion Launches in North Carolina
NC will get $1.8B in federal funds and hundreds of thousands of people will be covered, officials say. Will health professionals be able to keep up with demand?
Governor Roy Cooper and North Carolina Department of Health and Human Services Secretary Kody H. Kinsley celebrated the launch of Medicaid expansion on Friday.
The Affordable Care Act’s (ACA) Medicaid expansion now covers nearly all adults with incomes up to 138% of the Federal Poverty Level ($20,120 for an individual in 2023) and provided states with an enhanced federal matching rate (FMAP) for their expansion populations.
To date, 41 states (including DC) have adopted the Medicaid expansion and 10 states have not adopted the expansion. State lawmakers and officials estimate that healthcare coverage will be given to more than 600,000 newly eligible North Carolinians through NC Medicaid. Of those individuals, 300,000 North Carolinians were receiving limited Medicaid family planning benefits and have been automatically enrolled to receive full health care coverage through NC Medicaid beginning Dec. 1.
On March 27, 2023, Governor Cooper signed into law legislation that would direct the state to expand Medicaid but, per the legislation, implementation was contingent upon the enactment of the State Fiscal Year (SFY) 2023-2024 budget by June 30, 2024. On September 22, 2023, the North Carolina General Assembly passed the state budget, and Governor Cooper announced he was directing NCDHHS to begin the process of expanding Medicaid while he allowed the budget to become law without his signature.
“North Carolina projects it will receive almost $1.8 billion in additional federal funding under President Biden's American Rescue Plan (ARP),” Centers for Medicare & Medicaid Services (CMS) said in a release.
"After years of fighting for high-quality health care for every person in our state, today’s launch of Medicaid expansion means more than 600,000 North Carolinians can now access the care they need to stay healthier, treat sickness earlier and have the peace of mind knowing health care is within their reach," said Governor Roy Cooper. “Together with our partners in communities across the state, we will get the word out and help more people sign up for this life-changing care."
Legal and political analysts caution that there is a need for more medical professionals with Medicaid expansion. “There are challenges in the implementation now. One of those is to amp up the number of providers to meet the needs of 600,000 more people. And as you refer to one of the first things that the state has done was to increase reimbursement rates for behavioral health providers to get more providers in the field. It's also going back and reaching the eligible populations technologically and through social media. And it's also dealing with about, I don't know, 30,000 or so people who were cut off Medicaid earlier this year under newer rules. But now that it's expanded as of today, they'll get to come back on and so it's reaching them as well. So there (are) lots of challenges in the implementation, but this is a great thing for the state and people will be saved because of this,” Rick Glazier, a former state legislator and Campbell Law School professor said on PBS State Lines.
“Medicaid expansion doesn't change healthcare itself. It's access to healthcare. It's insurance, it's basically saying 'I've got a piece of paper or an insurance card that gets me healthcare.’ It doesn't mean extra healthcare. And the supply side on healthcare has been the major issue for years and years, not having enough doctors, not having enough nurses,” said Mitch Kokai, Senior Political Analyst at the John Locke Foundation. “Part of that is because of overregulation, things like certificate of need and not allowing nurses to practice to the full extent of their training. That's the type of thing that we're going to have to start addressing now because several hundred thousand more people are going to be saying, ‘Hey, I'm supposed to get healthcare now. Where is it?’ So this is gonna be a major issue.”
“Today is a victory for the 600,000 North Carolinians who have been waiting for health coverage,” said HHS Secretary Xavier Becerra. “Medicaid is a lifeline and ensuring everyone who qualifies for it can access it remains a priority for the Biden-Harris Administration. Every American deserves quality, affordable health care and the peace of mind that comes with knowing one unexpected doctor’s visit won’t throw their life into financial chaos. I want to congratulate North Carolina on joining the ranks of states that are bringing quality health coverage to our neighbors and families. I encourage the remaining 10 states to join us so that every eligible person can get covered.”
“This is a critical milestone for so many people in North Carolina who until now have faced unnecessary barriers to health care,” said CMS Administrator Chiquita Brooks-LaSure. “Expanding Medicaid is a major step forward towards equity in health for all North Carolinians, especially those in underserved communities, as well as helping to support hospitals across the state.”
Medicaid expansion will cover people ages 19 through 64 years with higher incomes, closing the coverage gap for North Carolinians. For example, expansion gives health care coverage to single individuals making under $20,000 a year. Likewise, a family of three earning less than $34,000 combined is now eligible. Medicaid pays for doctor visits, yearly check-ups, emergency care, mental health, and more — at little or no cost to participants, NCDHHS officials said.
However, tens of thousands of NC residents have lost Medicaid coverage since June. Some will have a chance to get it back, NC Newsline reported in October.
"More than 300,000 North Carolinians woke up today with full Medicaid health care coverage," said Health and Human Services Secretary Kody H. Kinsley. "This is a historic moment that will change North Carolina for the better, improving the health of our people and the health of our economy. It is the most significant investment in health care in North Carolina’s history."
NCDHHS launched a portal that includes information on income requirements, flyers with more information, videos on how to apply, and other essential information. More information about NC Medicaid is available in online FAQs. To find out if you’re eligible or to apply for Medicaid, visit Medicaid.nc.gov.
Governor Cooper and Secretary Kinsley marked the start of Medicaid expansion at an enrollment event in Charlotte at the Goodwill Opportunity Campus co-hosted by the NC Navigator Consortium, the Charlotte Community Health Clinic, and the Charlotte Center for Legal Advocacy.
"At the Charlotte Center for Legal Advocacy, we see so many clients who struggle with income stability and housing insecurity, who are then told they make too much to qualify for Medicaid," said CEO Toussaint Romain. "For them, Medicaid expansion is a literal lifeline that ensures they don't have to choose between going to the doctor or putting food on the table."
"This expansion will allow Charlotte Community Health Clinic to serve more people with necessary primary and preventive care," said CEO Carolyn Allison. "Access to healthcare changes lives, and we are thrilled this is finally happening."
"The NC Navigator Consortium has a 10-year track record of helping North Carolinians find quality, affordable health coverage," said Nicholas Riggs, director of the NC Navigator Consortium. "Our Health Insurance Navigators can help anyone understand their Medicaid eligibility, and either apply for Medicaid or enroll in Healthcare.gov Marketplace coverage."
In implementing its Medicaid expansion, North Carolina will be able to offer nearly all adults aged 19 to 64 who make less than $20,120 annually comprehensive health coverage through Medicaid.
HHS strongly urges the 10 remaining states – Alabama, Florida, Georgia, Kansas, Mississippi, South Carolina, Tennessee, Texas, Wisconsin, and Wyoming – to expand Medicaid and deliver essential healthcare coverage for their residents. If all remaining states were to expand their Medicaid programs under the ACA, as many as 3.5 million more uninsured or underinsured individuals could enroll in high-quality, affordable healthcare coverage through Medicaid. Medicaid expansion in these states would have an outsized impact in communities of color, with three in five people who would gain eligibility coming from Black or Hispanic communities, officials said.
Cops & Congress by Annie Dance is a service journalism newsletter, focusing on police, policy, and public records in the Lake Lure, NC area. It is free to read, but it is not free to produce. Please click on the button below to support my work.
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