North Carolina Medicaid expansion makes nearly 600K now eligible for coverage

Hundreds of thousands of people in North Carolina are eligible for Medicaid benefits beginning Friday, almost a decade after ObamaCare let states expand eligibility. 

Advocates say North Carolina’s expansion will give much-needed aid to adults who previously earned too much to be eligible for Medicaid but not enough to benefit from federal subsidies to help them afford private health insurance.  

Medicaid coverage includes doctor visits, check-ups, emergency care, hospital services, maternity and postpartum care, vision and hearing services, prescription drugs, behavioral health, preventive and wellness services, dental care and more. There is no monthly fee, and copays are never more than $4.

According to state and federal estimates, nearly 600,000 North Carolinians will be eligible for Medicaid on Friday, and about half will automatically be enrolled in coverage.  

Expansion marks the culmination of a long-fought campaign from Gov. Roy Cooper (D), who has been pushing for it since he was elected in 2017. 

“Medicaid Expansion is the working families bill of the decade for North Carolina, and its impact on peoples’ health, combating the opioid crisis, saving rural hospitals and boosting our economy will be life-changing for families in our state,” Cooper said in a statement.  

North Carolina Republicans refused for more than 10 years to accept federal funding to help expand coverage to low-income people. Under ObamaCare, the federal government will pay 90 percent of the costs of expansion.  

North Carolina is also taking advantage of a provision in the 2021 American Rescue Plan that gives an additional 5 percent “bonus” to previous holdout states to help offset the first two years of expansion. In North Carolina, that amounts to almost $1.8 billion. 

There are now only 10 holdout states remaining, and all are led by either a Republican governor, a GOP-majority legislature or both.

Single adults aged 19-64 who earn up to $20,120 per year are now eligible, and a family of three who earns a little more than $34,300 is now eligible.  

Previously, Medicaid covered parents earning only about $8,000 per year combined for a family of three. Childless adults had no coverage.

The Affordable Care Act made it mandatory for states to expand Medicaid for everyone earning up to 138 percent of the poverty level. Because the law did not envision it becoming optional, there is no mechanism to make subsidies available for people earning below the poverty level in states that refuse expansion funds. 

In a statement, President Biden praised Cooper’s efforts and knocked Republican efforts to repeal the law. 

“Every American deserves high-quality affordable health care. Today, we are one step closer towards meeting that promise, as 600,000 North Carolinians can now access the affordable, quality coverage they need under Medicaid,” Biden said.   

Biden and his campaign have spent the week hammering former President Trump, the front-runner for the 2024 Republican presidential nomination, over his recent comments in which he said he would push to get rid of ObamaCare if he is reelected.