Several studies by the National Institute of Medicine conclude that a lack of insurance is hazardous to individual and community health. The Patient Protection and Affordable Care Act, signed into law in 2010, has led to historic gains in health insurance coverage. A robust enrollment effort in North Carolina helped reduce the uninsured rate The number of people with health coverage increased by 17 percent from 2010 to 2019. However, North Carolina’s uninsured rate of 11.3 percent in 2019 was still well above the national rate of 9.2 percent due to the failure to expand Medicaid in the state. There is more work to be done to expand access to health services for the more than one million North Carolinians who remain uninsured.

The most important step for reducing the uninsured rate in North Carolina is expanding Medicaid eligibility. The Affordable Care Act incentivizes states to extend Medicaid coverage to residents with low incomes who do not qualify for traditional Medicaid or subsidies to purchase private health insurance. The federal government covers most of the costs for these new Medicaid enrollees. Studies show that expanding Medicaid will create new private sector jobs, bolster rural hospitals, and increase access to health care for the financial disadvantaged.

The Trust is interested in efforts to educate the public about the opportunity to close the Medicaid coverage gap. We will support campaigns to educate people who would benefit most from expansion, as well as key stakeholders such as providers, first responders, and local business leaders.