NC Budget and Tax Center, Trump Administration

Coverage losses, cost shifts to North Carolina could result from US House vote today on health care coverage

The U.S. House of Representatives is set to vote on the American Health Care Act today which seeks to strip the health care coverage extended to millions of Americans in recent years, shift the cost of health care onto middle and low income consumers and give the wealthiest taxpayers a tax cut.

It has been called by many the greatest redistribution upward in memory.

It is also a cost shift onto states.  North Carolina policymakers would have to find an estimated $6.6 billion over 10 years to maintain the Medicaid program alone.  To do so, state policymakers will have to raise taxes or cut services or cut off people from health care or cut payments to providers.  At a time when North Carolina’s leaders are contemplating their existing spending priorities with a tax code that continues to fall short of the needs, finding an additional $6.6 billion over ten years will be impossible without many of these steps.

The proposed restructuring of Medicaid represents unnecessary changes to a program that serves the state’s most vulnerable residents efficiently and with the goal of improving health outcomes of all North Carolinians.  This is a retreat by the federal government that will leave state policymakers responsible for the rationing of care and fallout from the health care industry.

Over time, as my colleague Luis Toledo detailed in recent analysis, these pressures on state government will grow.  The adjustment of the amount that the federal government will provide to North Carolina is not sufficient to keep up with the cost of services nor will it allow the state to contend with the next public health crisis or emerging treatments for existing diseases.

The loss of health care coverage through the dismantling of the Affordable Care Act and the restructuring of Medicaid will ripple through North Carolina, impacting families, health care providers and, yes, the economy.

Check Also

Early childhood educators in NC struggle to make ends meet, afford their own children’s early education

One issue central to ensuring the quality of ...

Top Stories from NCPW

  • News
  • Commentary

With just a few hours left until the crossover deadline, the state of North Carolina’s environment i [...]

On Monday morning, there was only one way left to save the Court of Appeals and a few hours with whi [...]

The political compromise that repealed HB2 was enough for the NCAA and ACC, both of which have retur [...]

Conference comes a day after new report lauds benefits of same-day registration The new line-up for [...]

How many times do we have to say it? Well, it’s worth repeating – especially in the aftermath of rec [...]

As the national pundits weigh in on President Trump’s first 100 days in office and the General Assem [...]

How the General Assembly is spending “crossover week” and what it ought to be doing The last week of [...]

To casual observers, the recent controversy surrounding public school class-size mandates in grades [...]

Featured | Special Projects

Trump + North Carolina
In dozens of vitally important areas, policy decisions of the Trump administration are dramatically affecting and altering the lives of North Carolinians. This growing collection of stories summarizes and critiques many of the most important decisions and their impacts.
Read more


HB2 - The continuing controversy
Policy Watch’s comprehensive coverage of North Carolina’s sweeping anti-LGBT law.
Read more