Commentary

New federal data: The ACA works, but would work better if NC expanded Medicaid

Today, the U.S. Census Bureau released state-level health insurance data that prove once again that the Affordable Care Act is working. In a year that has been filled with the White House working to sabotage the ACA and the GOP’s efforts to repeal and replace the ACA, lawmakers now have even more evidence that the ACA has led to significant coverage gains across the U.S.

Nationally, the uninsured rate for the entire year of 2016 is 8.8 percent — down from 9.1 percent in 2015. North Carolina has the same downward trend as the uninsured rate dropped from 11.2 in 2015 to 10.4 percent in 2016. When looking at longer trends in health coverage data, we see that since 2013, 5.2 percent more North Carolinians have health insurance coverage. Considering these historic health coverage gains, lawmakers in Washington need to stop reviving “zombie repeal bills”and focus on market stabilization and strengthening the ACA.

While these data from the Census Bureau give us good news, they also highlight how North Carolina lags behind many other states concerning its uninsured rate. That is because state lawmakers have failed to support bills that would increase access to Medicaid. The state-level data show that the uninsured rate for states that expanded Medicaid is 6.5 percent in 2016 compared to 11.7 percent in non-expansion states. Between 2015 and 2016 the decrease in the uninsured rate in expansion states was 0.9 percent compared to 0.7 percent in non-expansion states.

As North Carolina moves forward with its plan to reform Medicaid, expanding access to the program will make the process truly transformative. There are approximately one million people who remain uninsured in the state, approximately half of whom would finally be able to access the care they need if lawmakers moved forward to close the coverage gap. The proposed program design for Medicaid transformation notes a strategy to address the opioid crisis, but considering that 144,000 people with substance use disorders are in the coverage gap, it will only help some North Carolinians. Reports from expansion states like West Virginia and Kentucky prove that expanding Medicaid helps address states’ opioid crisis. Considering that year after year Census data show how the ACA positively impacts North Carolina’s health coverage rate, it is time for the state’s lawmakers in D.C. and Raleigh to work to strengthen the ACA and fully implement the law by closing the coverage gap.

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