North Carolina’s uninsured rate fell in 2014 thanks to the implementation of federal health reform but data released today show our state is leaving many citizens behind by refusing to expand Medicaid.

The Census Bureau today released the country’s official data on health insurance rates, which shows that 1.27 million North Carolinians lacked health insurance in 2014 compared to 1.5 million uninsured North Carolinians in 2013. Expanding Medicaid would have resulted in a more dramatic drop in the uninsured rate.

We see that many of the states that expanded Medicaid such as West Virginia and Kentucky now have single-digit uninsured rates whereas North Carolina’s uninsured rate was 13 percent in 2014 compared to 15.6 percent in 2013. The Affordable Care Act is working, but it would work better if policymakers stopped blocking coverage for the working poor families who don’t earn enough to buy private insurance and don’t currently qualify for Medicaid.

A study by George Washington University released last year shows that expanding Medicaid in North Carolina would extend coverage to 500,000 more people while creating 43,000 jobs and attracting $21 billion in federal funding over five years.

Nationally, the Census data show that the uninsured rate dropped to 10.4 percent last year, down from 13.3 percent in 2013. These numbers reflect individuals who were uninsured throughout the year. The Affordable Care Act helped more than 8.8 million people gain health insurance coverage.

It’s not too late for North Carolina to catch up with the rest of the nation. The Governor could propose, and the legislature could adopt, a state-specific plan to close the coverage gap at any time.


RWJA new report from Manatt Health Solutions on behalf of the Robert Wood Johnson Foundation finds that states that have tapped federal funds to expand Medicaid are seeing significant financial benefits. By the end of 2015 the savings and revenues across the eight states examined in the report are expected to exceed $1.8 billion.

This is consistent with the county level examination of expansion in North Carolina commissioned by the Cone Health Foundation and the Kate B. Reynolds Charitable Trust. That study, using conservative estimates, found that the savings and revenues more than offset the costs of expansion through 2020.

The states featured in the report — Arkansas, Colorado, Kentucky, Michigan, New Mexico, Oregon, Washington, and West Virginia — had direct budget savings from reduced spending on the uninsured, they experienced increased tax revenue from the new flow of federal funds into the state, and they realized additional savings from switching some existing Medicaid patients into the expansion program.

A source of significant savings, for example, comes from pregnant women. North Carolina has traditionally covered pregnant women in Medicaid up to 185 percent of the federal poverty level. This coverage, however, is only for pregnancy related services. Also, once a woman has the baby she oftentimes loses Medicaid because coverage for parents is quite stingy.

After expansion, pregnant women above 133 percent of federal poverty level would qualify for full Medicaid coverage. And, instead of the lower match rate, the federal government would pay 90 percent of the costs for these women. Once the baby is born many women would then be able to continue coverage through Medicaid. This would result in healthier babies, healthier parents, and major savings for the state.

The report notes that states will also garner savings in behavioral health and among the medically needy population.

States that opted to expand Medicaid early will have the largest benefits, but there are still plenty of positives for states like North Carolina that haven’t hit the leader board yet. The final year for the federal government to pay the full cost of expansion is 2016 so we need to act fast or our people, and our economy, will miss out on a much needed boost.



As the North Carolina NAACP holds a “Denial of Medicaid Funeral Procession” today, it’s worth considering some of the facts and data surrounding the impact of North Carolina’s ongoing refusal to expand Medicaid under the Affordable Care Act:

The North Carolina Institute of Medicine’s 2009 Access to Care study begins with this statement: “The lack of health insurance coverage is the foremost barrier to accessing health care services.”

In the report’s introduction it continues:

In a statewide survey of adults, nearly half of the uninsured in North Carolina reported forgoing necessary care due to cost, compared to 10% of individuals with insurance coverage. Lack of coverage also adversely affects health as the uninsured are less likely to get preventive screenings or ongoing care for chronic conditions. Consequently, the uninsured have a greater likelihood than people with coverage of being diagnosed with severe health conditions (such as late stage cancer), being hospitalized for preventable health problems, or dying prematurely. In fact, adults who lack insurance coverage are 25% more likely to die prematurely than adults with insurance coverage.

A Families USA report in 2010 estimated that before the Affordable Care Act passed nearly 1,000 North Carolinians died each year between 2005 and 2010 due to lack of health insurance.

What has changed is that the states now have an unprecedented tool for saving lives. North Carolina now has the opportunity to extend health insurance coverage to nearly all low-income adults, the majority of whom are working. The federal government will finance nearly the entire cost of this coverage expansion. Not expanding coverage is not only morally misguided but it is also fiscally irresponsible. Read More


Health-Reform-SBIn case you missed it, be sure to check out Sahil Kapur’s article today on Talking Points Memo about the fast-fading attacks on Obamacare and why a political “nightmare” may be coming to pass for the American right. One of Kapur’s key sources: none other than long-time conservative icon William Kristol, who two decades ago led the charge to defeat Bill Clinton’s proposed healthcare overhaul. Back then, Kristol’s chief fear was of what would happen was, effectively, the same thing that is happening now: the establishment of a new law that would fast become an integral part of the middle class safety net and, as such, quickly become politically unassailable.

As the TPM story notes: the massive healthcare industry is adapting, premiums are stabilizing and even Mitch McConnell wants the hundreds of thousands of newly-insured Kentuckians to keep their Obamacare.  In short, Kristol’s fear that “reform would paint Democrats as ‘the generous protector of middle-class interests’ and strike a ‘punishing blow’ to the GOP’s anti-government ideology” appears, by an increasing number of indications, to be coming true.


Winston Churchill famously stated that “Democracy is the worst form of government, except for all the others.” One is increasingly tempted to offer the same assessment of Obamacare.

Is it flawed and messy? Absolutely. Could we call envision a scenario in which each of us — acting as philosopher kings — could craft a better system? Sure.

But when it gets down to the nitty-gritty of making something work in a huge, complex and wildly diverse nation, the following AP story tells you what you need to know about Obamacare on July 24, 2014:

A new study estimates that more than 10 million adults gained health insurance by midyear as the coverage expansion under President Barack Obama’s law took hold in much of the country.

The study published Wednesday in the New England Journal of Medicine found that the share of Americans ages 18 to 64 without insurance dropped by a little more than 5 percentage points.

States that embraced the law’s Medicaid expansion saw significant coverage gains among low-income uninsured people. About half the states have expanded.

The law offers subsidized private insurance for middle-class people who don’t have access through their jobs and expanded Medicaid for low-income adults.

The latest study results are in line with findings by Gallup and with estimates from the Congressional Budget Office.

Read the AP article by clicking here.