NC Budget and Tax Center, public health

Virginia votes to expand Medicaid for some. We can do better.

Last week, North Carolina’s northern neighbor, Virginia, voted to expand Medicaid coverage to 400,000 low-income residents, making it the 34th state to do so since the passage of the Affordable Care Act in 2010. If North Carolina wants to compete with our southern neighbors, as we so often hear in policy debates, now is the time for policymakers to move ahead with closing our state’s coverage gap.

They should do so for everyone, demonstrating their leadership by passing a more comprehensive coverage plan that doesn’t include red tape or exclusions.

Virginia’s state legislature voted to extend coverage to many uninsured Virginians. However, the inclusion of requirements that those eligible work a minimum number of hours each month will limit coverage for an estimated 50,000 individuals who would otherwise be eligible for coverage. It is a move that doesn’t acknowledge current labor market realities and is likely to cost the state more to implement. So-called “work requirements” create significant administrative burden for states, and will cost Virginia approximately $1.2 million in the next two years alone.

Furthermore, work requirements do not address the root causes of poverty, and they generally exacerbate the problem. Data show that almost all adult Medicaid recipients who do not work either have a disability, serve as a caretaker to family, attend school, are retired, or could not find work. These requirements hurt most enrollees, including the most vulnerable, such as children, adults with disabilities and those with substance use disorders, as enrollees wrestle with complex administrative requirements for reporting and documenting their work hours each month.

Let Virginia’s restricted expansion of health coverage be a signal for North Carolina lawmakers to enact better, evidence-based legislation that demonstrates their commitment to promote the health and well-being of all in our state.

Suzy Khachaturyan is an MSW/MPH intern with the Budget & Tax Center, a project of the North Carolina Justice Center. 

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