After years of policy discussions and political wrangling, North Carolina is finally expanding Medicaid starting December 1, 2023.

The bipartisan effort will provide upwards of 600,000 people with access to affordable healthcare coverage.

The Affordable Healthcare Coalition of North Carolina scored and supported the expansion legislation.

The effort and work done by lawmakers to bring a fiscally responsible form of Medicaid expansion to the state will be factored into their Affordable Healthcare Scorecard grades at the close of the legislative session.

Starting December 1, individuals making up to 138 percent of the federal poverty level will have access to Medicaid coverage. That is about $18,000 in 2022.

Currently, with few exceptions, Medicaid coverage has only been available to only children, pregnant women, or individuals with disabilities.

At the same time, to qualify for subsidies to help buy health insurance on the marketplace you had to earn at least 100 percent of the federal poverty level. Or roughly $13,500 in 2022.

That means if you made less than $13,500 and did not fall into a category that qualified for Medicaid, you had no affordable options for health insurance.

A study found that in North Carolina, most who fall into the gap are individuals working in difficult, lower paying jobs like hospitality, retail and construction.

“The most common jobs,” the report finds, “for low-wage, uninsured workers in North Carolina are cashiers, cooks, freight and stock laborers, waiters/waitresses, and nursing assistants.

The expansion law fixes this coverage gap.

Closing the gap will benefit both working individuals who need insurance, as well as businesses and consumers who already have it.

That is because insured consumers currently subsidize the uninsured through their premiums each month.

For example, individuals who are currently uninsured still get sick. When they get sick, they go to high-cost settings like the emergency room. They get care they cannot afford. Those costs are passed onto insured individuals through higher healthcare costs. Those higher costs are reflected in their insurance premiums and cost shares.

Now that these previously uninsured individuals will have coverage, the burden on businesses and workers to subsidize uncompensated care will be greatly reduced, and thus will drive down costs.

We commend our legislators for passing a fiscally responsible, consumer friendly form of Medicaid expansion. It will mean better care and lower costs for millions across our state.

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