The medical debt crisis in North Carolina is among the worst in the nation.

Only five states have a higher share of residents with medical debt.

And to make matters worse, the state ranks in the bottom half nationally in terms of policies that protect patients from hospitals and their predatory debt collection practices.

And while medical debt is a serious concern for all North Carolinians, Medicaid expansion would offer some protection for our most vulnerable citizens.

This is something Penny Wingard of Charlotte knows all too well.

After a year of chemotherapy and radiation, she got the news that her breast cancer was in remission.

But the great news came with a devastating catch: she would now be uninsured.

Wingard qualified for Medicaid coverage under a state program that offers insurance to individuals undergoing active breast cancer treatment.

When she went into remission, she lost coverage. That meant all her follow-up appointments, tests, labs, and scans were on her to pay.

On top of it all, her oncologist refused to see her until she paid the bills.

“My hair hadn’t even grown back from chemo,” Wingard told NC Health News, “and I couldn’t see my oncologist.”

Wingard estimates her total medical debt today is over $50,000.

If North Carolina had expanded Medicaid, Wingard would have never lost her coverage when she went into remission and she would not be faced with the overwhelming debt she has today.

“Medicaid expansion would go beyond hospital costs,” National Consumer Law Center Jenifer Bosco to Kaiser. “It would touch all health care costs and pharmacy costs, which really does have the potential to reduce or eliminate a lot of medical debt for the lowest-income people.”

Top leaders in both political parties support expansion.

The House and Senate both passed Medicaid expansion bills.

So, why are people like Wingard still faced with devastating circumstances?

It comes down to money and political power.

North Carolina’s Big Hospital Lobby is fighting against Medicaid expansion legislation because of a provision that would allow for increased competition among healthcare providers in the state.

Increased competition could very well threaten their bottom line.


As sad as it sounds, if hospital systems are intent on protecting profits and opposing expansion, tens of thousands like Penny Wingard will continue to pay the price.

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