New report: Expanding Medicaid would be transformative for NC’s uninsured population

RALEIGH (January 29, 2019) – With one of the largest uninsured populations in the country, North Carolina is home to far too many people who lack regular health care access. Adopting Medicaid expansion would be transformative for these individuals and the state’s economy as a whole, according to a new report profiling uninsured North Carolinians from the NC Justice Center.

“By adopting Medicaid expansion, North Carolina can vastly reduce the uninsured population, thereby putting more money into the pockets of North Carolina households and improving health outcomes in our communities,” said Brendan Riley, a policy analyst with the Justice Center’s Health Advocacy Project and author of the report.

North Carolina has the 10th highest uninsured rate in the country, with 10.7 percent of North Carolinians living without insurance. The report uses the Census Bureau’s American Community Survey data to provide an updated profile of the uninsured in North Carolina, including men and women of all ages and backgrounds in all parts of the state.

Many of these individuals work in industries like construction and food service, and for small businesses that don’t offer health coverage to their employees. Hundreds of thousands of these uninsured North Carolinians are stuck in a coverage gap because they don’t qualify for Medicaid under North Carolina’s current eligibility rules, the report said, but they earn too little to qualify for subsidies to afford their own private plan.

Read the full report here.

Uninsured North Carolinians are disproportionately non-elderly adults with low incomes, the report said. The 1,075,983 people uninsured in North Carolina include both employed and self-employed workers, women, non-elderly individuals, and veterans, among many others:

• Over 600,000 employed workers
• 11.5 percent of all adults who worked full-time, year-round
• 14.9 percent of all self-employed workers
• 98,200 non-elderly adults with disabilities
• 15.9 percent of adult women of reproductive age
• 256,000 people with substance use and behavioral health disorders
• 30,000 veterans and 23,000 veteran family members

All in all, the report said, there are 391,635 non-elderly adults below 138 percent of the poverty line—the threshold to which we can expand Medicaid—who went uninsured in 2017. Expanding Medicaid eligibility to 138 percent of the poverty line would allow North Carolina to vastly reduce its uninsured rate.

In an economic landscape in which employers consider health outcomes in their location and expansion decisions, North Carolina’s uninsured rate makes us less competitive, the report said, and limits the ability of the state’s residents to thrive.

“Having health insurance improves the health and economic security of individuals and communities,” Riley said. “When people have coverage, they are more likely to have a source of regular health care, get the quality care they need, and report better health outcomes. When uninsured people gain coverage, they are less likely to face high out-of-pocket costs and less likely to incur medical debt, giving them a better shot at prospering in today’s economy.”