Incentives from American Rescue Plan Embolden Advocates to Continue the Fight for Medicaid Expansion

RALEIGH (March 11, 2021) — Advocates throughout North Carolina celebrate the much-needed incentives from the American Rescue Plan Act as a pivotal breakthrough in the years-long fight to expand Medicaid for 682,000 North Carolinians.

“The incentive to improve health care access by increasing the federal government’s share of the traditional Medicaid program is an amazing deal for North Carolina,” says Hyun Namkoong, Policy Advocate for the North Carolina Justice Center’s Health Advocacy Project. “If the N.C. General Assembly expanded Medicaid, at least $1.7 billion would be drawn down not only to improve access to health care coverage for our residents but also put North Carolina in the best fiscal position possible as we undergo Medicaid transformation.”

Under the American Rescue Plan, once a holdout state expands Medicaid eligibility, a five percent increase in the federal match for the traditional Medicaid program is triggered for two years while the federal match for the expansion population continues to remain at 90 percent in perpetuity.

“The five percent increase in the federal match for traditional Medicaid is not something that North Carolina can afford to walk away from,” says Namkoong. “Medicaid expansion is already a great deal, but these extra dollars make this the best fiscal decision for both the health and wealth of North Carolina.”

State advocates also consider the incentives a huge step in the struggle for health equity and racial justice.

The pandemic has exacted a staggering toll on Black and Latinx residents who are more likely to be uninsured workers on the pandemic’s frontlines and continue to be overrepresented in COVID-19 infections and deaths. An estimated 682,000 North Carolinians would be covered through Medicaid expansion, many of whom are essential workers and people of color.

“I’ve been in the coverage gap for two years and I have several underlying health conditions,” says India from Western North Carolina. “I’ve been facing a pandemic and an economic crisis without any kind of health insurance coverage. I worry about both getting sick and facing medical debt if the state legislature doesn’t expand Medicaid.”

Now that the federal government has substantially enhanced the incentive to expand Medicaid, the decision to accept billions of federal dollars falls to the N.C. General Assembly. Advocates remain hopeful and buoyed by this opportunity to expand health care access.

“North Carolina’s coverage gap isn’t going away unless the N.C. General Assembly does something about it,” says Namkoong. “We hope our state leaders will seize this opportunity to expand Medicaid and provide health care for North Carolinians.”