Archived Opinion

Medicaid expansion would boost WNC economy

Medicaid expansion would boost WNC economy

A strong and healthy economy will benefit everyone in Western North Carolina, which is why we need Medicaid expansion. As both Republicans and Democrats in our General Assembly have acknowledged, going the route of 38 other states would be a tremendous boost in several key ways. Boosts that would almost immediately pay dividends for our families and businesses

North Carolina is now tantalizingly close to approving Medicaid expansion. The N.C. Senate, the N.C. House and our governor agree that it is a good idea. Only the final terms remain to work out. For the sake of our economic well-being, our elected leaders should not wait long to act.  

At issue are the hundreds of thousands of North Carolinians who fall into what’s known as the health insurance coverage gap — folks who earn too much to qualify for Medicaid, but too little to qualify for a subsidy on the health insurance marketplace

Many North Carolinians clock into jobs day after day, but they don’t receive health insurance from their employers. And hundreds of thousands of working North Carolinians still fall below the federal poverty line, which is around $26,000 for a family of four. This means there are thousands of hard-working North Carolinians who cannot access basic health coverage

The Kaiser Family Foundation has estimated that if North Carolina took action to close its coverage gap, more than 600,000 people would gain health insurance and access to proper care. For now, they remain stuck in the gap

Working North Carolinians were top of mind for N.C. Senate President Pro Tem Phil Berger (R-Eden) at a press conference in May during which he endorsed Medicaid expansion. “First,” he said, “we need coverage in North Carolina for the working poor. Second, there is no fiscal risk to the state budget moving forward with this proposal … This is the right time and the right thing to do.”

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Indeed, closing the coverage gap is a good deal for everyone. The direct injection of additional federal spending within the state would, by conservative estimates, be $2.8 billion. These funds would create new jobs in the healthcare, construction, retail trade, administrative support and professional scientific industry sectors. The total number of new employment opportunities in North Carolina is estimated at 37,200. The Mountain West Region would see 558 new jobs

Medicaid expansion will support and stimulate small businesses, many of which can’t afford to offer insurance to employees while in the startup stage. Not being able to offer health insurance limits workforce development opportunities and therefore can cause businesses to fail. Even earlier in the process, some would-be entrepreneurs decide the insurance gap is too great a chasm to overcome and opt not to start a business at all.

In states that have expanded Medicaid, the percentage of small business employees covered by Medicaid increased from 9.1% to 13.4% from 2013 to 2016; the number of self-employed individuals covered rose from 7.3% to 11.6% during the same time

Bigger businesses would also benefit from Medicaid expansion. Among their highest priorities is a healthy workforce. Many North Carolinians live with diabetes, heart disease and other chronic illnesses, but can’t access healthcare providers to manage these conditions. When workers are sick, they can’t be as productive

All of this makes it clear why the boards of six of the seven counties represented by my organization, Mountain West Partnership, have issued resolutions supporting Medicaid expansion. And why our state’s major metro chambers — including Asheville, Charlotte, Durham, Raleigh, Winston-Salem and Wilmington — are also advocating for the policy.

Former N.C. Secretary of Commerce Sharon Decker (who served in a Republican administration) wrote of Medicaid expansion, “North Carolina cannot afford to be left behind as the rest of the country guns its economic engines.” 

Instead, let’s rev up North Carolina’s motor. Let’s improve everyone’s life and prospects in our region. Let’s close the coverage gap

(Josh Carpenter is director of Mountain West Partnership. The partnership is an organization of seven western counties that seeks to increase the economic well-being of the people who call Cherokee, Clay, Graham, Macon, Jackson, Swain, and Haywood counties home.)

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4 comments

  • How will you pay for it? Steal more from working families that are already having trouble making ends meet? People like Carpenter don't consider such things, and government budgets can not simply keep rising without limit as they have done during my lifetime.

    posted by Quartermaster

    Tuesday, 10/25/2022

  • "At issue are the hundreds of thousands of North Carolinians who fall into what’s known as the health insurance coverage gap — folks who earn too much to qualify for Medicaid, but too little to qualify for a subsidy on the health insurance marketplace."

    Wrong. The author doesn't get it. It's worse than that.

    This part is right: you can earn too little to qualify for Marketplace subsidy. Yes, you can be too poor to get a subsidy. Crazy, but correct.

    This part is wrong: you don't get Medicaid because you "earn too much." In states like North Carolina, which has not (yet) expanded Medicaid, you can earn ZERO and still not qualify for Medicaid. In these states, to get Medicaid, you have to BOTH be very poor, AND have some other special status--disabled, or custodial parent of minor children, etc. If you are a childless, non-disabled adult, you don't get Medicaid, NO MATTER HOW LITTLE YOUR INCOME IS.

    This is why Medicaid expansion is such a big deal.

    posted by Michel Phillips

    Wednesday, 10/19/2022

  • "At issue are the hundreds of thousands of North Carolinians who fall into what’s known as the health insurance coverage gap — folks who earn too much to qualify for Medicaid, but too little to qualify for a subsidy on the health insurance marketplace."

    Wrong. The author doesn't get it. It's worse than that.

    This part is right: you can earn too little to qualify for Marketplace subsidy. Yes, you can be too poor to get a subsidy. Crazy, but correct.

    This part is wrong: you don't get Medicaid because you "earn too much." In states like North Carolina, which has not (yet) expanded Medicaid, you can earn ZERO and still not qualify for Medicaid. In these states, to get Medicaid, you have to BOTH be very poor, AND have some other special status--disabled, or custodial parent of minor children, etc. If you are a childless, non-disabled adult, you don't get Medicaid, NO MATTER HOW LITTLE YOUR INCOME IS.

    This is why Medicaid expansion is such a big deal.

    posted by Michel Phillips

    Wednesday, 10/19/2022

  • Hospital greed is blocking Medicaid expansion, something you conveniently fail to mention.

    posted by Aaron

    Wednesday, 10/19/2022

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