North Carolina has one of the highest uninsured rates in the country. In total, 1.6 million residents lack health insurance.[i] If the state chose to expand Medicaid, over half a million of those people would gain access to health insurance and all of its associated benefits.[ii] In fact, for many of these North Carolinians, expanded Medicaid would be their only health care option.  

With Expansion

  • $27,310: That’s the maximum income for a family of three to quality for expanded Medicaid.  The new Medicaid program would cover North Carolina residents with incomes up to 138 percent of the poverty line. For an adult without children, that’s only $16,104 per year.[iii]
  • 100: The percentage of expansion costs the federal government would pay until 2016. After that, federal funds would decline to 90 percent by 2020 (and stay there).[iv]
  • 25,000: the approximate number of jobs that new federal funds would have generated if North Carolina had expanded Medicaid in January 2014. [v]

So far, Gov. McCrory and the NC General Assembly have chosen not to expand Medicaid (though their resolve may be weakening). Harvard Medical School professors used health and population data to predict North Carolina’s if lawmakers continue to block Medicaid expansion.

Without Expansion

“We predict that many low-income women will forego recommended breast and cervical cancer screening; diabetics will forego medications; and all low-income adults will face a greater likelihood of depression, catastrophic medical expenses, and death.”[vi]

  • 455-1,145: The number of North Carolinians who will die for lack of health insurance.[vii]
  • 4,500: The number of people who will get “catastrophic” medical bills that total more than 30 percent of their income.[viii] Part of Medicaid’s goal is to protect low-income people from expensive medical bills that could further threaten their economic stability.
  • 45,000: The number of residents who will be diagnosed with depression.[ix]
  • 1: The number of rural hospitals that have already closed, citing Medicaid expenses. Rural hospitals tend to have more uninsured patients, and therefore have more outstanding and unpaid medical payments, which translates to less money for operating costs.[x] If this keeps happening, rural residents will have less and less access to even basic health care services.

Simply put, expanding Medicaid would save lives. It would save the state and its residents money. And it would put North Carolina on the path to a healthier future. We can’t afford to keep opting out.

[i] Dickman, Sam; Himmelstein, David; McCormick, Danny; and Woolhandler, Steffie. (January 30 2014). Opting Out of Medicaid Expansion: The Health and Financial Impacts. Health Affairs. Available at

[ii] Families USA. (July 2014). “Medicaid Expansion in North Carolina: Health Insurance for Working Individuals and Families.” Available at

[iv] See note ii.

[v] Ibid.

[vi] See note i.

[vii] Ibid.

[vii] U.S. Department of Health and Human Services. (2013). “2014 Poverty Guidelines.” Available at

[viii] See note i.

[ix] Ibid.

[x] DeLeire, Thomas; Joynt, Karen; and McDonald, Ruth. (2014). “Impact of Insurance Expansion on Hospital Uncompensated Care Costs in 2014.” U.S. Department of Health and Human Services. Available at