top of page

Petition for Expanded Medicaid in North Carolina


by Marty O’Neill

The North Carolina Justice Center is seeking your support for a petition it has prepared supporting the expansion of Medicaid in the state.

North Carolina is one of only 11 states that have not approved expanded Medicaid. The Republican-led General Assembly has rejected federal dollars to provide expanded Medicaid for the last five years. (In 2022 the Federal Government will pay 90% of the funding.)

Governor Cooper took office in January 2017 and began working to expand Medicaid. Because of the resistance from Republicans in the General Assembly over Medicaid expansion, Governor Cooper did not approve a state budget until the 2022 state budget. In late 2021, the governor signed a state budget, which called for a joint legislative committee to study Medicaid Expansion and make recommendations for legislation. On a hopeful note, last year the Republicans and Democrats in Virginia came together to accept Expanded Medicaid.

It is estimated that between 400,000 and 600,000 uninsured non-elderly residents of North Carolina would become eligible for Medicaid coverage under expansion. Because the Affordable Care Act anticipated states would make Medicaid available for all low-income residents nationwide, the subsidies to purchase private plans in the exchange were not designed to apply to people living below the poverty level. (The Affordable Care Act called for Medicaid expansion in all states covering legal residents with incomes up to 133% of the poverty rate.)

However, in 2012, the U.S. Supreme Court ruled states could not be penalized if they didn’t expand Medicaid. As a result, hundreds of thousands of North Carolina residents who live in poverty are in the coverage gap, unable to afford private health insurance and ineligible for Medicaid because it hasn’t been expanded.

Governor Cooper and Medicaid expansion advocates have long noted the state is missing out on billions of federal dollars by rejecting Medicaid expansion. Tax dollars from North Carolina are being used to pay for Medicaid expansion in other states. North Carolina hospitals provide about $1 billion dollars in uncompensated care each year — a figure that would decline sharply if Medicaid were expanded and those patients had Medicaid coverage instead of being uninsured.

According to the North Carolina Justice Center, expanded Medicaid would:

  • Provide coverage to people who form the backbone of our economy and need access to care and services.

  • Help people get the medication and treatment they need, especially for substance use disorders such as drug addiction and chronic conditions like diabetes.

  • Inject our tax dollars back into the state to provide more coverage for more people and allow state dollars currently spent on care to be redirected to other priorities.

  • Protect families from medical debt and bankruptcy.

  • Help rural hospitals that are struggling to keep up with providing care for uninsured people.

  • Create jobs and stimulate economic activity, especially in the health care industry.

The North Carolina Justice Center has prepared a petition on its website for the expansion of Medicaid in our state. If you’re interested in Medicaid expansion, sign the petition. Go to the Justice Center’s website. On the search bar at the top of the page, enter “Medicaid Expansion petition.”


bottom of page