NC Rural Center President Patrick Woodie presented to the NC Joint Legislative Committee at the State Legislature on access to healthcare and Medicaid expansion this week, as they discussed the public health insurance program and challenges to building a healthcare workforce.

Woodie discussed the significant insurance coverage gap in rural North Carolina as compared with urban counterparts, stating that rural counties represent 20 of 22 counties in the state with the highest percentage of uninsured constituents.

In states that have yet to expand Medicaid under the Affordable Care Act, many low-income, adult workers fall within the the health insurance coverage gap, as they make too much to qualify for Medicaid (up to 42% of the Federal Poverty Level or FPL), and too little to qualify for subsidies on the marketplace (starting at 100% FPL). Furthermore, these low-income workers cannot afford commercial insurance and do not have the option of employee sponsored insurance. These members of our state’s workforce include agriculture workers, construction workers, childcare workers, cashiers, restaurant workers, and delivery drivers–all essential frontline staff.

In addition to benefiting individuals across the state, such an expansion would also have vast economic, opportunity, and healthcare benefits.

“We believe that Medicaid expansion is the economic solution that our state needs,” said Woodie. “Research projects that Medicaid expansion would create 83,000 jobs in North Carolina and boost local and state tax revenues, with an estimated $168 million estimated state and local tax revenue gained by 2025.”

Closing the coverage gap would serve the state in the following vital ways:

Medicaid expansion funnels money back into local economies because it is an economic solution with a multiplier effect to support the economy by boosting local and state revenue. 

• More money would be funneled into local economies through gross county product and new county tax revenue.

Medicaid expansion creates opportunities for small businesses by reducing prohibitive employee recruitment and retention barriers, furthering business growth and sustaining a healthy workforce. 

• Rural small businesses drive and sustain local economies, but the high costs of health insurance can affect their survival and profitability. 
• Small business owners have identified the need to provide health insurance for themselves, their families and employees as one of their top concerns.

Medicaid expansion supports rural healthcare because it provides support for healthcare in rural areas by injecting funds to retain providers, saving rural hospitals, and recouping previously uncompensated care. 

• It would address the rural hospital closure crisis (North Carolina has lost 11 rural hospitals since 2005, and uncompensated care from uninsured patients is a substantial financial burden on rural hospitals, and hospitals).
• Expansion addresses medical deserts by retaining and supporting the existing workforce.
• Compensating providers through Medicaid expansion strengthens the capacity and stability of our rural health care infrastructure.

“Expanding Medicaid will without a doubt improve the quality of life of rural North Carolinians in the communities that they call home,” said Woodie. “Our state’s rural people are deserving of a life where they can survive and thrive.”