Lunch & Learn: Understanding Medicaid Expansion and Transformation in NC
By Srujana Kanchibhotla
In our November 7, 2024, Lunch & Learn: Understanding Medicaid Expansion and Transformation in NC, we were joined by a powerhouse panel featuring Dr. Stephanie Cooper-Lewter, Executive Vice President of the Kate B. Reynolds Charitable Trust; Madison Allen, Senior Program Officer at the Trust; Julie-Ann Taylor, of the Charlotte Center for Legal Advocacy and moderated by Sabrina Clark, member. Together, they explored Medicaid’s transformative role in North Carolina’s healthcare landscape and its far-reaching impact on nonprofits and communities.
Did you know that by May 3, 2024, nearly 450,000 North Carolinians have enrolled in Medicaid since the state expanded the program in December 2023? This is a game-changer, but what does it mean for the people who have gained access and the state as a whole?
Why Medicaid Expansion Matters
Medicaid was established in 1965 as part of the Social Security Act to provide healthcare for low-income individuals. It’s often considered inferior to private insurance, but in reality, Medicaid is often just as good—or better—than private coverage, with much lower out-of-pocket costs. For example, copays are capped at just $4 for many services.
Medicaid is jointly funded by the federal and state governments, with the federal government picking up about seventy-three percent of the costs. A key provision of the Affordable Care Act (ACA) was the expansion of Medicaid to cover individuals up to 138% of the Federal Poverty Line (FPL). However, after the 2012 Supreme Court ruling, it became optional for states to expand Medicaid, which left a coverage gap for many low-income individuals.
Take, for example, a single mother working full-time at $7.25 per hour. She earns $15,000 a year. While that is below the poverty line for a family of two ($20,000), she was not eligible for Medicaid in North Carolina until the expansion. This left her, and many others, without healthcare options.
North Carolina, which became the 40th state to expand Medicaid, has enrolled nearly 500,000 people, with 60 percent being new enrollers. Of these new enrollers, 19-39 year olds make up the largest age group. Now, nineteen percent of North Carolinians are enrolled in Medicaid, a statistic demonstrating just how crucial the expansion is.
The Benefits of Medicaid Expansion
The benefits of expanding Medicaid go far beyond providing coverage for more people. Kate B. Reynolds Charitable Trust has been a strong advocate for these changes, pointing to compelling data on the positive effects of Medicaid access:
– 5x more likely to receive care when needed
– 4x more likely to receive preventative care
– Significantly lower rates of depression
And it is not just individuals who benefit. Expanding Medicaid boosts the economy, creating an estimated 37,000 new jobs and adding nearly $3 billion to state revenue.
The Health Opportunities Pilot: A New Approach to Healthcare
One of the most exciting aspects of North Carolina’s Medicaid expansion is the Health Opportunities Pilots. This innovative program tests a new model of “whole-person care”—using Medicaid dollars to address not just health, but also the social determinants of health like food, housing, transportation, and safety.
After two years, the pilot has already saved $85 per participant and resulted in fewer emergency department visits and hospitalizations. The goal is to eventually roll out these services statewide, though Mecklenburg County is currently not participating in the pilot.
What’s Next?
This discussion left attendees with a clearer understanding of Medicaid’s role in improving health outcomes for families across North Carolina, particularly in rural communities. But there’s still much to be done to raise awareness and ensure nonprofits are fairly compensated for their efforts in delivering these essential services.
The panel also issued a powerful call to action: let’s continue the conversation around Medicaid’s impact, who benefits from it, and how it improves lives. Advocates urged those in positions of influence to keep pushing for progress, ensuring that even more people can access the care they need.
Want to Learn More?
If you missed the session or want to dive deeper into the discussion, watch the full video here. You won’t want to miss the valuable insights shared by these thought leaders.
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About Kate B. Reynolds Charitable Trust
For 75 years, Kate B. Reynolds Charitable Trust has been dedicated to improving the health and quality of life for North Carolinians. Their mission focuses on ensuring equitable access to healthcare and positive health outcomes statewide, with special emphasis on Forsyth County, home to Winston-Salem, the state’s fifth-largest city. The Trust allocates 75% of its resources toward improving health across North Carolina, while 25% is focused on local improvements in Forsyth County.
About the Charlotte Center for Legal Advocacy
The Charlotte Center for Legal Advocacy works tirelessly to ensure access to healthcare and other vital government programs like food stamps for low-income families. Their work is a crucial part of supporting North Carolina’s most vulnerable communities.
