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N.C. Medicaid reform would benefit nearly half million people

By Susan Fitzgibbon Shumaker & Allen Smart / January 29, 2016

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December 18 marked the one year anniversary of the release of a first-of-its-kind, county-by-county study showing that by 2020 the North Carolina workforce could grow by more than 43,000 jobs, and the state’s economy could gain tens of billions in business revenue if the state expands Medicaid eligibility requirements. The report, a nonpartisan economic analysis—authored by university researchers and funded by Cone Health Foundation and the Kate B. Reynolds Charitable Trust—includes data for all 100 North Carolina counties, and concludes that nearly 500,000 residents would benefit if the state closes the Medicaid coverage gap.

It is important to understand North Carolina’s current Medicaid coverage policy – you must be a low income child, a pregnant woman, an extremely low income parent, a low income senior or a person with a disability to qualify for Medicaid in North Carolina. Who gets left out? Adults who don’t have children, no matter how low their income is. These are people we all know and rely on every day: people working for a living in construction and food service, people taking care of our children. Many North Carolinians in the coverage gap do not get insurance through their jobs and cannot afford insurance on their own. Surprisingly, their incomes are too low to qualify for tax credits through Healthcare.gov and too high to qualify for Medicaid. That’s the coverage gap we need to close for the hard-working people our service-based economy depends on.

We can still close the coverage gap. North Carolina has the opportunity to shape how we take care of our own, through Medicaid reform, passed by state lawmakers in September. The Medicaid Reform mandate passed by the State Legislature puts North Carolina on a tight timeline to customize our plan. The goal is to seek permission from the federal government by June 2016. North Carolina can negotiate with the federal government for a Medicaid waiver that is North Carolina-specific, that closes the coverage gap and takes advantage of $21 billion in federal funds. This does not have to be political. North Carolina can join the 30 other states who have expanded coverage.

The report makes the case that closing the coverage gap could be an important engine for economic growth and job creation across the breadth of North Carolina. Expanding coverage for half a million North Carolinians will enable them to get timely, affordable health care, including preventive and primary care that can help keep them healthy, as well as meet their needs when they are ill or injured.

Our Foundations bear the names of some of the titans of economic development in North Carolina, Reynolds and Cone. These names are synonymous with job creation, leveraging opportunity and caring about the future of North Carolina. Closing the coverage gap for hard-working North Carolinians continues that legacy and fuels economic and employment growth. Let’s make sure our lawmakers understand that economic reality.


Susan Fitzgibbon Shumaker is president of Cone Health Foundation & Allen Smart is interim president/vice president of programs for Kate B. Reynolds Charitable Trust.




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Since 1967, the Carolina Peacemaker has served as North Carolina’s leading news weekly with a national reputation. Founded by Dr. John Kilimanjaro, the newspaper is published by Carolina Newspaper, Inc.

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