How to Build an Economy that Works for All: Close the Gap

By Ciara Zachary
Policy Analyst, Health Advocacy Project
November 2016

The How to Build an Economy that Works for All series aims to establish policy priorities and proposals that policymakers can advance and North Carolinians can support throughout the election season and the start of the legislative session in January.

There are 20 million individuals across the United States who gained health coverage due to the success of the Affordable Care Act, our current law. There are many unknowns when it comes to the future of the ACA given the outcome of the recent presidential election—it is unclear yet how individuals’ coverage will be affected or whether lawmakers will repeal parts of or replace the law entirely. This makes it doubly uncertain how the coverage gap will be addressed, given how difficult it will be to close the Medicaid gap if there are varying opinions on how to proceed with the current law.

However, 31 states, in addition to the District of Columbia, have already closed the coverage gap—including states with conservative leadership, such as Vice President-Elect Mike Pence, who approved the expansion of Medicaid as governor of Indiana. These lawmakers have already recognized that the good health of their residents leads to personal, community-level, and state-level economic gains. Time will tell whether closing the coverage gap in North Carolina will be possible under new national leadership. But the benefits will unquestionably be significant, as laid out in this brief.

North Carolina lawmakers have failed to fully implement the Affordable Care Act so that up to 500,000 parents, young adults, workers, and veterans could experience the health, financial, and social benefits due to comprehensive health care coverage. While North Carolina has experienced a 28 percent decrease in the uninsured rate since the first open enrollment in 2013, the failure to expand Medicaid in our state means the Tar Heel state lags behind 31 states and the District of Columbia when it comes to making greater strides to reduce the overall uninsured rate.

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