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Justice Circle 
(Raleigh, NC – Nov. 5, 2025) NC Justice Center Senior Health Policy Advocate, Rebecca Cerese, shared her expert perspective on the US health care system and the impact of current policies during the North Carolina Institute of Public Leadership’s forum on “Medicaid, Medicare, and the Private Insurance Market.”
The debate, which was streamed on Spectrum News, November 2, took place at the Kresge Auditorium at Meredith College on October 22. It was part of the NCIOPL’s 2025 Hometown Series.
Rep. Tim Reeder (R – Pitt County), Rep. Carla Cunningham (D – Mecklenburg County), and Ben Popkin, health policy consultant and former state legislative official, served as panelists alongside Cerese. The forum highlighted how North Carolinians have benefited from the state’s expansion of Medicaid.
“Medicaid expansion was a lifeline for patients and a lifeline for rural communities, who are facing a lot of uncompensated care costs, which were really hurting their bottom line. Medicaid is incredibly comprehensive care. It has very low out of pocket costs, so people are encouraged to go to the doctor, get a primary care physician, and get those preventative services that they need, which keeps them from getting sicker – saving money in the long run,” said Rebecca Cerese, senior health policy advocate at the NC Justice Center.
When the discussion shifted to the skyrocketing costs for coverage, Cerese explained that people are increasingly struggling with higher deductibles and out-of-pocket costs and other barriers to coverage and care that result from the profit-centered model of care in the United States. These problems are being exacerbated by the federal funding crisis, which may result in significant increases in ACA marketplace insurance premiums.
“There is a perverse incentive in our for-profit health care system to deny people care in order to make more profit…No one else [in the world] allows profit to the extent that we do in our health care system,” Cerese said. “What it has done is create an incredibly bloated, broken, overcomplicated system, where our outcomes are pretty terrible. We have lower life expectancy than other developed countries, and our maternal and infant mortality rates are terrible.”
Panelists also discussed current Medicare policies and identified gaps in health coverage. Before the debate concluded, panelists shared insights about what could be done to create a more sustainable health care system.
“We should really transform our health care system into a single payer system where we come up with fair reimbursement rates for providers, because we want our providers to participate in this system and cut out the costly administrative burden,” Cerese said.