In 2010 the Patient Protection and Affordable Care Act (ACA) was signed into law, thus increasing people’s ability to access and utilize affordable quality health care. In 2012, the Supreme Court upheld the ACA, but made it optional for states to expand Medicaid to individuals and families who have historically been in the Coverage Gap. Starting in 2014, families and childless adults who have traditionally been uninsured as they did not meet eligibility requirements for public health coverage such as Medicaid or did not earn enough money to purchase insurance on their own could become insured if their state of residence accepted federal funding to extend health coverage.

Today, North Carolina and 18 other states have failed to close the Coverage Gap. In NC, the failure to expand public health insurance coverage leaves approximately 500,000 without access to health care. Nearly 300,000 of those in the Gap have no other insurance option.