How North Carolina can fight COVID-19 by covering the uninsured 

By: Adam Sotak | April 2020

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Before COVID-19 struck, one in ten adults in North Carolina had no health coverage. Now those numbers are growing. Essential personnel are over-represented among the uninsured, including child care teachers, grocery and food service workers, and health aides. They are working on the front lines of a pandemic with no health insurance.  

As we struggle to recover from the economic impacts of COVID-19, it will be more important than ever to remove this major financial barrier from families and businesses. It’s time for North Carolina to accept the federal funds to expand our Medicaid program.  

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Many other states are making changes to Medicaid to protect their residents from COVID-19. North Carolina can, too. 

Most states have already taken this step. 37 other states have taken the federal funding to expand Medicaid. They are experiencing better health outcomes and positive fiscal impact. Not one state has reversed this decision since 2010. 

North Carolina is missing out on billions in federal health care funding that will be critical to our economic recovery 

TAKE ACTION:  Click here to contact your state legislators and urge them to cover North Carolina’s uninsured to fight COVID-19 

Our hospitals and health care systems are stretched to the brink. They should not have to continue to provide unpaid care for the uninsured when there is a solution available. 

Expanding Medicaid would bring over $11 billion in federal health care funds to North Carolina between 2020 and 2022, according to recent estimates from the Cone Health Foundation. This is funding our health care providers desperately need.  

Health coverage brings families more financial security 

Expanding Medicaid right now will make sure that people who lose jobs – and who lose their employer-provided health insurance – can still get affordable health coverage. We need North Carolina’s work force to stay healthy, and be ready to work again after the crisis is over.   



In states that have already expanded Medicaid, the increased health coverage has improved families’ economic security. Having health coverage helps people work. For example, survey results of people in Michigan and Ohio who got coverage through Medicaid expansion found that having health coverage made it easier for those with jobs to work, and for those who need jobs to look for work.  

People in states that expanded Medicaid have less medical debt compared with non-expansion states. Medicaid expansion has even resulted in fewer evictions, by allowing people to put more of their budget toward housing costs, rather than health care costs. One recent study found that people who gained health coverage from Medicaid expansion were 25% less likely to fall behind on a rent or mortgage payment. People in North Carolina could be getting the same financial benefits as those in other states.  

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Health care providers are calling for Medicaid expansion to fight COVID-19. 

When people can’t afford basic care, they often wind up in the ER with preventable – and very expensive – health crises. Hospitals have to eat the cost – and those costs are often passed along to the rest of us. Covering more uninsured people doesn’t just protect hospitals’ bottom lines: it reduces health care costs for everyone, even for those who have their own private health insurance.  

Since 2010, seven rural hospitals have closed in North Carolina. Many more are scaling back services, forcing patients to drive long distances for the care they need. Providing “charity care” in the emergency department is a major strain on hospital finances. Getting affordable health coverage to those who really need it could help these hospitals stay open to provide care during COVID-19. It would also keep people in rural communities employed in good health care jobs. 

Medicaid has a history of helping people in times of crisis. 

The Medicaid health insurance program is there for families when the unthinkable happens. Just like after 9/11, Hurricane Katrina, and the recent hurricanes in Puerto Rico, Medicaid can expand to offer quality, affordable health coverage for those who lose jobs or become ill through no fault of their own. 

Expanding Medicaid is an urgent need. It is one of the best tools our state can use right now to protect people during the COVID-19 crisis. And it would be a major asset to help North Carolina bounce back from the economic hardship that is hitting so many of us now.  


NC Child is dedicated to getting health coverage to every parent and caregiver in North Carolina. Support our work with a donation today.