Run for coverage

Thousands of North Carolina children are at risk of losing health coverage in 2023 without action

By: Kaylan Szafranski | February 2023

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Children across North Carolina have had extraordinary access to health coverage over the past three years thanks to a 2021 law that prevented those covered by Medicaid and NC Health Choice from getting dropped during the COVID-19 public health emergency. As the provisions of the Public Health Emergency come to an end, that extraordinary coverage guarantee will also end gradually, beginning April 1, 2023 – increasing the risk of children and families becoming uninsured. 

A new report from Georgetown’s Center for Children and Families showed the huge impact of the coverage guarantee on North Carolina’s children. Our state saw a nearly 30% increase in access to health care for children in low-income families between February 2020 and August of 2022. This means more than 500,000 North Carolina children had access to regular checkups, specialists, and mental health care. Every child needs continued access to both preventive and critical care, but as the state moves towards the April deadline, many have an uncertain future ahead for health care access.  

Coverage gained could be coverage lost

Historic gains under the Public Health Emergency gave more children the opportunity to get and stay healthy. Now North Carolina’s Department of Health and Human Services (NC DHHS) has until May 2024 to complete the unprecedented task of conducting Medicaid eligibility checks for nearly 2.3 million people, including more than 1.3 million children, currently enrolled in the health care program. 

As a result, the state risks the loss of coverage for an estimated 375,000 individuals, including many kids and families, once the “unwinding” of coverage protections begins April 1. Loss of coverage is likely to happen for two reasons:  

  1. Family income has risen, and parents and/or their children are no longer eligible under state Medicaid limits; or  
  2. Errors such as administrative barriers, failed communication, and/or inadequate staffing levels and training prevent families from renewing their coverage – even though they remain eligible. 

Medicaid expansion is an important solution 

Importantly, if the General Assembly passes Medicaid Expansion this year, hundreds of thousands of people who gained access to Medicaid during the pandemic would be able to keep their health care. Ensuring parents have health coverage is a proven tool to safeguard children’s coverage as well.  

Medicaid expansion can also prevent some of the situations that will lead to coverage loss for those who are eligible: Notably, the Medicaid expansion bill recently passed by the NC House, H76, includes $50M in funding for county DSS offices to support them in the huge task of determining eligibility.  

What Can You Do?

If you and/or your child have coverage through NC Medicaid or HealthChoice:

There are several important actions that you can take to make sure you have everything you need when eligibility recertification kicks off in April.  

  • First and foremost, make sure all contact information for anyone enrolled in Medicaid or NC Health Choice is correct and up to date by calling the DSS office closest to you.  
  • If you are currently enrolled in a Health Plan through NC Medicaid, make sure they have your correct contact information too!  
  • Check your mail regularly and keep an eye out for notices from the NC Department of Health and Human Services. 
To advocate for better coverage for families and children:

Take Action

Contact your state House representatives and thank them for passing a bill to expand Medicaid eligibility in North Carolina, so that low-income families have access the care they need. The next step is the state Senate.