Five Ways Closing North Carolina’s “Coverage Gap” Helps Kids

May 2021

Lack of health insurance has become a dire issue for many more families during the COVID-19 pandemic. The latest federal COVID-19 relief bill provides our state with significant financial incentives to expand Medicaid coverage to low-income families who have no other health insurance option. It would provide approximately $2 billion in additional funds for the state’s existing Medicaid program, which mostly covers children and disabled adults.

  1. Family Financial Security

Parents can’t work and take care of their children when they’re not healthy. Many North Carolina parents don’t earn enough to buy private health insurance, but do not qualify for Medicaid. A family with two parents and two children that earns as little as $1,000/month makes too much for Medicaid.

Expanding Medicaid can help working families pull through incredibly difficult times.

The economic impacts of the pandemic have hit low-wage working North Carolinians hardest of all. Expanding Medicaid right now will make sure that people who lost hours or jobs can still get affordable health coverage to get healthy, stay healthy, and be ready to work again as we reopen.

  1. Covering Parents & Caregivers Means More Kids are Covered, Too

A growing number of children in our state have no health insurance. An estimated 142,000 North Carolina children were uninsured in 2019 , a 23% decrease from 2016 (1). North Carolina is now one of the bottom ten states in terms of covering children.

Without health coverage, children cannot access the care they need to grow, thrive, and learn. They often miss developmental screenings, critical childhood vaccinations, and forego needed care. Research shows children with health coverage are more likely to graduate from high school, attend college and grow up to be healthier and more productive adults.

When parents and caregivers have health insurance, children are more likely to be covered as well.  New research has found that states that expanded Medicaid have significantly lower rates of uninsured children (2).

  1. Addressing Racial & Ethnic Disparities

Black and Latinx families are less likely to have health insurance than other groups in our state – a factor that contributes to disparities in both parents’ and childrens’ health outcomes. In North Carolina, Black people are 30% more likely than whites to be uninsured, and American Indian people are 60% more likely to be uninsured. Hispanic/Latinx people are 3 times more likely than whites to be uninsured.

If North Carolina were to expand Medicaid, half of those newly insured would be people of color (3). Expanding Medicaid in North Carolina can help address long-standing health disparities for people of color in our state, including infant and maternal mortality. We can tackle the racial and ethnic disparities head-on, setting up more children for life-long health and well-being, by making health coverage affordable for all families.

  1. Fighting Infant Mortality

North Carolina continues to have one of the highest rates of infant mortality in the nation. Black families suffer at nearly three times the rate of white families – but it doesn’t have to be this way.

States that have expanded Medicaid have seen a drop of more than 50% in infant deaths, compared to states that have not expanded Medicaid (4). Much of this decline was driven by a reduction in deaths among Black infants in particular. When parents get the health care they need before, during, and after pregnancy, babies can thrive – and we can save lives.

  1. Covering Parents and Caregivers

Every parent and caregiver needs reliable, affordable access to health care. Income should not be the factor that determines whether parents & caregivers can get the care they need – including foster and adoptive parents, grandparent caregivers, and anyone with children depending on them.


  1. Georgetown University Center for Children & Families: Children’s Uninsured Rate Rises by Largest Annual Jump in More Than a Decade
  2. Georgetown University Center for Children & Families, 2021: Medicaid Expansion Associated with Lower Child Uninsured Rates
  3. Kaiser Family Foundation, 2021: Who Could Medicaid Expansion Reach in North Carolina?
  4. Georgetown University Center for Children & Families, 2019 Medicaid Expansion Fills Gaps in Maternal Health Coverage Leading to Healthier Mothers and Babies
  5. NC Child, 2020: North Carolina’s Rural Health Systems in Crisis.


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