Health Care Can’t Wait: How Medicaid Expansion Helps Kids

Increasing access to affordable health care is critical to ensuring healthy kids and families in North Carolina

February 2023

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Insurance for parents is good for kids too

Getting kids covered: Approximately 135,000 North Carolina children are uninsured, ranking our state near the bottom nationally for covering children.i

One important reason: When parents and caregivers have health coverage, children are more likely to be covered as well. Research has found that states that expanded Medicaid have significantly lower rates of uninsured children. North Carolina is not yet one of those states.

Healthy pregnancy and birth: Medicaid expansion also supports healthy pregnancies and births, by allowing new parents to take care of their health in the critical time before pregnancy.ii

Preventing child neglect: Medicaid expansion takes real stress off families – both financial and health-related. As a result, in states that have expanded Medicaid, there has been a significant drop in child neglect.iii

Expansion would help working families with children

Expanding Medicaid can help working families.  Most of those who would be covered by expanded Medicaid are working – sometimes in multiple jobs – but don’t earn enough to qualify for a private marketplace plan. Many work in essential jobs like child care, food service, construction, and nursing homes.

Parents in a family of four earning as little as $1,000/month would typically fall in the coverage gap, but they would not qualify for subsidies through the health care marketplace .

Health coverage protects families from medical debt and unaffordable doctors’ bills. This leads to greater household economic security, including housing security.

Closing the “coverage gap” in North Carolina

As coverage through the federal Public Health Emergency comes to an end in April 2023, thousands of North Carolina parents could be removed from the NC Medicaid program – sending many of them back into the coverage gap. Expanding Medicaid can prevent this problem so that those who truly need coverage can get it.

Legislative leaders in both the House and Senate have filed legislation to expand Medicaid and close the “coverage gap” in North Carolina. The 2023 legislative session is the time to come together and close the deal.


i The Children’s Health Care Report Card, Georgetown Center for Children and Families, 2021, available at

ii Expanded Income Eligibility for Health Insurance, Prenatal-to-3 Policy Center, Vanderbilt University, 2022, available at

iii Expanded Income Eligibility for Health Insurance, Prenatal-to-3 Policy Center, Vanderbilt University, 2022, available at