Rural North Carolina leaders call for Medicaid expansion 

Waynesville NC municipal building. Photo: Warren LeMay, via Flickr

Earlier this month, the county commissioners in rural Franklin County North Carolina unanimously passed a resolution to expand Medicaid and get health coverage to their low-income neighbors. They are urging their state legislators (namely Rep. Lisa Stone Barnes and Senator John Alexander, both Republicans) to work across the aisle to pass a bill. Franklin Commissioners cited many reasons for their support, particularly the high numbers of North Carolinians who work hard but simply don’t earn enough to buy private health insurance.   

Meanwhile, across the state in rural mountain Haywood County, the Waynesville Town Council passed their own similar resolution in support of a bi-partisan compromise Medicaid expansion proposal (House Bill 655). The all-Republican Graham county commissioners passed one last summer. 

Don’t think there has been a blue wave in rural North Carolina. The same night as the Medicaid expansion resolution, the Franklin Commissioners passed another resolution to uphold and defend the Second Amendment – that is, the right to bear arms. Like many rural North Carolina counties, Franklin is a place where many residents, Democrats and Republicans, own and use guns. And like many rural North Carolina counties, there is widespread agreement that Medicaid expansion would be hugely beneficial here.  

While these counties’ health care resolutions may seem out of step with the Republican leaders who control the NC General Assembly, they reflect the practical and non–partisan nature of the health coverage crisis felt in many rural communities. Nowhere is this more true than in states like ours that have not yet expanded Medicaid.  

Speaker Tim Moore and Senate Pro Tem Phil Berger (both Republicans) have refused to schedule votes on any Medicaid expansion bill. They’ve been taken to task for it by conservatives and moderates in communities across the state. Just a few examples:  

• Graham County commissioner Dale Wiggins’ letter to Senator Berger after the Graham County commissioners passed a similar resolution in August 2019.  

• Alamance County Sheriff Terry Johnson, who has said that due to lack of health coverage, he’s running the largest mental health facility in Alamance County – inside his jail.  

• Moore county businessman and former GOP gubernatorial candidate George Little, who believes that the barriers to health coverage are hurting local businesses.   

Business owners, health care executives, and people living without health coverage – many of whom identify as conservatives – have joined the call for Medicaid expansion in North Carolina. In fact, 17 local chambers of commerce and over 100 influential business leaders across the state have also joined the call to close the health insurance coverage gap. When legislators return to Raleigh in April for their next session, will legislative leaders continue to cover their ears and look the other way?  

Adam Sotak is NC Child’s Public Engagement Director 

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