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As North Carolina Implements Medicaid Expansion, Republicans Block Coverage for 3.5 Million People Across 10 Holdout States

By December 1, 2023No Comments

North Carolina Is the 40th State to Expand Medicaid, Extending Affordable Health Care to 600,000 North Carolinians 

Washington, DC — Today, North Carolina is beginning to implement its Medicaid expansion program, extending affordable health care to an estimated 600,000 people. As North Carolinians are finally given this long overdue relief, Republican lawmakers in 10 states are blocking the lifesaving program. As a result, nearly 3.5 million people are uninsured and have no options for affordable coverage. 

Back in Washington, Donald Trump and his MAGA allies renewed calls to repeal the Affordable Care Act (ACA) — including Medicaid expansion — and rip coverage and core protections away from millions of Americans. In addition to securing coverage for those who need it, Medicaid expansion strengthens the economy, boosts support for rural hospitals and other safety net providers, and relieves hardships for families living in poverty. Medicaid expansion especially helps low-income workers, moms and children, people with disabilities, and Black, Brown, Indigenous, and rural residents. Medicaid expansion is widely supported, with voters in seven states, including six red states, opting to expand Medicaid. In response, Protect Our Care Executive Director Brad Woodhouse issued the following statement:

“North Carolina is celebrating this hard-fought victory after years of Republican obstruction. Governor Cooper, Democratic lawmakers, and advocates worked tirelessly for North Carolina’s Medicaid expansion for years, and now North Carolinians will see stronger hospitals, a better economy, and healthier communities. Yet there is more work to be done to ensure every state is providing this lifesaving access to health care. Republican lawmakers in the 10 holdout states could not be more out of step with the American people on this issue — Medicaid expansion is widely supported across the nation, even in some of the deepest red states. It’s time to stop playing politics and deliver relief to the 3.5 million Americans who desperately need care.” 

Background On The States That Refuse To Expand Medicaid

  • Alabama: Over 204,000 people would gain coverage if Alabama expanded Medicaid. Even though over 66 percent of Alabamians support Medicaid expansion adoption, Republicans continue to vote against the American people and lower-cost health care.
  • Florida: If the state were able to expand Medicaid around 1.4 million Floridians could have access to coverage. Since 2012, when then-Governor Rick Scott pledged to never pass Medicaid expansion, the state Republican party has refused to take up the question.
  • Georgia: Full Medicaid expansion in Georgia would provide coverage for up to 678,000 people in 2023, but Governor Brian Kemp and Republicans in the state legislature continue to block it. 
  • Kansas: Governor Laura Kelly ran her campaign on bringing Medicaid expansion to Kansas; however, at every turn and in every legislative session she has been blocked by Republican state legislators. In all, over 82,700 people have been actively denied the quality and affordable health care they would be eligible for under Medicaid expansion by Kansas Republicans.
  • Mississippi: Over 75 percent of all rural hospital closures from 2010 to 2021 occurred in states that had not adopted Medicaid expansion. Along with around 217,000 people who would be eligible for coverage under Medicaid expansion in Mississippi, expansion adoption would also open up billions in federal funding which could help end the hospital crisis plaguing Mississippi and leading to hundreds of excess deaths in the state.
  • South Carolina: From the Governor’s office to the state legislature, Republicans in South Carolina have staunchly refused to expand Medicaid to over 345,000 people. 
  • Tennessee: The Republican opposition to Medicaid expansion has meant that over $20 billion in potential funding to the state has been forfeited since 2014. Around 226,200 people would be eligible for low-cost health coverage if expansion was adopted and over 15,000 new jobs would be added to the state. 
  • Texas: Expanding Medicaid would bring access to coverage to over 1.4 million Texans, but Governor Greg Abbott and Republicans in the legislature continue to block it. 
  • Wisconsin: Republican legislators have shot down any proposals to adopt Medicaid expansion in the state, making it one of only two Midwest states to have not yet adopted the program. About 90,000 people in Wisconsin would be eligible for coverage under Medicaid expansion.
  • Wyoming: Despite a proposal adopting Medicaid expansion passing through committees this year, state Republican leaders refused to allow a reading of the proposal on the state House floor, effectively killing the bill. Year after year legislation is introduced which would expand coverage to more than 34,000 people, and every time Republicans block these measures.