Legislation introduced last week to expand Medicaid should be welcome news to the hundreds of thousands in North Carolina who currently can’t see a doctor when they need one. House Bill 5  was introduced by lead sponsors Reps. Gale Adcock, Carla Cunningham, Verla Insko, and Jean Farmer-Butterfield, and Senate Bill 3  was introduced by lead sponsors Sens. Ben Clark, Dan Blue, and Gladys Robinson – all Democrats. A Republican-led bill is expected soon in the state House.
Covering parents will lead to healthier kids
Child advocates and clinicians have long stressed the importance of closing North Carolina’s “coverage gap,” because children thrive when parents are healthy. Our state could make this happen by expanding Medicaid, or through a more North Carolina-specific plan similar to the “Carolina Cares” bill filed in 2017 by Rep. Donny Lambeth.
“In my practice I see how profoundly the health of parents impacts a child’s health,” said Dr. Kathleen Clarke-Pearson, a pediatrician and NC Child Board Director. “Bringing affordable health care to low-income parents in North Carolina will mean that babies are born healthier, and children have a better shot in life because of improved health and more stable families at home.”
But strict Medicaid eligibility requirements in North Carolina currently keep many parents out. Parents in a family of three cannot make more than $8,004 if they are not disabled or pregnant. Sadly, adults without children who are not disabled or pregnant can never get Medicaid, no matter how poor. As a result, many low-income women in North Carolina do not receive the pre-conception and prenatal care that is critical to the health of their babies. In 2017, nearly one-third of expectant mothers in North Carolina did not receive prenatal care during the first trimester, according to the NC Center for Health Statistics .
Impact on infant mortality
One leading reason we at NC Child are advocating for Medicaid expansion: North Carolina’s shocking infant mortality rate. For every 1,000 births in our state, seven babies do not survive. That survival rate is even worse for African-American babies. But states that have expanded Medicaid have seen dramatic improvements in infant mortality – particularly among African-American families, who are more often uninsured in North Carolina.
Another reason we believe Medicaid expansion will benefit our state’s kids: More financially-stable families. It can be very hard for parents to go to work and keep earning a paycheck when they are in poor health. When people put off basic care, they wind up suffering from expensive and often preventable health crises. Even basic family finances are affected. In states that have expanded Medicaid, for example, new research  found that people are 25% less likely to miss a rent or mortgage payment. That means fewer evictions and fewer kids kicked out of their housing.
Child welfare and the opioid epidemic
Research we undertook at NC Child in 2018  showed how Medicaid expansion could help keep kids out of foster care. Over the past decade, more kids entered foster care due to an increase in substance use, including opioid use, in their families. Uninsured parents who need care for mental health or substance use are forced to go without – putting their kids at risk, and straining our over-stretched foster care system. Medicaid expansion offers hope for low-income parents to get the treatment they need to recover, and keep their families together.
Record voter turnout and repeated polling have shown that access to health care is not a partisan issue. Most North Carolinians – of every political party – believe that affordable health care is a basic right, and that the system needs to change. With over 1 million people in North Carolina uninsured or under-insured, the question is urgent. Nobody should have to choose between getting the health care they need and putting food on the table. But hundreds of thousands in North Carolina currently find themselves stuck with that very choice.
Expanding Medicaid in North Carolina has the potential to bring us healthier kids, stronger families, and significant economic growth. We urge North Carolina’s leaders of both parties to come together to create a solution that will bring much-needed affordable health care to our state – and to get it done in this legislative session.