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You are here: Home / Anderson On Health Insurance / Medicaid Expansion in North Carolina is finally coming

Medicaid Expansion in North Carolina is finally coming

by David Anderson|  September 22, 202312:12 pm| 19 Comments

This post is in: Anderson On Health Insurance

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Last spring, North Carolina passed a law that would expand Medicaid to 138% FPL as part of the ACA.  Medicaid Expansion’s start date was up in the air.  The law did not set a date.  Instead Medicaid Expansion start was dependent on a state budget getting passed.  The state government took steps to make the gap between initial authorization and go-live as small as possible.  But even with front-running, the binding constraint was the state budget.

As of this morning, that is not the case any more.  The state has a budget and Medicaid Expansion is going live.

From WRAL:

 North Carolina Gov. Roy Cooper announced Friday he would let the state budget bill coming to his desk become law without his signature, opening the way for Medicaid coverage for 600,000 low-income adults, with some receiving the government health insurance within weeks.

There is no definite go-live date.  I know the state will do everything it can to make the go-live date as early as possible.  I have heard rumbles of ambitious 2023 start dates.  I would be shocked if the go-live is later than January 1.

10 more states to go.

 

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Reader Interactions

19Comments

  1. 1.

    Baud

    September 22, 2023 at 12:18 pm

    Congrats, NC.  Now vote blue next year and enjoy many other good things.

  2. 2.

    Burnspbesq

    September 22, 2023 at 12:19 pm

    Considering the legislature and courts he’s burdened with, Gov. Cooper has done a hell of a job for North Carolinians.

  3. 3.

    Old School

    September 22, 2023 at 12:24 pm

    10 more states to go.

    Those would be Florida, Georgia, Kansas, Mississippi, South Carolina, Tennessee, Texas, Wisconsin, and Wyoming.

  4. 4.

    john b

    September 22, 2023 at 12:41 pm

    @Baud: It will be a long road. NC is gerrymandered to all hell and it will take overwhelming tides turning to get the power back in order to make things more fair.

  5. 5.

    Mike in NC

    September 22, 2023 at 12:42 pm

    Next thing to do is to legalize weed in NC.

  6. 6.

    rikyrah

    September 22, 2023 at 12:43 pm

    should they really be congratulated for doing the right thing after all this time. how many people have died because they wouldn’t expand?

  7. 7.

    David Anderson

    September 22, 2023 at 12:47 pm

    @john b: Gerrymandering matters on the margin, but the base case is right now North Carolina’s voters lean GOP — it is an honest majority.  Dems had their asses kicked inside and out in the 2022 state elections — kept it close at the top of the ticket with state wide candidates who lost, but the bottom fell out in the state legislature.

    Maps where the median district was Trump +2 (2020 Trump won the state by ~1.4%)  likely would have meant that Cooper had a viable veto threat but after 2022, the GOP earned under pretty much any theory of democratic legitimacy is large working majority in both chambers.

  8. 8.

    hueyplong

    September 22, 2023 at 1:01 pm

    @David Anderson: Gerrymandered enough for one fraudulent candidate outside Charlotte to give them a supermajority capable of overriding a veto and making NC a women’s health desert.

    GOPers didn’t honestly come by that kind of power with their majority.  So I’d be disinclined to dismiss their efforts at gerrymandering.

  9. 9.

    john b

    September 22, 2023 at 1:03 pm

    @David Anderson: it is an honest majority, not an honest supermajority. That is not marginal. And it has been used to cement their honest gains in 2010 and 2020.

    Gerrymandering is a feedback loop, where polarization is reinforced and people become fatalistic and apathetic. I know this isn’t news. I’m saying it’s a long road because even with D gains, actual power is very far off because of the obstacles the GOP has added. And don’t even get me started on the state GOP thwarting local blue governments (hello from CLT).

  10. 10.

    jonas

    September 22, 2023 at 1:04 pm

    @David Anderson:Dems had their asses kicked inside and out in the 2022 state elections — kept it close at the top of the ticket with state wide candidates who lost, but the bottom fell out in the state legislature

    What’s going on, do you think? Is the state party just an organizational clusterfuck, a la Florida, or has there just been a demographic or political realignment outside the research triangle that has pushed things rightward? For a while, it looked like NC might be drifting towards being another Virginia, but it sounds like it’s becoming more like its southern sibling. Which sucks, of course.

  11. 11.

    pensive

    September 22, 2023 at 1:11 pm

    @Old School: Was wondering what the list was and wasn’t surprised to see Texas on it. C’mon people – even Alabama did it!

  12. 12.

    Old School

    September 22, 2023 at 1:58 pm

    @pensive: Whoops!  Left Alabama off the list!

    Should be Alabama, Florida, Georgia, Kansas, Mississippi, South Carolina, Tennessee, Texas, Wisconsin, and Wyoming.

    (Yes, that’s 10.)

  13. 13.

    Citizen Alan

    September 22, 2023 at 2:17 pm

    @Old School: Thank you. I was genuinely shocked at the mere possibility that Alabama had expanded Medicaid. Mississippi and Alabama have always been each other’s Evil Twin, after all.

  14. 14.

    Hoodie

    September 22, 2023 at 2:27 pm

    @jonas: My impression after 30 years here is that, while the state leans red, this disparity is exacerbated by the fact North Carolina dems are concentrated in distributed urban pockets that are very different from one another, much like Texas and unlike Georgia, where Atlanta is the 800 pound gorilla and dems are relatively unified.  Charlotte, Raleigh and Greensboro might as well be in different states, they have different media markets, power structures, etc.   Makes it harder to build a statewide bench of strong candidates.  Cooper is more of a legacy of the old Eastern Carolina Dem machine, which was decimated by scandal.

  15. 15.

    Mike E

    September 22, 2023 at 2:50 pm

    @Hoodie: the sclerotic NC Dem party has a couple of generations of inertia to overcome and the TEA legislature is happy to exploit this condition. Cooper is that rare “old school” party member (reminds me of our current president) who had no fucks left to give and gave it his best efforts despite the math/reality/GOP fuckery.

  16. 16.

    Betsy

    September 22, 2023 at 4:27 pm

    Hooray! This is a big Biden deal for the 9th most populous state in the nation!!

  17. 17.

    Mike in NC

    September 22, 2023 at 4:31 pm

    Been here for 15 years and read that NC is actually more rural than Georgia, hence leaning GQP.

  18. 18.

    Betsy

    September 22, 2023 at 4:33 pm

    @jonas: Gerymandering and voter suppression.  We haven’t had a legitimate election for the legislature in over a decade due to the Republican legislature drawing its own districts.

    Also, northern transplants have been some of the worst right-wingers. For example, trying to resegregate our schools, and raising tax rates on the poor.

  19. 19.

    Betsy

    September 22, 2023 at 4:35 pm

    @Burnspbesq: It’s really true.  Some of NC’s best governors have started as state Attorney(s) General.  And now Josh Stein is stepping up !

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