Medicaid expansion study finds 58,000 potential beneficiaries in Triad

Another national public health nonprofit has been addressing the issue of North Carolina’s Medicaid expansion, with the Urban Institute estimating at least 346,000 potential beneficiaries if it occurs in 2023.

This includes at least 30,000 beneficiaries in the greater Greensboro-High Point area — 15,000 White, 11,000 Black, 2,000 Hispanic and 2,000 listed as Others.

In comparison, at least 28,000 residents in the Winston-Salem metro area from five counties would qualify — 16,000 White, 8,000 Black, 3,000 Hispanic and 1,000 listed in the other category.

The Institute’s report was commissioned by the Robert Wood Johnson Foundation.

North Carolina is one of only 12 non-expansion states, all with Republican-controlled legislatures. A separate report was prepared for the non-enlargement country Georgia.

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The report comes after Senate Chairman Phil Berger, an Eden Republican, said Nov. 9 that the legislative debate on expanding Medicaid in 2022 would not proceed, forcing between 450,000 and 650,000 potential beneficiaries to face another year on action waiting.

“This single policy change would have a profound impact on hundreds of thousands of people in these two states,” said Katherine Hempstead, the foundation’s senior policy advisor.

“Previous research has shown that health insurance saves lives, improves individuals’ financial security, and improves hospital finances.”

According to the NC Department of Health and Human Services, Medicaid currently covers 2.71 million North Carolinaians.

States may extend eligibility for Medicaid under the federal Affordable Care Act to non-elderly individuals with incomes up to 138% of the federal poverty line.

Those who might be eligible under the expanded program are between the ages of 18 and 64 and make too much to qualify for Medicaid insurance, but not enough to buy coverage in the private insurance market.

For Greensboro-High Point, the expanded non-insurance rate would be 7.4%, the lowest in North Carolina. It would be slightly higher in the Winston-Salem region at 7.6%, but that would be much lower than the current rate of 11.6% there, the report said.

“Increasing coverage through Medicaid expansion would have significant benefits for North Carolina, bringing the state to the 24th highest with the ninth-highest non-insurance rate in the country,” said Michael Simpson, senior research fellow at the Urban Institute.

“In Winston-Salem, Greensboro and three rural North Carolina areas, about one-third of people without health insurance would get coverage.”

spread of the pandemic

The report does not account for approximately 589,000 North Carolinians who received Medicaid coverage through federal public health relief laws during the COVID-19 pandemic.

According to the Kaiser Family Foundation, a national nonprofit public health advocacy group, Congress enacted the Families First Coronavirus Response Act in the United States in mid-March 2020, shortly after the pandemic broke out.

Part of the law is a requirement that Medicaid programs keep people continuously enrolled until the end of the month that the COVID-19 public health emergency ends, in exchange for improved federal funding.

This is how many of NC’s additional Medicaid beneficiaries received coverage during the pandemic

The latest expectation is that the Biden administration will set an end date for Jan. 11 after several extensions, but there is speculation that the end date could be extended to April.

Demographic triad

The report found that the uninsured population in the Winston-Salem area is slightly older compared to the statewide total.

About 54% of this population is between the ages of 35 and 64, compared to 48% in that age group nationally.

Additionally, about 59% of the non-elderly, uninsured population in the Winston-Salem area has no more than a high school education, compared to 54% statewide.

The study found that there would be 14,000 beneficiaries of the enlargement between the ages of 19 and 34, along with 12,000 between the ages of 35 and 54 and 3,000 between the ages of 55 and 64.

By gender, it would be 15,000 men and 13,000 women.

15,000 full-time workers would benefit, along with 4,000 part-time workers and 9,000 unemployed.

About 27,000 of the recipients would be US citizens, while 2,000 would be non-citizens.

By comparison, in the Greensboro-High Point Metro, there would be at least 15,000 beneficiaries between the ages of 19 and 34, along with 11,000 between the ages of 35 and 54 and 4,000 between the ages of 55 and 64.

By gender it would be 16,000 men and 13,000 women.

13,000 full-time workers would benefit, along with 5,000 part-time workers and 11,000 unemployed.

About 26,000 of the recipients would be US citizens, while 3,000 would be non-citizens.

In July 2021, Care4Carolina, an advocacy group pushing for Medicaid expansion, released a report with similar numbers for the triad.

However, the country has not come any closer to expansion.

When asked about a planned December special session on Medicaid expansion, Berger said after last week’s election, “I think we’ll look at that next year.”

Berger’s comments served as confirmation that although the House and Senate passed a bill in June that represents their version of Medicaid expansion, talks over the past five months have not resulted in a compromise ready for a vote.

Rep. Tim Moore recently told the News & Observer of Raleigh that lawmakers are “close on some things, not on others” and would come back in 2023 for a “fuller discussion”.