Dive Brief:
- North Carolina has officially expanded Medicaid to more of its low-income residents.
- As of Friday, about 600,000 more people in the state have access to the safety-net insurance coverage. Before, North Carolina had about 2.9 million people in Medicaid, according to the state’s health department.
- North Carolina passed legislation approving expansion in March, following a prolonged political battle in the state.
Dive Insight:
North Carolina is the 40th state to expand Medicaid under the Affordable Care Act, following other recent expansions in Missouri, Oklahoma and South Dakota.
Expanding Medicaid provides insurance to people who make too much money to qualify for traditional Medicaid, but too little to qualify for federal subsidies for plans in the ACA exchanges.
Red states — traditionally leery of expanding government-funded programs — have become increasingly open to considering expansion a decade after the government gave them the option to extend Medicaid insurance to a larger share of their low-income populations.
Ten states have yet to expand Medicaid: Alabama, Florida, Georgia, Kansas, Mississippi, South Carolina, Tennessee, Texas, Wisconsin and Wyoming.
The Biden administration on Friday urged the holdout states to expand Medicaid, saying that 3.5 million uninsured or underinsured Americans would be able to gain Medicaid coverage if the states approved expansion.
North Carolina’s expansion should help reduce the number of uninsured individuals in the state. Last year, 9.4% of its population was uninsured, the tenth highest uninsured rate in the nation, according to KFF.
The expansion will also boost rolls — and revenue — for the managed care organizations that participate in North Carolina’s Medicaid program. Centene has 34% of North Carolina’s managed care Medicaid lives, while Elevance has 27% and UnitedHealthcare has 21%.
Those payers should particularly benefit from the expansion, assuming that additional Medicaid lives are allocated based on market share and current per-member per-month fees, Credit Suisse analysts said when North Carolina’s expansion was announced earlier this year.
Medicaid enrollment swelled over the COVID-19 pandemic and became the largest source of healthcare coverage in the U.S., covering more than 90 million people as of the end of 2022. However, millions of people have lost Medicaid coverage this year after states were allowed to resume checking member eligibility in the program following a pandemic pause.
