North Carolina’s budget has yet to be passed by the General Assembly, and the logjam is leaving Medicaid expansion in the lurch. The impacts on the uninsured and underinsured in the Tar Heel state are already being felt.

On Monday, North Carolina Governor Roy Cooper’s administration announced that the planned expansion to hundreds of thousands of low-income adults early this fall will be further delayed until the budget law is approved. It was supposed to have been in place by July 1, but Republican leaders in the House and Senate have been slow in their negotiations, and Cooper has been unable to force quicker action due to the GOP’s veto-proof majority.  

Mark Hall, who directs the Health Law and Policy Program at Wake Forest University, says every month delayed means people are not getting the health services they need. And the timing of this recent setback poses serious challenges.  

"The expansion of Medicaid that occurred under COVID is rolling back," says Hall. "So, Medicaid became more generous during COVID, but Congress ended the generosity and so people are losing their Medicaid benefits. And that makes it all the more essential to get this expansion in place as soon as possible."

Hall says the delay disadvantages a large swath of the population — urban, rural areas with chronic illness, people with jobs who have to miss work due to illness — up and down the board. Estimates from state officials say up to 600,000 North Carolinians stand to benefit from the expansion of government-funded health coverage.

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