Call To Action: Say No to NC’s Medicaid Expansion

Contact your representatives and alert them to your concerns.  Medicaid Expansion is not a winner for our state.

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With a legislative vote pending, it is important to contact your representatives and alert them to your concerns.  Medicaid Expansion is not a winner for our state.

After a decade of resisting Medicaid expansion, North Carolina, one of the last 12 states to hold out, is poised to accept expansion.  In June, the Senate passed H.B. 149, “Expanding Access to Healthcare,” and a final legislative vote is expected before the end of the year.

North Carolina Physicians for Freedom (NCPFF) is opposed to expansion based on North Carolina-specific research regarding expansion’s positive assertions versus likely outcomes, as well as current research and data from states that have expanded, which challenges many of expansion’s promises.  (See Fact Sheet below)


Medicaid Expansion: Facts and Figures

Leading NC legislators state: “Medicaid has been cleaned up” and we are now ready to receive more money; that many poor people cannot afford insurance; it will be a financial boom for the state; a 90/10 match is guaranteed; rural hospitals are in serious condition; if expansion occurs before the end of 2022, NC will receive a $1.5 billion dollar bonus; billions of dollars will flow into the state every year; if we refuse expansion, the Biden Administration will force it by year’s end anyway.

  • North Carolina is one of 12 hold out states that have refused Medicaid expansion.
  • Led by key NC Senators proponents, expansion is now likely
  • House Bill 149: Expanding Access to Health Care Act has become an Omnibus Bill: adding SAVE (allowing Nurse Practitioners to practice independently), and changes to Certificate of Need regulations (CON) to “support and reinforce expansion”.
  • If passed, one in three North Carolinians will be on Medicaid, a giant step in the direction of accepting socialized medicine.
  • Approximately $7,500 is allocated for each recipient (projected to be 600,000-1,000,000 new recipients)
  • The sweeping government move is one more step toward formula-based control of medicine, including ever changing regulations, more mandates and decreased quality of care
  • Large health systems/hospitals and insurers will benefit, rural hospitals will suffer as competition is smothered (Certificate of Need-CON) control benefits large systems.
  • Senator Phil Berger acknowledged that we cannot require work (a federal provision)
  • To date, expansion states enrolled more than twice as many as projected
  • Under the emergency health provision (COVID) thousands were already added to the Medicaid rolls, no purging will occur until 2023; ongoing eligibility is difficult to determine; dual coverage is not uncommon (both employer provided and Medicaid).
  • According to the Congressional Budget Office (CBO), $86 billion was spent improperly by Medicaid last year alone
  • North Carolina already has more than 300 federally qualified health care centers and clinics, providing care to low-income at low or no cost

Cite: *Foundation for Government Accountability, 2021-2022

The Tentacles of Medicaid

  • Schools employ billions of Medicaid dollars in psychological and counseling services
  • School Mental Health services are confidential for all ages (meaning parents do not have to be informed); growing evidence suggest many promote sex and gender-related information, treatments and surgeries not supported by most parents.
  • According to U.S. Health and Human Services, “Medicaid funds are now woven into the nation’s education system.”
  • U.S. Health and Human Services proposes allowing coverage for gender-affirming care through Medicaid. Additional policy changes in states that still have bans or lack clear language addressing coverage would ensure that transgender Medicaid beneficiaries have access to coverage for necessary medical care no matter where they live. In addition, more transgender people could benefit from Medicaid covered services if all states adopted Medicaid expansion and if barriers to accessing public benefits, such as requirements pertaining to identity documents, were removed. *U.S. Centers for Medicaid and Medicare: June 2021
  • “Sex reassignment surgery/transition” covered by Medicaid for those 18 and over was recently revised to allow for any age ‘in specific cases if medical necessity is demonstrated, and prior approval is received.”

Medicaid Expansion: Puts NC on Thin Ice

  • States that have expanded report longer wait times, especially for specialists; longer waits for provider reimbursement, and growing enrollee and provider dissatisfaction
  • The 90-10 Medicaid match is unsustainable, and in a climate of Recession; at some point, it will become North Carolina’s unfunded mandate
  • Expansion: Will push over 500,000 able-bodied into dependency and out of the workforce.  It will take $96 billion from NC taxpayers over the next 10 years; individuals covered by employer-sponsored or federally subsidized plans are shifted to Medicaid; 10,000 individuals with disabilities will be left in waiting lines.

More Information on Medicaid Expansion can be found here.


To find out which House and Senate district you live in use the address look-up function in the embedded district maps on the Representation section of the NC General Assembly website.

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