Medicaid expansion has been a topic of lively and lengthy debate in the North Carolina General Assembly for the better part of a decade. As a representative of the people, I have thoroughly reviewed the presented data, listened to the feedback provided by my constituents and concerned citizens in neighboring counties, and have come to the conclusion that ObamaCare Medicaid expansion is a bad deal for North Carolina. 

Here’s why: 

  1. It would force many North Carolinians out of private insurance. 

Currently, many able-bodied adults in the state qualify for free, silver-level private health care plans on the federal exchange. This benefit would be eliminated if we expand Medicaid, and these North Carolinians would be forced onto Medicaid — coverage that is accepted by fewer providers. 

  1. It would trap North Carolinians into government dependency and keep them out of the workforce. 

Nationally, more than half of all able-bodied adults on Medicaid don’t work — in part because the Biden administration has banned work requirements in the program. The state has nearly 400,000 job openings, and expanding Medicaid would make it even harder for businesses to find workers. 

  1. It would shift resources away from North Carolinians with disabilities who are already on Medicaid waiting lists. 

More than 15,000 people with disabilities in our state are waiting to get the help they need — many end up waiting years. Adding thousands of able-bodied adults to Medicaid would mean fewer truly needy North Carolinians get the care they need. At the very least, it would give them even longer wait times. 

  1. It would put our hospitals on the chopping block. 

Roughly two in every five states that expanded Medicaid saw hospital job losses as a result, and many affected hospitals end up closing. Medicaid shortfalls in expansion states were in the billions, too, because Medicaid reimburses providers at a fraction of the rate of private insurers

A recent report from the Center for Healthcare Quality and Payment Reform points to low payments from Medicaid patients being the primary cause of losses at rural hospitals. Many rural hospitals are, indeed, at risk — but expansion is not the answer. Eliminating Certificate of Need laws, passing the SAVE Act, and keeping more North Carolinians on private plans with higher reimbursement rates would all be better options. 

  1. It would lead to high expenditures on Medicaid. 

If we want to know what Medicaid expansion would look like here, all we have to do is consider the other states that have tried expansion and found it to be a huge failure. 

In state after state, Medicaid enrolls far more able-bodied adults than projected. For example, in Idaho, it was estimated that 62,000 able-bodied adults would enroll — but the grand total was closer to 120,000, nearly double original estimates. Virginia’s enrollment was more than twice what was expected, too.  

As has happened in other states, these dramatic underestimates in enrollment will result in catastrophically high expenditures on Medicaid. Our state already spends about 30% of our budget on Medicaid. If Medicaid is expanded to thousands more in North Carolina, we will face what other states have experienced: welfare expansion crowding out other critical budget priorities like public safety and education. 

Bad for North Carolina

Expanding Medicaid to able-bodied adults under ObamaCare is a lose-lose scenario. It would force many North Carolinians off private insurance, trap more people into government-dependency, shift resources away from those who truly need it, put our hospitals at risk, and lead to high expenditures on Medicaid. 

As a representative of the people, I cannot, in good faith, vote for a measure that would push the truly needy to the back of the line, threaten to cost jobs and close hospitals, and crowd out other critical priorities in our state budget. 

These are the facts that have led me to oppose Medicaid expansion in North Carolina. I implore my colleagues in the General Assembly to consider these points carefully and make the best decision for the people of our state.