Medicaid Expansion is Priority Number One


The North Carolina General Assembly is heading into the final stretch of budget negotiations, which normally marks the end of each year’s legislative session. But this year instead of wrapping things up, it seems like we are headed for a stalemate.

Governor Cooper and legislative Democrats have made it clear that our top priority is expanding Medicaid. The Republicans, however, have not included the policy in their budget proposals thus far. The Governor has also communicated that he will veto any budget that does not expand Medicaid. Democrats have enough votes in the legislature to sustain the Governor’s likely veto. Then the real negotiations begin, but what if neither side will give?

Unlike the federal government, North Carolina’s government does not shut down without a budget. Most things keep operating under the spending levels of the previous budget, but new initiatives like state employee raises will not go into effect.

It is conceivable that a budget stalemate could last all the way through the 2020 elections. While I hope that does not happen, I also think that Medicaid expansion is so important that I am willing to support a protracted fight. There is no single policy that could do more for North Carolinians than expanding Medicaid. Here’s why.

Working families should not have to go without access to health care. Across North Carolina, more than 500,000 working people fall in the Affordable Care Act health care coverage gap. In Orange County, 3,647 people would be eligible for coverage. In Caswell County, 688 people would qualify.

Even better, taxes would not have to go up a single cent to pay for Medicaid expansion. Cost for the expansion would be covered by the federal government and hospitals and health care systems. North Carolina taxpayers are already paying 90 percent of the cost in our federal taxes, and that money is currently providing coverage to people in other states.

Every family in our state would be better off. The economy would benefit from an infusion of $4 billion and the creation of 40,000 jobs, including an estimated 726 in Orange County and 44 in Caswell County. On the flip side, failure to expand Medicaid has a significant negative impact. Government experts estimate that not expanding Medicaid would cost Orange County $395 million in business activity and $5.8 million in tax revenues between 2016 and 2020. Caswell County would miss out on $15 million in business activity and $334,000 in tax revenue.

Even those who currently have medical insurance would benefit, as states that have expanded Medicaid have health care premiums that are an average of seven percent lower than states that haven’t. Closing the care gap has also been linked to reducing racial disparities in cancer diagnosis and treatment. Schools would benefit from having access to additional mental health resources. Our vital rural hospitals would be less likely to close.

Expanding Medicaid is the single most important thing North Carolina can do to fight the opioid epidemic. Orange and Caswell Counties had 15 opioid deaths in 2017 and more than 65 opioid-related visits to the emergency room. Expanding Medicaid would make addiction and mental health treatment more accessible, allowing those struggling with opioid addiction to get the help they need.

Our large veteran population also stands to benefit from this proposal. Veterans often have complex health needs including chronic conditions, disabilities, mental illness, and substance abuse. If North Carolina expanded Medicaid, 23,000 of our state’s uninsured veterans would gain access to the affordable health care they need but don’t have today.

Expanding Medicaid isn’t just smart policy – it’s the right thing to do. It’s the moral thing to do. I hope you can understand why it is the Democrats’ top priority. I hope that our Republican colleagues will come to the table on this by the end of June. If not, I am willing to wait on their priorities until we can move forward on this one. It’s too important not to.

Graig Meyer is the State Representative for House District 50. He can be contacted at

This article was previously published in The News of Orange and the Caswell Messenger.