It’s important to understand why North Carolina has some of the world’s best healthcare, and some of the most expensive.
There are often many opinions about the state’s medical industry, but former Wall Street Journal and Bloomberg News healthcare journalist Michael Waldholz wrote an excellent fact-based piece last week for The Assembly online publication. Here are some details from his story that help frame the debate:
- About 4.8 million North Carolinians, or slightly less than half of the population, get their health insurance through their employers.
- Another 2.2 million, or roughly 20% of the state’s population, are enrolled in Medicare, the federal program covering those over age 65.
- About 1 million people, or 9% of the state, have private insurance via the Affordable Care Act marketplace.
- About 3 million people depend on Medicaid coverage for low-income citizens, including 1.2 million children. A family of four with an income as high as $44,367 qualifies for Medicaid.
- Medicaid accounts for about one-third of state government’s annual budget. A $500 million increase approved earlier this year was $319 million less than what the program needed, according to Gov. Josh Stein’s administration.
- Congress is debating whether to restore tax subsidies that helped make health insurance more affordable during the pandemic. Those subsidies ensured that ACA plan members paid no more than 8.5% of their incomes.
- Stein says if the subsidies end, about 157,000 ACA members may be priced out of the ACA market.
- Blue Cross Blue Shield of North Carolina estimates that a couple with ACA insurance and making $125,000 a year could pay $24,392 a year more in premiums next year, without the tax credits. A single adult making $25,000 a year could face a $1,200 increase, the insurer said.
- Two in five children in the state are covered by Medicaid, the Kaiser Family Foundation reports.
- 42% of N.C. adults covered by Medicaid work full time. About 25% work part time, and 33% are unemployed
- Congress this year required non-elderly and nondisabled adult Medicaid recipients who received coverage under Medicaid expansion to work, attend school, or volunteer for at least 80 hours a month. There are some exceptions.
- N.C. officials say the new work rules could spark 255,000 North Carolinians to lose Medicaid coverage, starting in 2027.
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