Medicaid Expansion is a Women’s Health Issue


President Tara Romano

President Tara Romano

Since the 2012 Supreme Court decision that upheld the constitutionality of the Affordable Care Act (ACA), North Carolina is one of 20 states that has still opted to NOT expand Medicaid. In making this legislative decision, approximately 500,000 North Carolinians still do not have access to affordable, quality health insurance, limiting their ability to access health care. In addition to leaving people in the “Medicaid Gap“, there are economic consequences to not expanding Medicaid, such as lost opportunities to create new jobs in NC’s healthcare industry, and the loss of federal dollars that are being offered to assist states with implementing the ACA (those federal dollars aren’t just coming from Washington, DC; the federal tax dollars we pay as citizens are helping fund this implementation money  for other states).

There is some talk from our state leadership about reforming Medicaid before expanding it, although we haven’t seen much action on that since this original decision was made. This leads us to believe that the opposition to the ACA and expanding Medicaid is based on ideology more than a thoughtful attempt to figure out a way to best deliver affordable, quality health care for all in North Carolina…..

Regardless of one’s values and ideological beliefs, however, we haven’t come across many people who believe our health care system is fine as is. We are experiencing a health care crisis in North Carolina, and it is not going to go away on its own. Montana just this week became the 30th state to expand Medicaid, providing 70,000 people with access to affordable health insurance. In NC, that number would be closer to 500,000.  

The refusal to expand Medicaid in NC affects everyone. We took the opportunity recently (October 28), to highlight the unique ways lack of access to health care impacts women. October is Breast Cancer Awareness Month and Domestic Violence Awareness Month – issues that directly impact women in greater numbers then men.  And because of women’s role in reproduction, women typically use (adult) health services at earlier ages than men, and also more consistently. Most people would agree healthy mothers lead to healthy babies, but our current system of Medicaid eligibility only covers poor women without health insurance when they are pregnant. Many medical professionals would agree that regular screenings for breast and cervical cancer are a good way to prevent cancer deaths, but without insurance, one is rarely able to access needed treatment much less preventive services. And many domestic and sexual violence advocates agree that the health care system is a point of entry for many domestic/sexual violence victims to the support services available; so we need to help get them access those resources.

Medicaid Die-In Participants

Medicaid Die-In Participants

Along with Action NC, NC NAACP, MomsRising NC and Progress Action NC, we held a press event to highlight women’s unique health care needs as well as the overall impact of the Governor and NCGA’s decision to not expand Medicaid. The Die-In portion was well covered by the press, and below we are pleased to share the comments from the speakers who directly addressed women’s health.

Domestic Violence and Medicaid Expansion – Tara Romano, President, NC Women United

Stand With Women – Expand Medicaid – Kevin Rogers, Policy and Public Affairs Director, Action NC

To Improve Birth Outcomes – Expand Medicaid – Robin Lane, Health Care For All NC, RN, PNP-C, MPH

Don’t Judge a Medicaid Book By It’s Cover – A Personal Story – Jessica Muerrell, MomsRising NC

North Carolina can still expand Medicaid. The clock is ticking on the offer by the federal government to cover all of the costs during the first years of implementation, but the offer is still there. The Governor and legislators can reverse this decision, and show us they are committed to ensuring access to health care for all residents of the state.

Tara Romano, President, NC  Women United