When the Patient Protection and Affordable Care Act passed in 2010, several states opted to reject participation in the expansion of Medicaid provided under the law. North Carolina was one of those states and has continued to be one of 12 states that have continued to refuse to expand coverage for their most needy citizens. Finally, in 2022, the state legislature is seriously considering joining the majority of Americans in expanding these benefits.
Among the thousands of lower income North Carlina citizens who would benefit from expansion are military veterans. In 2016, the Wake Forest School of Law Health Law and Policy Program published a brief that analyzed the effect of expansion on veterans. The report noted many false assumptions held by the general public about benefits for veterans, including that they have full medical benefits from either the Veterans Administration or Tricare. In fact, Tricare is only available for veterans and immediate families following a complete career of service and VA benefits are limited for non-service-related health issues. Additionally, most veterans living outside metropolitan areas are not able to easily access VA facilities. The inability to access health insurance also has a significant age factor resulting in 25% of veterans of the wars in Iraq and Afghanistan being uninsured and unable to access the VA system. In 2016 this included roughly 30,000 North Carolina veterans of whom 12,000 fell into the coverage gap created by the state’s failure to expand Medicaid. Cumberland County, the home of Fort Bragg, is one of the 6 counties with the highest number of veterans who fall into the coverage gap. In 2022, the State of North Carolina’s Department of Health and Human Services raised the estimate of the number of veterans who could benefit to over 14,000.
On June 21, Spectrum News included an interview with retired officers Doug Carver and Jim Hoffman who called for the state to expand coverage. Major General Carver noted the undue effect that the coverage gap has on the younger veterans and Major Hoffman reported that nearly 14,000 veterans were in the coverage gap. On May 30, the Fayetteville Observer printed an opinion piece from Quaker House calling for the state legislature to expand Medicaid. On Tuesday, August 23 Quaker House joined activists from across the state to call for an end to the stalemate and approval of Medicaid expansion. Despite these efforts, it was reported that no progress had been made on expansion during a session of the legislature and that no change was likely before the end of the year. North Carolina has deprived all of its citizens, including thousands of veterans, of the benefits of health insurance and better health care for over 12 years. They should not have to wait another day, much less many more months.