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Closing the Coverage Gap


North Carolina Still Has a Coverage Gap

What is the Coverage Gap?

In states that do not expand Medicaid, many adults fall into a “coverage gap” of having incomes above Medicaid eligibility limits but below the lower limit for Marketplace premium tax credit (Kaiser Family Foundation). Because North Carolina did not expand Medicaid, we have hundreds of thousands of people that fall into this coverage gap.

  • Estimates indicate that 400,000-626,000 people would benefit from closing the Medicaid Coverage Gap in North Carolina.
  • There are more than 119,000 uninsured children in the state (44th in the nation), and closing the Coverage Gap could greatly reduce that number since children are more likely to get covered and stay covered if their parents gain access to insurance coverage.
  • In 2017, 43% of all FQHC patients in North Carolina were uninsured, and more than 70% of patients lived at or below 100% FPL (source: 2017 BPHC UDS)
  • Community health centers served more than 207,000 uninsured adults in 2017, and the majority of those fell in the Medicaid Coverage Gap. Our providers see firsthand the significant health challenges and barriers to needed services that these patients face.
  • Expanding coverage in NC could bring 40,000 jobs to the state as well as $4 billion in economic impact (Cone Health report)
  • Estimates indicate Medicaid expansion would bring 15,400 jobs to rural counties.

  • Community health center providers often have to modify treatment plans for uninsured patients because of the patients’ inability to afford a specialist visit or pay for needed medications.
  • Under Medicaid expansion, outpatient providers could address many of the currently untreated issues that often result in patients seeking inefficient, costly, and inappropriate care in the emergency department. 

Want To Get Involved?

  • NCCHCA issued a press release about a 2019 Republican-sponsored bill that works to get more people health insurance. Read the release here.
  • Join one or both of two coalitions working to expand coverage in North Carolina.
  • Or, find out how expansion could help your county. County reports can be found here.
  • Got stories?

    Health Action NC wants to hear from some of the 300,000 uninsured North Carolinians who have fallen into the health coverage gap because of our state's decision to not expand Medicaid. Personal stories are the most powerful tool we have in our fight to expand access to quality affordable healthcare. By telling your story, you put a face on the Tar Heels whose lives would be improved if they could get the health care they need. These stories will be at the center of our advocacy work for Medicaid expansion during the 2019 North Carolina Legislative Session. If you have any questions about stories you might want to share, please contact Rebecca Cerese at

    We also have a Story Collection Phone Line if you'd rather leave your story in a voice message. That number is 1-833-831-2035. We will not use any stories without your consent, and we can accommodate anyone that wants to remain anonymous. 



In partnership with the Health Access Project in 2016, we collected stories from CHC patients and assembled a Close the Gap Storybook.

Click here or on the image above to download and view the storybook.

Here’s how you can help

Show Your Support for Closing the Coverage Gap!

North Carolina could help as many as 400,000 North Carolinians who lack access to affordable health insurance. Federal funding is set aside to provide insurance to this population. 

  • Write a Letter to the Editor
  • Talk to Policymakers and the Media

Research and Analysis

more Events and Training

6/26/2019 » 6/28/2019
2019 North Carolina Primary Care Conference - Sponsors & Exhibitors

6/26/2019 » 6/28/2019
2019 North Carolina Primary Care Conference

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