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Hi John,

Last December, more than 600,000 North Carolinians became eligible for Medicaid following a vote to expand the healthcare program in the state.

That may sound compassionate, but in this week’s edition of Locke Notes, we’ll dive into why expanding Medicaid actually may worsen healthcare access for those who need it most while driving up costs for taxpayers.

Worsening Access to Care

It’s been over a decade since the Affordable Care Act (Obamacare) allowed states to expand Medicaid. Studies conducted since then have shown that expanding Medicaid limits access to healthcare for the most needy.

North Carolina’s healthcare system already faces a looming staffing shortage ([link removed]) . Expanding access to Medicaid means that more patients will see the doctor when it’s not necessary, meaning longer wait times for appointments.
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That’s not all.

Medicaid expansion has also been linked to slower ambulance response times and longer emergency room delays. And one study even found that overall mortality trends worsened in states that expanded Medicaid programs ([link removed]) . Mental health among Medicaid enrollees also declined, especially in rural areas.

As our Senior Vice President of Research Brian Balfour has warned, greater coverage does not mean better access to care. And expanding Medicaid may very well make care worse.

To add insult to injury, the expansion adds high costs to already bloated state and federal budgets. Taxpayers should not have to shell out millions more to fund these trouble-plagued, counterproductive measures.

A Better Way

Instead of expanding coverage, North Carolina should reduce the government intervention that causes these healthcare woes in the first place. Free market options that reduce costs should be considered instead.

Furthermore, the federal government can help by restructuring Medicaid. Giving North Carolina and other states more budgetary flexibility with annual block grants ([link removed]) could prevent Medicaid cost overruns.

Ultimately, it’s by deregulating healthcare that our state can improve care for North Carolinians and ease costs.

Esse Quam Videri,
Brooke Medina


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of North Carolinians will be dependent on Medicaid under the new expansion ([link removed])
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