Roughly 8 percent of the 2.9 million Americans who exist in the “Medicaid gap” are in North Carolina, according to health advocates who planned to raise the issue at the General Assembly on Wednesday.

“It’s amazing,” said Ciara Zachary, Health Access Coalition policy analyst, who added that North Carolina ranks fourth in uninsured people after Texas, Florida and Georgia in a 2015 Kaiser Family Foundation analysis. The North Carolina Justice Center argues that closing the gap would provide health care coverage for 500,000 North Carolinians.

The issue stems from Congress passing the Affordable Care Act in 2010, which intended to expand Medicaid to millions of uninsured individuals. A subsequent U.S. Supreme Court ruling, however, allowed states to opt out, which North Carolina did.

On Wednesday, advocates, patients, health care providers and lawmakers, including Sen. Floyd McKissick, a Durham Democrat, planned to gather at the General Assembly and urge lawmakers to support legislation containing language addressing the gap, including Senate Bill 365 and House Bill 330.

Medicaid’s shadow falls across North Carolina politics, with opponents calling it a bureaucratic nightmare of mismanagement and waste. When announcing his budget in April, Gov. Pat McCrory said lower-than-anticipated Medicaid enrollment had improved the states fiscal outlook enough that additional funds were available to potentially cover pay raises and bonuses. Last year, one of the state’s most watched legislative battles involved shifting Medicaid from a fee-for-service model to a managed care system.

Earlier this year, a poll conducted by the liberal-leaning Public Policy Polling found a majority of Republican and unaffiliated voters supported providing health insurance to people caught in the gap. Commentators noted, however, that the poll’s accuracy was questionable because of its language. The poll asked respondents about “fixing the health insurance coverage gap” as opposed to “expanding Medicaid.”

Advocates push for Medicaid expansion
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