Medicaid expansion is all over the news. Learning the ins and outs of government programs that may not impact you or your family members can be a tall and boring task. So let’s try to wrap our heads around this subject by using numbers.
- There are currently 2.1 million Medicaid recipients in North Carolina[i]
- Today Medicaid expenditures in North Carolina total $14.6 billion[ii]
- The state government’s cost of the Medicaid pie is $3.7 billion[iii]
How big are current Medicaid expenditures?[iv]
- $14.6. billion is 61% of the $23.9 billion North Carolina State Budget.
- $14.6 billion is a equal to the combined annual budget of public education (K-12, UNC System and community colleges) as well as the Departments of Labor, Commerce and Agriculture and Consumer Services.
- $14.6 billion is enough to fund the budget of the Department of Justice and Public Safety for almost 5 and-one-half years.
- $14.6 billion divided among 2.1 million Medicaid patients in North Carolina is $6,952 per recipient.
- $14.6 billion is enough money to give every person in North Carolina a check for $1,445.
North Carolina’s share of current Medicaid expenditures is $3.7 billion. How much is $3.7 billion?
- $3.7 billion will buy 123,333 cars priced at $30,000.
- If you spent $1 dollar per minute, you would not run out of money until you were 7,039 years old.
Medicaid expansion is expected to add 620,000 to Medicaid rolls.[v]
- 77.7 percent – the percent of able-bodied adults, working age adults with no dependent children[vi].
- $341 million – the expected cost of Medicaid expansion, for the first year, alone[vii].
What can you buy with $335 million?
- A pay raise of $3,559 for every teacher in North Carolina.
- If you add $4 million more, you could fund the police budgets of Charlotte, Raleigh and Garner for one year.
90 percent – Expected percentage of costs covered by federal government for Medicaid expansion.
- 698 — percent increase in federal Medicaid budget from 1966 to 2018 ($.9 billion to $629.3 billion)
- $22 trillion – debt level for the federal government[viii].
$94 million — first Medicaid budget in North Carolina (1971); $14.6 billion Medicaid budget in 2018[ix].
What the numbers don’t explain is that Medicaid expansion would fundamentally change the program from one designed to help the neediest among us to an insurance program for many able-bodied adults.
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[i] Monthly Medicaid Enrollee Chart, February 2019, North Carolina Department of Health and Human Services. Available online at:
[ii] Expenditure Dashboard, Medicaid YTD, June 2018 – NCDHHS. https://medicaid.ncdhhs.gov/reports/dashboards#annual.
[iii] Expenditure Dashboard, Medicaid YTD, June 2018 – NCDHHS. https://medicaid.ncdhhs.gov/reports/dashboards#annual
Figure does not include NC Health Plan spending.
[iv] See State Budget figures for 2018, Fiscal Research Division of North Carolina General Assembly for comparison figures.
[v] Enrollment in 2003: 1,047,444 Enrollment in 2018: 2,067,132. Difference is 1,019,688 new enrollees. State Fiscal Year Medicaid State Reports, 2003 and https://medicaid.ncdhhs.gov/reports/annual-reports-and-tables/annual-reports-archive-1979-2008 SFY09 through SFY19 https://medicaid.ncdhhs.gov/reports/enrollment-reports
[vi] Urban Institute, “Opting in to the Medicaid Expansion under the ACA: Who Are the Uninsured Adults Who Could Gain Health Insurance Coverage?” August 2012. https://www.urban.org/research/publication/opting-medicaid-expansion-under-aca
[vii] Senate Bill 290, 2017.
[viii] US DebtClock.org. Accessed on February 15, 2019
[ix] See Annual Report of Medical Assistance, 1980, North Carolina Department of Health and Human Services.
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