National Medicaid leader joins NC Gov. Cooper to celebrate Affordable Care Act, Medicaid expansion

One of the nation’s top Medicaid leaders was in Raleigh on Wednesday to celebrate a big milestone in health care coverage under the Affordable Care Act, sometimes called Obamacare.

Centers for Medicare and Medicaid Services Administrator Chiquita Brooks-LaSure said national ACA enrollment through the federal marketplace and state-based plans had reached 20 million people this year. Brooks-LaSure appeared with North Carolina Gov. Roy Cooper at a small event at Martin Street Baptist Church.

The deadline for ACA enrollment this year is 11:59 p.m. on Tuesday, Jan. 16.

"We cannot wait for the final number. We hope that it's over 20 million so we can legally pop a bottle of champagne," Brooks-LaSure said.

"ACA coverage is not just a card in your pocket. It means access to doctors, nurses, medications, and mental health care," LaSure said. "We have come so far, and this state has so much to celebrate with historic ACA enrollment and the expansion of Medicaid in the same year."

Brooks-LaSure and Cooper had high praise for North Carolina’s healthcare navigator consortium in particular. As of Jan. 10, there are 996,250 people in North Carolina covered through the federal ACA marketplace, found at healthcare.gov.

“Think about how complicated health insurance can be,” Cooper, a Democrat, said. “For people who really haven't even had the opportunity much to deal with health insurance, having a navigator who can help explain it to them in everyday language is critical.”

Navigators can also help people apply for Medicaid. Under the expansion, some who were previously ineligible are now eligible. Cooper urged people to reapply if they’ve been turned down in the past.

“A lot of working North Carolinians who are working a couple of jobs and don't have health insurance, or they work for a company that can't afford to give them health insurance — this is a way to get covered,” Cooper said.

The governor said more than 311,000 people have been added to the state’s Medicaid rolls since expansion took effect on Dec. 1, 2023. There's no enrollment deadline for Medicaid — it's always open.

Some people have been able to transfer out of the ACA marketplace onto Medicaid, like Patrick Dunnagan of Raleigh. His ACA coverage was costing him $500 a month. He’s now covered by Medicaid expansion, so he no longer pays a premium, and he can purchase the drug he needs for his kidney disease at a much lower price.

“Medicaid expansion gives me access to doctors, specialists, prescriptions and therapies I need while giving me greater financial freedom to support my family,” Dunnigan said at the event. “This is powerful. And I'm so thankful.”

Cooper said all the progress that's been made under the ACA and Medicaid expansion could be at stake in this fall's election. He pointed out that former President Donald Trump has said he'll try again to repeal the ACA if he's elected to a second term. A repeal effort in 2017, during Trump's first term in office, came within one Senate vote of succeeding.

"That was one of the promises that [Trump] actually tried to keep, so we need to believe him when he says these things," Cooper said.

Cooper added that repealing the ACA would affect people who have private insurance, as well as those on ACA plans and expanded Medicaid.

"These insurance companies would have more freedom to exclude people and exclude services without the Affordable Care Act," he said. "You have people running who don't believe that these people should be provided with health care, and they do not have an alternate plan that could provide that coverage."