A celebration of the Affordable Care Act at an uncertain time for Medicaid
NC Medicaid director Jay Ludlam talks about the consequences of federal cuts to Medicaid at Martin Street Baptist Church in Raleigh on March 24, 2025. (Photo: Lynn Bonner)
A celebration of the 15th anniversary of the Affordable Care Act came with warnings of potential cuts to Medicaid.
The Affordable Care Act, known as Obamacare, was signed into law about 15 years ago. Now, 1.6 million people in North Carolina are insured under some aspect of the law. Nearly 1 million people have subsidized health insurance through the ACA, and about 640,00 adults are enrolled in Medicaid under expansion, which the ACA allowed, and state leaders approved in 2023.
Congressional Republicans are contemplating federal budget cuts that could erode Medicaid services and force people who enrolled in expanded Medicaid off of their health insurance.
Republicans in the U.S. House are considering Medicaid cuts of up to $880 billion over 10 years. That would translate to a $27 billion funding decrease for North Carolina over 10 years.
Medicaid improves residents' health and brings billions into the state's economy, state Medicaid director Jay Ludlam said Monday at Martin Street Baptist Church in Raleigh.
'Despite widespread support for North Carolina Medicaid, Congress is proposing massive cuts that will hurt North Carolina,' he said.
The federal government pays 90% of the cost for people covered under Medicaid expansion. In North Carolina, hospitals pick up most of the rest. None of the costs come from state coffers.
Congress could decide to reduce federal support for people covered under expanded Medicaid. If that happens, current state law says that Medicaid expansion will end, and people who use the insurance would lose it.
Other Medicaid reductions under consideration in Congress would mean 'a cut to the number of people who are eligible, a cut of the number of services available, and a cut to what providers are paid,' Ludlam said.
'Bottom line, it means fewer people getting fewer services, and providers getting paid less,' he said.
In all, 3.1 million North Carolinians use Medicaid as their health insurance.
Forty percent or more of the residents in 29 mostly rural counties are enrolled in Medicaid, according to the state Department of Health and Human Services. Older adults and people with disabilities account for 21% of the state's Medicaid enrollment but 54% of Medicaid spending, according to DHHS.
Gov. Josh Stein and his administration have been warning about the consequences of Medicaid cuts for citizens and hospitals.
The NC Navigator Consortium, which offers people advice about Medicaid plans and ACA marketplace insurance plans, is already facing a massive budget cut.
In February, the Centers for Medicare & Medicaid Services announced a 90% cut in navigator services grants. For the NC Navigator Consortium, that means a reduction from $7.5 million to $750,000, said director Nicholas Riggs.
The Consortium is designed to provide one-on-one assistance to people searching for insurance coverage. Last year, it provided 124,000 people with one-on-one help, Riggs said.
In 2017, the last time the Consortium had to absorb a big federal grant cut, it helped only 25,000 people, he said. Now that more people than ever need the Consortium's help, it doesn't have the capacity to provide it, Riggs said.
Jennifer Snowhite of Winston-Salem said she and her husband, both artists, lived without health insurance for years because they couldn't afford it.
'When the ACA was first introduced, we jumped on board,' she said.
A few years later, her husband saw a doctor for a cough. Later that day, they were told he had two tumors in his chest.
'To say we were terrified is the understatement of the year,' she said.
The next day, she attended an ACA open enrollment event at a public library. There, Snowhite said, she sought out a Consortium navigator who worked with her for hours to find the best insurance plan.
'Thanks to her depth of knowledge of ACA coverage choices, we were able to find a plan to allow him to go out-of-network to see the doctors that he needed,' she said.
When Snowhite was diagnosed with breast cancer a year later, she didn't have to worry about insurance coverage. She is now cancer free.
Her husband's recovery meant he was able to launch a project that employed 150 people, she said.
'We are so incredibly fortunate to be the beneficiaries of the ACA as well as the NC Navigators,' she said. 'Without you, I fear we would now be a too-typical story of bankruptcy or far worse. Instead, we have so much to celebrate.'
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May's Consumer Price Index (CPI) report showed inflation pressures eased on a monthly basis despite investor concerns that President Trump's tariffs would accelerate the pace of price increases. The Consumer Price Index (CPI) increased 0.1% on a monthly basis in May and 2.4% on an annual basis, a slight uptick from April's 2.3% gain. Yahoo Finance's Allie Canal reports: Read more here. I would keep an eye on consumer names off the news of a trade deal with China floated by President Trump this morning (see our prior post below). Seeing upticks premarket in heavily China-exposed retailers such as Nike (NKE), Walmart (WMT), Target (TGT), and Abercrombie & Fitch (ANF). The premarket gains here aren't mind-blowing in part because tariffs appear to still be in place. Trump posted on Truth Social: OUR DEAL WITH CHINA IS DONE, SUBJECT TO FINAL APPROVAL WITH PRESIDENT XI AND ME. FULL MAGNETS, AND ANY NECESSARY RARE EARTHS, WILL BE SUPPLIED, UP FRONT, BY CHINA. 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"China is hurting, yes—but they still hold the upper hand on critical resources, and they know how to use them." Any lessening of tensions — and freer flow — of these mineral resources in China would be a significant boost to the global economy with China holding outsized leverage in both the reserves and processing capacity of these key building blocks for everything from computers to electric vehicle batteries to medical devices. Likewise, the US offering concessions on export controls would be a significant move after years where successive US administrations have wielded these controls — especially around the design and manufacture of semiconductors — by saying they need to be tight on China for national security reasons. Read more here. May's Consumer Price Index (CPI) report will be released on Wednesday and its expected to show that prices rose a bit faster than in April. Yahoo Finance's Allie Canal breaks down what to look out for and how President Trump's tariffs are impacting what consumers are now paying for goods and services. Read more here. Now that the US-China trade truce is back on track, both sides are keen to ensure it stays that way. China's Vice Premier He Lifeng said both sides need to now 'show the spirit of good faith in abiding by their commitments and jointly safeguard the hard-won results of the dialogue.' Bloomberg News reports: Read more here. Reuters reports: Read more here. Despite the US-China trade truce resuming the pain from President Trump's tariffs remains in China, especially among small exporters. Reuters reports: Read more here. Japan warned Wednesday that tariffs threaten its economic growth, the government said in a monthly report. Reuters reports: Read more here. Reuters reports: Read more here. Reuters reports: Read more here. A federal appeals could said on Tuesday that President Trump's sweeping tariffs can continue for now. This is a significant win for Trump, who introduced tariffs back in March and declared "Liberation Day," as he saw them as a way to free the US from what he called unfair trade practices. Bloomberg News reports: Read more here. Early summer sales for Inditex, the owner of fashion retailer Zara, came in weaker, as the company missed expectations for first quarter sales on Wednesday. President Trump's tariffs have impacted consumer demand in the US and other major markets. Reuters reports: Read more here. After weeks of back and forth, the US and China have agreed on a framework to implement the Geneva consensus that helped ease tariffs. The breakthrough came after two days of talks in London, including a marathon session on Tuesday. US Commerce Secretary Howard Lutnick said both sides had to "get the negativity out" before making progress. 'Now we can go forward to try to do positive trade, growing trade,' he said. As part of the deal, Beijing has promised to speed up shipments of rare earth metals, a crucial component for global auto and defense industries. Washington will ease export controls. This marks the first sign of movement on key issues. The proposal will now be presented to President Trump and China's Xi. Still, the discussions also did little to resolve a long-standing issue: China's trade surplus with the US. 'Markets will likely welcome the shift from confrontation to coordination,' said Charu Chanana, chief investment strategist at Saxo Markets. 'We're not out of the woods yet — it's up to Trump and Xi to approve and enforce the deal.' The meeting was set up after a phone call between the two leaders, following weeks of each side accusing the other of breaking the Geneva commitments. Both countries had used chips, rare earths, student visas and ethane as bargaining tools. Josef Gregory Mahoney, a professor at East China Normal University, said trust, not money, has been the biggest casualty of the trade war. 'We've heard a lot about frameworks,' he said. 'But the fundamental issue remains: Chips versus rare earths. Everything else is a peacock dance.' Bloomberg reports: Read more here. Sign in to access your portfolio
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