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.'
Hashtags

Try Our AI Features
Explore what Daily8 AI can do for you:
Comments
No comments yet...
Related Articles

Yahoo
30 minutes ago
- Yahoo
Maxwell: DeSantis orders Orlando Sentinel to stop investigating his scandal. That's not happening.
Late last week, Gov. Ron DeSantis' administration publicly threatened the Orlando Sentinel reporter who has been investigating the Hope Florida scandal. Welcome to the 'Free State of Florida,' where the governor feels free to live out authoritarian fever dreams surrounded by staff who are apparently unwilling to tell Mao ZeRon that emporers can't control journalism in this country. Just after noon on Friday, Florida's Department of Children and Families issued what it labeled a 'cease and desist' demand that Sentinel reporter Jeff Schweers stop his reporting efforts after saying it had 'heard' that Jeff might be 'threatening or coercing' foster families in Florida. There was no proof. No specifics. The letter wasn't even signed by anyone — maybe because no reputable attorney would put their name on a document that looked like it was written by a Twitter bot trying to cosplay as a lawyer. It was just an anonymous, undocumented claim that someone had heard something about harassment, which the governor then tweeted along with the comment: 'Bottom feeders gonna bottom feed…' The governor's tweet — which included Jeff's email address — prompted the kind of online reaction DeSantis surely expected. One of the governor's followers called for Jeff to be arrested. Others responded to the governor's name-calling with more name-calling, either opting for antisemitism or just blanket statements like: 'Journos are some the worst people alive. Scum of the earth.' By this point, you might be wondering: So what did Jeff do? Well, for months now, he's been trying to track down how the DeSantis administration has been spending money — some of it public, some of it private donations that are supposed to be carefully accounted for the IRS. That apparently scared the hell out of the governor and his staff. Specifically, Jeff was trying to find out what happened to public money given to the beleaguered Hope Florida program championed by Ron and Casey DeSantis. And Jeff isn't the only one. Legislative Republicans have flat-out said they believe crimes were committed. A prosecutor is looking at the issue as well. But apparently Jeff was getting too close to the truth for comfort. So the DeSantis administration bogusly claimed he was 'threatening' foster families and ordered him to stop his reporting. Well, that ain't gonna happen. As the Sentinel's executive editor, Roger Simmons said: 'We stand by our stories and reject the state's attempt to chill free speech and encroach on our First Amendment right to report on an important issue.' Editorial: Intimidation won't make the Sentinel back down on Hope Florida story Reporting, after all, is what newspapers do. We search for answers. And Jeff has been doing it for years. In fact, before he started working for the Sentinel a few years ago, Jeff worked for the Tallahassee Democrat where he investigated scandalous behavior by Andrew Gillum. Gillum, as you may recall, was the Democratic candidate for governor against … wait for it … Ron DeSantis. And some of Jeff's reporting was so damning to Gillum that the stories generated by Jeff and his colleagues were used by the DeSantis campaign to help DeSantis eke out a 0.4% victory. So to recap: When newspapers investigate a Democrat, everyone should pay attention. But if they investigate DeSantis, it's bottom-feeding that needs to be shut down. The latest scandal involves Hope Florida — the moniker for both a state program and affiliated private charity that the DeSantises have championed. The couple say the programs have been successful at getting struggling citizens off welfare. But GOP legislators (yes, lawmakers from the governor's own party) say they believe public money was inappropriately 'laundered' to political causes and campaigns. For journalists, a common mantra is: Follow the money. But that's been particularly challenging in this story that involves two entities by the same name, money transfers and incomplete financial records. Maxwell: Scandals for Dummies. Breaking down the Hope Florida fiasco It has been my experience that, when financial stories are complicated, that's often intentional. Someone doesn't want you to follow the money. But Jeff and other Florida reporters have kept on digging. And that's what has the DeSantis administration nervous. Last month, Jeff tracked down one of the few, specific people Hope Florida had touted as a success story for being weaned off public assistance only to learn that she appeared 'no better off than she was. She lives with her three youngest daughters in a double-wide mobile home … not working, and she and her children are still on Medicaid … just as they were three years ago.' Financial independence eludes Hope Florida 'graduate' 3 years later This week, Jeff combed through IRS records to learn that a golf-tournament fundraiser staged by the Hope Florida Foundation actually reported losing $17,000 — only to have the foundation's attorney say that the foundation would soon be filing an amended report. How fortuitous for the charity that Jeff was able to help it sort out its finances. Hope Florida Foundation to amend tax return to show golf tourney made more money And those are just the stories Jeff was able to ferret out with access to limited records. He said he's still waiting for the state to provide specific details about how it spent more than $20 million in federal relief funds — a request he filed back in October 2024 If Hope Florida looks like a three-alarm dumpster fire right now, one wonders how many alarms would go off if journalists and the public ever get to see the full financial picture. To that end, when the governor of America's third-largest state took to Twitter to try to debase and bully, Jeff responded with a pretty simple, nine-word question: 'Why not respond to my numerous public records requests?' The answer to that is becoming increasingly obvious. Because the more the facts get out, the worse things look for DeSantis. So the state's top elected official is trying to use all the influence he can to stop journalists from even asking questions. smaxwell@


Washington Post
34 minutes ago
- Washington Post
Ahead of UN climate talks, Brazil fast-tracks oil and highway projects that threaten the Amazon
MANAUS, Brazil — Months before hosting the U.N.'s first climate talks held in the Amazon , Brazil is fast-tracking a series of controversial decisions that undercut President Luiz Inácio Lula da Silva's lofty environmental rhetoric and show widening divisions within his cabinet. The country's federal environmental agency approved plans for offshore drilling near the mouth of the Amazon and rock blasting along another river in the rainforest, while Congress is moving to make it harder to recognize Indigenous land and easier to build infrastructure in the rainforest.
Yahoo
35 minutes ago
- Yahoo
Republican Senator Co-Sponsors Bill To Raise The Minimum Wage To $15
Sen. Josh Hawley of Missouri proposed a bill Tuesday that would raise the federal minimum wage to $15 per hour, his latest move to frame himself as a new kind of pro-worker Republican. Hawley's legislation is not in any danger of actually becoming law — his fellow Republicans hold a majority in the Senate and have been blocking minimum wage increases for years. But the proposal aligns him with a core Democratic demand and further separates Hawley from the traditional anti-union, free-market wing of the GOP when it comes to labor policy. 'Right now, working families, I mean, they haven't gotten a real wage raise in years, and they can't afford anything,' Hawley told HuffPost. 'Right now, the federal minimum wage, if you index it for inflation, or relative to inflation, it's the lowest level since the 1940s.' The federal minimum is just $7.25 per hour and hasn't been raised in more than 15 years, by far the longest such stretch since it was created during the Great Depression. It prevails in the 21 states that currently don't mandate a higher one, many of them clustered in the South. Right now, working families, I mean, they haven't gotten a real wage raise in years, and they can't afford Josh Hawley of Missouri (R) Hawley's bill, co-sponsored by Democratic Sen. Peter Welch of Vermont, would raise the wage floor to $15, then tie it to an inflation index so that it goes up with the cost of living — a common feature in more progressive legislation. Such a hike would force increases in all but the mostly blue states where the wage floor has already been raised above that level. Hawley did not pretend that his proposal stands much chance of becoming law. 'I will try to move it. I mean, I'd love to get a vote on it,' he said. The proposal puts Hawley far ahead of other Republicans, but still behind Democrats on the issue. Most Democratic lawmakers are now pushing for a $17 minimum wage, arguing that $15 — the rallying cry of the Fight for $15 labor campaign, which began in the fast food industry in 2012 — has become inadequate as a living wage due to inflation. Although he supports a more aggressive raise, Sen. Bernie Sanders (I-Vt.) seemed pleased to see Hawley separate himself from other Republicans on the issue. 'I think every Democrat, last month, voted to raise the minimum wage to $17, and I'll look forward to working with Sen. Hawley,' Sanders told HuffPost on Tuesday, referencing an April vote on an amendment to a symbolic budget resolution. The amendment failed by a vote of 47 to 52 with every Republican except Hawley voting no. Hawley said that if the Republican Party wants to brand itself as the party of working people — which it does, according to statements from President Donald Trump and other leaders — then Republicans need to back policies that benefit the working class. 'This is what President Trump ran on. I mean, if we're going to be a working party, we have to do something for working people, and working people haven't gotten a raise in years,' Hawley said. Hawley's positioning himself as a populist, pro-worker conservative has drawn plenty of suspicion from progressives who fear it's a ploy to further drain the Democratic Party's working-class support. Hawley is not the first Republican to back a minimum wage increase. Back in 2021, Sen. Tom Cotton (Ark.) and then-Sen. Mitt Romney (Utah) proposed a boost from $7.25 to $10. But the bill included an immigration measure that would have mandated nationwide use of e-Verify to crack down on undocumented workers, a poison pill for Democrats that isn't part of Hawley's legislation. Earlier this year, Hawley released a policy platform dubbed a 'Pro-Worker Framework.' It included some pro-labor reforms typically associated with Democrats, like putting limits on mandatory 'captive audience' meetings, in which employers pressure workers not to form unions. Then, in March, he joined Democratic Sen. Cory Booker (N.J.) in proposing a bill that would speed up the process for workers to secure their first union contracts, the sort of legislation a typical Republican wouldn't go near. As with Vice-President J.D. Vance, Hawley's positioning himself as a populist, pro-worker conservative has drawn plenty of suspicion from progressives who fear it's a ploy to further drain the Democratic Party's working-class support. But when it comes to maybe moving legislation, lawmakers like Sanders like the idea of having a Republican to work with. 'It would be great if we could get some other Republicans,' the Vermont senator said. '$7.25 federal minimum wage is a national disgrace. We've got to raise it.'