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Member Research & Reports

Member Research & Reports

UNC: 200,000 North Carolinians Are in the ‘Medicaid Gap.’ What Does That Mean?

North Carolinians who fall in the “Medicaid gap” are less likely to regularly use preventive care and more likely to put off needed care due to cost, finds a new study from the University of North Carolina Gillings School of Global Public Health.

North Carolina is one of several states that has not expanded Medicaid eligibility to cover all low-income adults, and it’s estimated that there are about 200,000 North Carolinians in the “Medicaid gap.” Their income is below the poverty limit — making them ineligible for premium subsidies through the health insurance marketplace — but they cannot access Medicaid, either.

Dr. Jennifer Spencer, a recent UNC Gillings graduate, and Mr. Alex Gertner, a doctoral candidate, worked with Dr. Pam Silberman, professor in health policy and management, to examine the health status and access to care of North Carolinians who would receive Medicaid if North Carolina expanded the program. Their study was published online by the North Carolina Medical Journal.

In addition to being less likely to use preventive care and more likely to put off needed care due to cost, those in the Medicaid gap are less likely to have complex health problems than traditional Medicaid beneficiaries, the study revealed.

“The Medicaid gap population is not well understood in North Carolina, and the differences between the traditional Medicaid population and the Medicaid gap population is really striking,” says Dr, Spencer, the lead author of the study. “Particularly, the finding that this population is less likely to have complex health needs may lessen some of the worries that expanding Medicaid for this population would be a burden on our health care system. A lot of what we find is individuals with poor access to primary and preventive care, which is a problem expansion could address.”

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