Under the Affordable Care Act, states have the option to expand Medicaid eligibility to nonelderly people with incomes up to 138 percent of the federal poverty level. In North Carolina, which has not expanded Medicaid, key stakeholders are considering adopting the policy. In an earlier report, Urban researchers estimated that full Medicaid expansion in North Carolina would decrease uninsurance by 346,000 people in 2023. In this report, we expand those results to show the characteristics of uninsured people in North Carolina with and without Medicaid expansion and the characteristics of those gaining coverage under expansion. We show results for eight areas: Charlotte, Winston-Salem, Greensboro, Durham/Chapel Hill, Raleigh, and three rural regions (western, southeastern, and northeastern North Carolina).

Overall, uninsurance in North Carolina would fall by 3.8 percentage points, but uninsurance and coverage gains would vary by sociodemographic characteristics and geographic area. By area, the decrease in uninsurance would vary from 4.6 percentage points in western North Carolina to 2.4 percentage points in the Raleigh area. Decreases by race and ethnicity show similar differences, whereas differences by age group, education, and the type of worker in a family vary even more. For example, uninsurance would decrease by almost 8 percentage points for adults ages 19 to 34 but by just 3 percentage points for those ages 55 to 64. Similarly, uninsurance would fall by more than 9 percentage points for people with less than a high school education but by less than 2 percentage points for those who have graduated college. Results by sex and family citizenship status are shown as well.