Report Ranks NC 48th on MedicaidNorth Carolina ranks 48th out of 50 states for how it runs Medicaid in a report card released in September by the free-market Heartland Institute, ahead of only Rhode Island and California. The state scored 28 of 100 points on 16 measures. Kansas topped the list with 74. The national average was 45.5. The report docked North Carolina for expanding Medicaid under the Affordable Care Act, not acting on work requirements, limiting new hospitals and clinics through certificate-of-need laws, and winning few fraud convictions. Medicaid covers about 3 million North Carolinians, roughly one in four residents. Expansion, approved in a bipartisan 2023 law, now covers about 740,000 adults and is the most heavily weighted item on the Heartland Institute’s scorecard. Beginning Jan. 1, those expansion enrollees must work, study, or volunteer 80 hours a month to keep coverage under a 2025 federal law. |
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