Medicaid Expansion was a part of the Affordable Care Act when it was originally passed in 2010, but the US Supreme Court decision in 2012 that found this act constitutional, also gave states the option to opt out of expansion. North Carolina made that choice in February, 2013, leaving up to 500,000 people in our state with little opportunity to get health insurance coverage.
In December, 2014, the Cone Health Foundation from Greensboro released a study it had commissioned on the economic impact of not expanding Medicaid in North Carolina. Recently, Susan Shumaker, the president of the Foundation, offered a presentation highlighting how not only the state but each county in North Carolina is impacted economically by not expanding Medicaid. The presentation includes statistics on the impact in several counties in the west, including Buncombe County. You can also listen to a short, 9 minute interview with Susan Shumaker, on WCQS here.