Running the Numbers

North Carolina Medicaid primarily serves the state's most vulnerable populations: children from low-income households, older adults, people with disabilities, pregnant women, and refugees. North Carolina's Medicaid program, the 12th largest by expenditure in the United States, served an average of more than 1.8 million beneficiaries each month during state fiscal year (SFY) 2016. Children under the age of 18 years make up over half of the beneficiary population for these programs (see Figure 1). North Carolina Health Choice, the state's version of the Children's Health Insurance Program, provides health care to a monthly average of more than 80,000 children whose household incomes are too high for them to qualify for Medicaid but who still cannot afford private health insurance. Given that significant changes in the state's Medicaid system are anticipated in the near future, it is important that readers understand the current system, who it benefits, and how current funds are spent. This article provides an overview of the scope of North Carolina's medical assistance programs and outlines the ways that tax dollars provide critical health care to North Carolina families. Medicaid and Health Choice Enrollment Over the past 10 fiscal years, enrollment in the North Carolina Medicaid program increased by 53% (see Figure 2) [1]. During this period, the biggest increase in monthly average enrollment occurred in SFY 2015 [2], largely as a result of the Patient Protection and Affordable Care Act's open enrollment period, during which potential Medicaid-eligible beneficiaries were directed to available resources. Additionally, changes in the…