North Carolina is facing alarming health challenges. The opioid epidemic is still raging. Steep racial disparities are driving unacceptable differences in life expectancy. The state’s infant mortality rate is higher than the national average.

And clinics and small hospitals, especially in rural regions, are closing or operating on life support.

As the leaders of health foundations, we are tasked with helping our state’s most vulnerable residents thrive. We know there is no magic elixir to accomplish this task. But there is a policy that is putting many states on the path to progress: expanding Medicaid eligibility.

Currently, our Medicaid program is remarkably restrictive, which leaves large gaps in our state’s safety net insurance system. In North Carolina, parents who earn more than $10,000 per year are ineligible for Medicaid. Childless adults, no matter how poor, are not eligible unless they are disabled or elderly.

Other states, including Kentucky, Virginia, Ohio, and West Virginiam are leveraging federal funds to broaden eligibility in Medicaid. This move is generating billions of dollars in new business activity, giving families better access to preventive care, and bolstering rural health care facilities.

To understand the impacts of expanding Medicaid, we commissioned a study of the coverage and economic implications for every county. According to this newly released research, closing the coverage gap will create 37,000 new jobs by 2022, and it will extend health insurance to hundreds of thousands of uninsured residents. These new jobs will spur local economies in every corner of the state and boost business activity by $11.7 billion in the near term.

For us, this decision is not about politics.

As a physician and a nurse, we have many years of experience caring for patients. We know the terrible toll of uncontrolled diabetes and high blood pressure. We have seen the tragic results of people waiting too long for routine care. We also know that many parents and caregivers who are raising our next generation fear the financial upheaval of their own health problems. And we know that we can do better.

We don’t always have policy levers like Medicaid expansion that could do so much for so many. We know this opportunity will continue to attract attention and debate. And once we move past the myths and misgivings, we trust that policymakers will do what is right and sensible.

Closing the Medicaid coverage gap means more jobs and billions in economic benefits to our state. It means a better chance to combat the opioid epidemic and the infant mortality rate head on. It means health care access for hundreds of thousands of hardworking residents.

Expanding more care to more people is who we are as a state. North Carolina must act now.

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Laura Gerald, M.D., M.P.H., is the president of the Kate B. Reynolds Charitable Trust, which works to improve the health and quality of life of financially disadvantaged residents in Forsyth County and around the state.

Susan Fitzgibbon Shumaker, R.N., M.H.A., is the president of Cone Health Foundation, which works to measurably improve the health of the people in the greater Greensboro area.

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