Medicine and Health

Opposition of Legislation Bill

To Whom It May Concern,

Representatives from the North Carolina General Assembly drafted HOUSE DRH30016-ME-26A* to refute the federally mandated health benefit exchange as summarized in the Affordable Care Act and instead use its own exchange program, while also rejecting the Act’s expansion of Medicaid services (General Assembly of North Carolina, 2013). I hereby oppose this Bill because it does not coincide with the basic principles of the Affordable Care Act, which was mandated by the federal government for all states to follow. Naturally, there is some flexibility within the Act and may be interpreted by states differently, but this bill essentially overrides the exchange mandate and leaves entire control in the hands of the state. From a citizen’s perspective, refuting the federal mandate is not a viable approach in order to achieve the requirements of the rest of the Act and this change will likely limit the freedoms that North Carolinians have in obtaining access to health insurance without difficulty.

The Affordable Care Act established a program known as Affordable Insurance Exchanges as a means of enabling citizens to make insurance selections from a “one-stop shop” where all insurance plans will be available (CMS, 2013). This program will begin in 2014 and will provide consumers with options for health insurance that they choose themselves when they do not already have insurance from another source (CMS, 2013). This program is designed to provide affordable insurance premiums for consumers with private health insurers, regardless of their health status (CMS, 2013). This program is integral to the success of the objectives of the Affordable Care Act and should be accepted as the new normal.

Another issue with the Assembly bill is the refusal to expand Medicaid services for those without any other form of insurance. If this option is taken, there will be no option for many consumers at the poverty level or facing other challenges who have no other means of health insurance (Waldman). Medicaid expansion could provide health services for patients when these rates are not accepted by providers (Waldman). By removing this option for North Carolina residents, it is likely that they will suffer at the expense of poor government choices over the long term. This set of circumstances is particularly problematic in a society which has expanded its emphasis on optimal health and wellbeing for all citizens, including the poor and impoverished living in North Carolina. For this population group, a perception exists that the government has essentially turned its back on the poor and will not provide them with any type of expanded support when healthcare assistance is required. This circumstance is unacceptable and should not be tolerated. With Republican leadership in the governing seat, it is likely that this decision is GOP-motivated and does not truly consider the needs of the population at large (Kaiser Health News, 2013). This decision reflects quite poorly on the legislative and executive branches of North Carolina and the motivation behind this practice is unjust and unacceptable for its people.

In reference to the General Assembly Bill, it is important to reconsider the consequences of this Bill for the poorest and least fortunate communities of North Carolina because they will ultimately suffer more than other groups. As a resident, this decision should not move forward because it places a serious economic burden back on the State and on the federal government by refusing to support Medicaid expansion as needed. In addition, the refusal to accept the mandates of the Affordable Care Act is in direct contrast with the objectives that are being sought with the creation of a universal healthcare process. Please reconsider the long-term consequences of this decision and how it will impact many communities and their residents, including young children, in significant ways.


Centers for Medicare and Medicaid Services (2013). Affordable insurance exchanges. Retrieved  from

General Assembly of North Carolina (2013). House DRH30016-ME-26A* (01/03). No N.C. Exchange/No Medicaid Expansion.

Kaiser Health News (2013). Other governors pressured for and against Medicaid expansion. Retrieved from

Waldman, B. The ACA’s now optional Medicaid Expansion. Retrieved from