Expanding Medicaid in North Carolina could mean more jobs, about 37,000 statewide, and health insurance coverage for some 365,000 people.

That analysis comes from George Washington University through funding from Cone Health Foundation and the Kate B. Reynolds Charitable Trust.

The information, held close to the vest until today, comes with an estimate that business activity in the state will increase $11.7 billion — with a “B” — in just three years.

In the report, Wayne County’s share of the Medicaid expansion largesse is impressive, too. The county can expect to see 386 more jobs created in 2022; 9,145 more people getting Medicaid in 2022; $78.1 million more in economic growth from 2020 to 2022; and steady increases in county tax revenue.

“Medicaid expansion is a job creator and can extend health coverage to thousands of previously uninsured North Carolinians who are falling through the gaps in our current system,” said Susan Shumaker, president, Cone Health Foundation, in a statement issued with the study results. “States that have already expanded Medicaid are better equipped to tackle critical health care concerns like opioid addiction and infant mortality rates, issues that need to be addressed here at home in North Carolina.”

Few people would argue against the benefits of Medicaid expansion as laid out in this report. But a few do.

The Civitas Institute argues in a December 2017 paper that the reality of Medicaid expansion is quite the opposite.

• Condemns low-income citizens to an already overcrowded system with little to no access to actual medical care.

• Subjects those enrolled to more inadequate health results.

• Crowds out Medicaid resources for the neediest in favor of childless, healthy adults.

• Costs North Carolina thousands of jobs.

• Comes with a hefty price tag for North Carolina, and increases the national debt.

• Traps more people in poverty.

• Makes health care more expensive for everybody.

“Expanding Medicaid would have disastrous consequences for those it purports to help, and the state of overall healthcare in North Carolina,” the Civitas report suggests.

Cone and Kate B. Reynolds both say that closing the Medicaid gap, getting hundreds of thousands more people health care coverage, means improved lives, even if the coverage comes from a government program designed through federal and state funding to pay the medical bills of low-income households, people with disabilities, pregnant women and others without insurance.

“This report confirms what we’re hearing from families across the state — increased access to quality health care and economic opportunities helps communities thrive, and research shows that expanding Medicaid delivers both,” said Dr. Laura Gerald, president, Kate B. Reynolds Charitable Trust. “Every community stands to benefit from Medicaid expansion. The evidence shows that closing the Medicaid gap will improve population health, support vulnerable North Carolina families, and boost the economy across the major sectors.”

Those opposed to a Medicaid expansion maintain their hard line.

The Civitas report reads: “The goal of expanding Medicaid to hundreds of thousands of North Carolina citizens is sold as a compassionate way to provide access to medical care for low-income families. The reality, however, is that new enrollees would struggle to find access to doctors and the care they need.

“Medicaid rolls in North Carolina have ballooned from about 1 million in 2003 to roughly 2.1 million today. Adding another 630,000 (Civitas estimate for expansion) would push the program over 2.7 million enrollees and mark more than 1.7 million new Medicaid patients in just 15 years.”

Then what’s the alternative? Does one exist?

Proponents of the Affordable Care Act, or Obamacare, openly say that Medicaid expansion is one of its most important provisions. To make the ACA happen, 38 states passed Medicaid expansion while 12 have not. North Carolina has not. But some of those that have adopted it are seeking alternatives to blanket coverage of state residents, such as the health savings accounts, using Medicaid monies to purchase private insurance, reliance on the private insurance market and more cost-sharing among enrollees, practicing personal responsibility and seeking healthy behaviors.

Options are out there. No one group has all the answers. Some are better than others, and where people land pretty much is dictated by how the political pendulum swings. One thing is known for sure. All Americans deserve to have affordable health care. Someday, someone may figure out a way that we get there. Maybe the Cone and Kate B. Reynolds report is enough to persuade North Carolina to join Medicaid expansion. Two bills have failed in the past, but the General Assembly is starting to see some Republican support. We’ll see.

Contact Duke Conover, Goldsboro News-Argus editor, at dconover@newsargus.com or 919-739-7840.