Impacts of North Carolina’s Medicaid Expansion on Crowdsourcing Medical Debt

Impacts of North Carolina’s Medicaid Expansion on Crowdsourcing Medical Debt

Zachary Finn, Northeastern University

Policy Brief 2024-5

November, 2024

The Affordable Care Act’s (ACA) Medicaid Expansion has provided millions of low-income Americans with access to affordable health insurance. However, many Americans both with and without health insurance still struggle financially when faced with an adverse health event. These individuals often turn to their local communities through online crowdfunding, as a means to help reduce the financial burden of hospital and other health care related debt.

This policy brief provides a summary of research findings from a project assessing the impact of North Carolina’s recent Medicaid Expansion on online crowdfunding activity. Using data from nearly 60,000 GoFundMe medical fundraisers from July 2023 to April 2024 the project explores how medical fundraising changed in North Carolina compared to other states that did not expand their Medicaid programs. The analysis shows that the number of campaigns created in North Carolina fell after the Medicaid Expansion; in addition, private donations were crowded out by 22% relative to non-expansion states.