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NCNA: It Is Time to Pass Both Medicaid Expansion and The SAVE Act

March 29, 2022

RALEIGH, NC - Two of the most important healthcare proposals facing legislators shared the stage at the North Carolina General Assembly today. The Joint Legislative Committee on Access to Healthcare and Medicaid Expansion focused Tuesday’s agenda on the SAVE Act (H277/S249), a bipartisan bill designed to cut outdated red tape that currently prevents Advanced Practice Registered Nurses (APRNs) from practicing to the full extent of their training and education.

Both the SAVE Act and closing the coverage gap have been high priorities on the North Carolina Nurses Association’s (NCNA) legislative agenda for several years, and the association is encouraged that both issues are garnering serious attention from legislators leading up to the 2022 short session.

“Our patient population needs a lot of help, and it is vital the North Carolina General Assembly takes notice and makes some long-overdue upgrades that will improve access to quality healthcare,” said NCNA President Meka Douthit EL. “Both the SAVE Act and Medicaid expansion have a tremendous amount of stand-alone value, so seeing them discussed in the same conversation makes total sense because pairing them together increases the positive impact of each.”

So far, 39 other states (including DC) have expanded Medicaid1, while 24 other states have passed bills similar to the SAVE Act2; both of these measures have been thoroughly vetted and demonstrated time and again that the benefits far outweigh any downsides of which opponents have warned. The desperately-needed federal funding that Medicaid expansion would trigger is a major opportunity to provide healthcare for patients across the state who currently have few feasible options.

“Closing the coverage gap is a big deal, because so many of our patients cannot afford basic care, and by the time they finally get the opportunity to see a healthcare professional, it is often too late to stave off conditions that could have been preventable,” said Margaret Marsden Fryer, Chair of NCNA’s Commission on Advanced Practice Nursing. “Of course, you need a workforce to provide that care, and cutting red tape for APRNs is one of the fastest and most efficient ways of connecting healthcare professionals to those patients who need care the most.”

The SAVE Act has the support of 19 organizations outside of the nursing profession, including Blue Cross Blue Shield of North Carolina, AARP of North Carolina, the North Carolina Rural Center, and Americans for Prosperity North Carolina, to name a few3. To date, no organizations outside of organized medicine have opposed this legislation. The bill was introduced with more than 100 sponsors last year from across the political spectrum; that includes a majority of the NC House and exactly 50 percent of the NC Senate, so it would likely pass both chambers easily if advanced to the floor for a vote.

The SAVE Act is primarily designed to grant “full practice authority” to APRNs, aligning North Carolina with national recommendations after more than 40 years of regulatory stagnation for some of the most highly-trained nurses in the profession. In a landmark 2010 report, the Institute of Medicine encouraged state legislatures to modernize outdated APRN regulations4. A 2015 study from Chris Conover, a Duke University healthcare economist, showed that North Carolina would save between $433 million and $4.3 billion annually in wasted costs, while increasing access and, notably, not sacrificing quality of care5.


Chris Cowperthwaite
NCNA Director of Communications & Outreach
(919) 821-4250 or

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The North Carolina Nurses Association serves the changing needs of its members, addresses nursing issues, and advocates for the health and well-being of all people.