By Seth Effron
More than 25,000 people in Bladen, Columbus, Robeson and Scotland counties have enrolled in Medicaid since state lawmakers expanded the health care program in late 2023.
But many of them could lose benefits. The One Big Beautiful Bill Act passed by Congress and signed into law by President Donald Trump slashed an estimated $1 trillion in Medicaid spending over the next decade.
In North Carolina, 3.1 million residents are enrolled in Medicaid—28 percent of the state’s population. More than 675,000 have enrolled under the expansion program.
Statewide, 10.5 percent of adults ages 19 to 64 enrolled in Medicaid expansion. The percentages were higher in the Border Belt. In Robeson County, the figure was 21.7 percent.
Three Border Belt counties—Robeson, Scotland and Bladen—rank among the top 10 in North Carolina for
the percentage of residents enrolled in Medicaid. Robeson County is tied with Vance County for the largest percentage (58). Scotland County ranks fifth with 52 percent, and Bladen County ranks eighth with 47 percent. Columbus County ranks 15th with five other counties at 41%.
See below for more details about Medicaid expansion in the Border Belt.
| Enrolled in Medicaid expansion | Population (ages 19-64) in 2023 | Portion of adults enrolled during Medicaid expansion | Portion of all residents enrolled In Medicaid | |
| Bladen | 2,898 | 16,389 | 17.7% | 47% |
| Columbus | 4,326 | 28,444 | 15.2% | 41% |
| Robeson | 14,813 | 68,166 | 21.7% | 58% |
| Scotland | 3,668 | 18,150 | 20.2% | 52% |
The Columbus County Community Foundation recently awarded the Border Belt Independent a $5,000 grant to fund Data Point, a concise feature that focuses on numbers and statistics highlighting an issue or trend in the Border Belt region. The Columbus County Community Foundation is a nonprofit that connects people with causes and organizations they care about. It is part of the North Carolina Community Foundation network.