- Yeah, we're here with the Camino Health Center in University City.

It's a nonprofit clinic (gentle music) that treats both the uninsured and the underinsured.

Camino calling itself a place of hope and healing.

- Do I have an appointment?

- [Jeff] Offering low cost or no-cost healthcare appointments primarily to Charlotte's Latino and immigrant community.

- The people we serve come with a dream.

(interpreter speaking in Spanish) They come with amazing values.

(interpreter speaking in Spanish) And they end up being incredible contributors back to our society.

(interpreter speaking in Spanish) We're seeing whole families come with young children.

(interpreter speaking in Spanish) - [Jeff] Camino founder Rusty Price talks about his staff's trip to the US Mexican border.

Also seeing where so many of the families they treat here in Charlotte come from and where so many more are on the way.

- Exactly, this big wave is coming.

The first part is here.

(Sylvia speaking in Spanish) - They give me medical services they give me my vaccines.

(Sylvia speaking in Spanish) At low cost.

- [Jeff] Sylvia Bonos made her trip from Mexico to Charlotte 17 years ago.

She's her family's Abuela, a stay-at-home grandmother who takes care of her daughter's kids, Sylvia's granddaughters, while their mom and dad are working.

(Sylvia speaking in Spanish) - And the littlest, her name is Leah and she's six years old.

- Sylvia speaks with us through a Camino interpreter.

- [Jeff] You don't have insurance?

(interpreter speaking in Spanish) (Sylvia speaking in Spanish) - No, we don't have insurance.

- [Jeff] And you're not covered by Medicaid?

(interpreter speaking in Spanish) (Sylvia speaking in Spanish) - [Interpreter] Yes, it's super scary.

It's super, super scary.

And if we don't have insurance, what happens if you have to go to the hospital, then we'll have to end up paying so much at high costs.

- [Jeff] Meanwhile, PBS News Hour also caught up with Kenneth Small, a self-employed landscaper in Rowan County who credits his free clinic in Salisbury with helping him survive heart surgery both physically and financially.

- I've never paid out of pocket to come here or anything.

So they're filling a large gap between people that are making too much money to qualify for Medicaid and can't afford insurance.

And that's where I fall in.

(tense music) - We have 1.1 million uninsured folks in North Carolina.

What we hear is that Medicaid expansion will cover about half of that.

- North Carolina is now the 40th state to expand Medicaid under the Affordable Care Act.

- [Jeff] PBS News Hours National correspondent John Yang picks up our story at the state capitol.

- When North Carolina's Medicaid expansion is fully implemented, an estimated 600,000 people will gain access to health coverage.

- Hey man, what you doing?

- Like Evida Bass who works in childcare in Hillsboro and didn't qualify for Medicaid under the old rules.

- [John] You're an assistant director here?

- I am.

- Work full-time?

- I do.

- But no health insurance?

- No health insurance.

- Now are you constantly worried about what happens if I get sick?

What happens if I have an accident?

- It's very hard to keep yourself, you know, up there, but I do what I have to do so I don't have a doctor bill.

They can.

- [John] Last year, Bass who's 30, had emergency surgery that left her out of work for a month and stuck with more than $36,000 in debt, an expense Medicaid would've helped pay.

- One thing I've always lived by, "Better late than never."

You kind of just gotta roll with the punches.

Granted, I wish it would've came a little bit earlier.

- If Bass qualifies under Medicaid's new income requirements, as she believes she will.

She says she'll enroll as soon as possible.

And then how quickly are you gonna make that appointment for a checkup?

- Soon as they approve me.

(laughs) - [John] Last month, Governor Roy Cooper, a Democrat, signed a bill passed by the Republican-controlled legislature expanding Medicaid access in the state.

- We have a Medicaid expansion bill.

(group applauds) - When it's implemented, the program will be open to families and individuals whose incomes are lower than 138% of the federal poverty line.

That's about $20,000 for an individual.

Before expansion, most adults without children or a disability weren't eligible at all, no matter how low their income.

State Representative Donnie Lambeth is a former hospital executive.

Since 2017, he'd been trying to get his fellow Republicans, who controlled both legislative chambers all those years, to pass expansion.

So it was really an education process to get your fellow Republicans on your side?

- Exactly, and I think when you first talk about expansion, it's like, and this was what they said to me, "Oh no, we're expanding "another government entitlement program."

The neat thing about this program is, it doesn't cost the state any money.

- [John] In all, the expansion and a one-time federal bonus is expected to bring in 8 billion a year for the state's healthcare providers.

The state government's contribution to the cost of expanded coverage will come from hospitals, not taxpayers.

- [Jeff] Back here in Charlotte, Atrium Health, North Carolina's largest Medicaid provider, calls the expansion "A big step forward "for our entire state that will usher in "a healthier tomorrow for all."

But the smaller low-cost clinics like Camino worry about their poorest patients who still won't have health insurance, even after Medicaid expands.

- Unfortunately for the community that we serve, that doesn't offer any relief.

(interpreter speaking in Spanish) No, it does not cover them.

(interpreter speaking in Spanish) Absolutely, I think for us, the priority continues to be this community that is uninsured, that is underserved.

(interpreter speaking in Spanish) And that are under-prioritized.

- You know that North Carolina expanded Medicaid, but that doesn't help you does it?

(interpreter speaking in Spanish) (Sylvia speaking in Spanish) - Yes, I want help, not a handout.

- That's the saddest story.

When older folks who need healthcare, when young children who need healthcare, don't get the care they need.

(Sylvia speaking in Spanish) - Yes, we feel silenced.

We feel that frustrated, we feel there's nobody to help us elevate our voices.

(tense music) - Yeah, elevating those unheard voices are why Camino leaders were in Raleigh shortly after the governor signed that Medicaid expansion bill, they were thanking lawmakers for their help, but also reminding them that for now at least, they're not helping everybody who needs it.

they're not helping everybody who needs it.