Access to Health Insurance

Duke supports increased access to affordable health insurance coverage for all North Carolinians and endorses legislation designed to close the coverage gap.

Behavioral Health

Duke supports comprehensive access to resources for our behavioral health patients to ensure that they receive the right care at the right time in the right place, regardless of insurance status.

Certificate of Need

Duke supports the existing Certificate of Need (CON) law regulating the growth of health care services and facilities to control costs, utilization, and distribution. CON ensures medical providers are able to meet the health needs of their communities.

COVID-19 Relief

Duke Health and Duke University quickly pivoted resources and operations to respond to the COVID-19 pandemic. Caring for and treating COVID-19 patients, ramping up vaccine distribution, providing PPE and testing supplies, and switching to remote learning caused a significant financial strain for our health system and university. Duke will look for opportunities to work with the state legislature on COVID-19 relief for providers, hospitals, and institutions of higher education as we continue to respond to the pandemic.

Economic Development

Duke University is a key partner in state economic development strategies.  Duke supports efforts to attract and retain talent in North Carolina, align degree production with workforce needs, and promote innovation and entrepreneurship.

Graduate Medical Education

Duke supports maintaining the current state appropriations to graduate medical education and is opposed to any changes to the funding of the existing program that would lead to any decrease or elimination of payments that support Duke’s mission to train medical residents.  Duke supports measures to address the state’s current provider shortage through maintaining current medical education programs and expanding access to additional GME funds in more areas of the state.

Higher Education

Duke partners with the 35 other private colleges and universities in North Carolina, as well as the 17 campuses of the UNC system, to articulate the value of higher education to North Carolina—in workforce development, employment, economic impact, cultural contributions, and other dimensions.

Interstate Medical Licensure Compact

The Interstate Medical Licensure Compact (IMLC) is a partnership entity among state physician licensing boards for the purpose of promoting medical license portability. 29 other states and the District of Columbia participate in the IMLC. Duke is supportive of entering into the IMLC in order to increase access to care all across North Carolina.

Medicaid Transformation / Safety Net Payments

Duke supports legislation that will ensure federal funds received through Medicaid payment programs and self-imposed hospital taxes support hospital-based care for the uninsured.  Duke opposes re-distributing those funds to entities that do not treat patients or contribute to the hospital tax.  North Carolina is set to transition to a managed-care system of Medicaid on July 1, 2021. More information about North Carolina’s Medicaid transformation and its impact can be found here.

Need-based Aid

As part of Duke’s commitment to access and affordability, Duke will continue to partner with other private universities in North Carolina to maintain or increase current appropriation levels for North Carolina’s Need-Based Scholarship.

Research Funding

North Carolina ranks nearly last in terms of state appropriations for the support of research at both private and public universities. Duke supports legislation that would provide any additional state funding to support the research mission and activities of universities in North Carolina.

State Health Plan

Duke’s position is that the State Health Plan should adopt proven methods to provide and coordinate quality-driven care to improve the lives of state employees and retirees while achieving efficiencies in cost to both the plan and taxpayers.

Taxes, Nonprofit Status and Related Issues

Duke University and Duke Health System are nonprofits that receive certain exemptions under the North Carolina Tax Code. Duke supports the current treatment of nonprofits and is opposed to any changes to the tax code that would impact its status as a nonprofit.


Duke supports a legislative and regulatory solution, as well as reimbursement policies, that promote equal access to telehealth services for every North Carolinian in every part of the state.

Workforce Development

COVID-19 has exacerbated an existing shortage of licensed nurses in the state of North Carolina. Our nursing workforce is critical as we care for and treat patients from the pandemic and begin to ramp up vaccine distribution across the state. Duke supports improving the nursing pipeline in North Carolina to build a stronger healthcare workforce as we continue to respond to challenges from the COVID-19 pandemic.