Karida Giddings

It’s the most wonderful time of the year.

Well, almost. Autumn leaves will fall first, rolling out a brownish-orange carpet for Thanksgiving and, before that, Halloween. Just how happy those holidays will be is the thing. The National Retail Federation should have some insight during a Nov. 6 media call announcing its retail sales forecast for the 2025 winter holiday season. Next to back-to-college shopping, the winter holidays are when we spend the most money, according to the NRF.

We, the people, had the holiday spirit in early NRF forecasting. During the last winter holiday season, the average U.S. consumer spent $874,67. That’s expected to increase to $901.99. Which is surprising after our elected officials in Congress shut down the federal government by failing to agree on a budget that would keep funds flowing to cover or offset costs for necessary stuff — like health insurance.

Here, listen to Karida Giddings: “How do you decide between filling prescriptions or having food on the table, between going to the doctor or presents under the tree?” 

She’s the access to health care program coordinator for North Carolina Black Alliance. Two of Giddings’ visionary initiatives positioned her to take North Carolina’s pulse this year. Rooted in Wellness Day is an annual statewide health and wellness outreach. Leaders in several cities declared Sept. 20, 2025, Rooted in Wellness Day. And her OUR State of Health tour took her to several of the state’s rural communities, where she delivered wellness information with an ear to the ground.

“We’ve had the opportunity to hear directly from Black North Carolinians about what wellness really means when the cost of living keeps rising and health care affordability feels increasingly out of reach,” Giddings said. “Our communities are carrying the weight of policy decisions they didn't make — decisions that will soon force them to choose between their health, their household and their holiday traditions.”

On Nov. 1, the health care premiums of 22 million Americans will double. Next year, according to the Congressional Budget Office, 4.2 million people won’t have health insurance because they’ll be priced out of the Affordable Care Act marketplace on account of rich people who got tax breaks while those in the middle and working classes or lower lost the subsidies that made their lifesaving colonoscopies affordable.

Republicans did that. Americans are watching.

“Retail sales dipped in September as consumers hit the pause button after two solid months of back-to-school spending,” NRF President and CEO Matthew Shay said. “Amid continued economic uncertainty, consumers opted to preserve spending power in preparation for the important holiday season. While month-over-month spending data has fluctuated, as consumers have reacted to changing circumstances, year-over-year gains show robust growth and signal momentum as we head into the holidays.”

Feels different in rural America. “As premium tax credit enhancements expire and insurance premiums climb, many will wonder whether they can afford to stay insured at all. Medicaid expansion offered long-awaited relief, but that progress is now at risk of being undermined by policies that raise costs elsewhere,” Giddings said.

On the Fourth of July, the One Big Beautiful Bill Act was signed into law. One of the things it set in motion was some $800 billion in Medicaid cuts over the next decade, with $10 million people projected to lose coverage, according to the CBO.

“I go to the doctor regularly. I’m with Medicaid,” Anson County resident Chavis McQueen said. “Four dollars when I go to a visit. My co-pay is not very high, so my health is pretty good right now.”

Right. For now. “Medicaid is good,” McQueen continued. “Medicare is more for, like, the older [people]. I’m not there yet. But if we get rid of Medicaid, I might not make it there.”

McQueen, 43, works with youth at the HOLLA! Center in Morven, a rural North Carolina town. He’s trying to get a baseball team going for the kids. That’s a good thing for obvious reasons, keeping young people off the streets and all of that. But if one of them breaks a leg sliding into third base, let’s hope the kid’s mama ain’t on Medicaid.

“Eight-hundred billion dollars. Eight-hundred billion,” said McQueen, recalling the Medicaid cut, dripping sarcasm the whole time. “Where’s that money going? I wonder where this money’s going to? The billionaires.”

Politicians are accountable to the people, both those who did and didn’t vote for them.

“OUR State of Health and Rooted in Wellness Day reminds me of the resilience that continues to transcend time in our communities,” Giddings said. “At every stop, I've seen Black people organizing, advocating and showing up to protect the gains we've made.”

If Thom Tillis, Ted Budd and others on their side of the aisle don’t do what they know is right by extending health care subsidies, then a whole lot of folks are looking at paying roughly $500 extra each month for the right to go see a doctor. That’s from the Robert Wood Johnson Foundation. It’s really unconscionable to know that’s why the government is shut down, all because individuals who are able to afford medical care are OK denying it to other human beings.

Not everybody has insurance through their jobs. The ACA marketplace provides an option for accessing coverage. Millions of people in rural America are counting on it to stay affordable. 

“This is the type of economic uncertainty many folks will face: families stretching dollars, skipping follow-up appointments or postponing lifesaving screenings,” Giddings said. “The question isn't just how we'll get through the holidays, it's how we'll continue to build power to ensure wellness isn't seasonal but sustained year-round.”

All of that while heading into the most wonderful time of the year. 

John McCann is the communications and campaigns strategist for Advance Carolina.

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