Commentary

It’s time for a plan to cover 500,000 North Carolinians

Now that the Supreme Court has ruled — again — that the structure of the Affordable Care Act is constitutional, it is time to move forward with making the law work better in our state.

The first, and most important, step is accepting federal funds to extend the benefits of affordable health insurance coverage to 500,000 more people in our state. Gov. McCrory said last year that his staff was assembling options to expand coverage and that he would make an announcement about his recommendation after the Supreme Court ruled in King v. Burwell. The ruling has arrived.

When asked about expansion today McCrory was sort of squishy and said he wants a North Carolina plan. We all do. But first we need the Governor to draft and release such a plan. Conservative Governors in Ohio, Indiana, Utah, Michigan, Tennessee and other states have either closed the coverage gap or assembled a strategy to accomplish a coverage expansion. There’s no reason our Governor can’t do the same.

Legislators are still critical of expansion. Sen. Ralph Hise says that he doesn’t think the federal government will be flexible enough to allow a state option. His wish list includes wanting to expand using private insurance and imposing co-pays on recipients above the federal poverty level.

Of course, the federal government has approved even more conservative measures than Hise mentions. Several states including Arkansas, Iowa, and Michigan do use private insurance to expand coverage. Some states are charging co-pays and premiums even on enrollees earning less than the federal poverty level. The federal government has shown a degree of flexibility that makes many advocates uncomfortable. The idea that our hands are tied is, to quote Justice Scalia, pure applesauce.

Recently released data from the National Health Interview Survey show the dramatic impact of expanding coverage. In Kentucky the adult uninsured rate dropped from 24.1 percent in 2013 to 15.6 percent in 2014. In Arkansas the rate went from 27.5 percent to 15.6 percent. And, most stunningly, in West Virginia the adult uninsured rate went from 28.8 percent in 2013 to 12.2 percent in 2014. These numbers reflect only the first year of expansion and states nearly cut their adult uninsured rates in half. In North Carolina the adult uninsured rate moved from 25.6 percent to 22.5 percent.

A majority of states are expanding coverage while reforming their Medicaid programs. More states will join their ranks now the Supreme Court has ruled that the Affordable Care Act is here to stay. The Governor must show leadership on this issue and ensure that all of our citizens have access to comprehensive, affordable health insurance.

2 Comments


  1. LayintheSmakDown

    June 26, 2015 at 1:01 pm

    Yes, call your federal representatives so that they will come up with a viable plan to cover this mythical 500,000. Maybe they can actually do something rather than sticking it to the state. They could easily use the funds to come up with their own single payer plans, and it would then begin that trip to progessive nirvana.

  2. Barbara Wright

    July 2, 2015 at 1:01 pm

    What are Gov. McCrory intentions toward going for the “affordable Care Act”? I have a 49 yr. old daughter who lives with me (I am on Social Security $834.00 mo.) and shehas not been able to work since March 2013. We are currently trying to get disability (turned down) and waiting for the last appeal now. She has multiple ailments: Mental, Fibromyalgia (SP?), los of hair, Fatique, Thyroid, Extreme Migraine Headaches, along with some OBGYN problems.etc. She is on the Medicaid program probably a little over a year. She is having a hard time finding any Physicians who will accept medicaid, some say they don’t accept medicaid or that they have met their quota. One saw her and said she could not treat her as she had to many problems and she didn’t have the time to take up with her. That she should go to somewhere like Duke, Etc. to get treatment. She is stressed continuously because of not getting the proper doctor or treatment to get these ailments under control. Her therapist stated she can not work with her mental conditions. She has even said many times she would better off dead. There is so stress in this house you can cut it with a knife.

    We have always been classified as a working middle class family and now we are poor. We need help and do not know where to turn. If you have any suggestions or directions of what else we could try we would appreciate any advice.

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