Commentary

This is news? Study: Closing the coverage gap improves access and health outcomes

A new study from the Harvard School of Public Health confirmed the obvious facts that our Governor and legislature continue to ignore: when uninsured people get health care coverage, they enjoy improved health care access, fewer financial barriers to care, and better health outcomes.

Over a two-year period between 2013 and 2015, researchers compared the health care experiences of consumers living in two Medicaid expansion states with those of residents in a non-expansion state. In 2014, both Arkansas and Kentucky accepted federal funding to provide coverage to hundreds of thousands of low-income people as called for by the Affordable Care Act. On the other hand, Texas—like North Carolina—has thus far left its residents in the coverage gap, where they’re too poor to qualify for financial help on the Marketplace but make too much to qualify for Medicaid.

When Arkansans and Kentuckians gained health coverage through Medicaid expansion, they were more likely than their Texan counterparts to have a personal physician and to access preventive care through an annual checkup. Instead of being forced into the emergency room for their non-emergency primary care needs, insured patients in Arkansas and Kentucky got appropriate care at the right time and at a lower cost. On the other hand, Texans were more likely to rely on the high-cost ER as their usual source of health care. Being uninsured limited their access to a primary care provider, costing both these individuals and the larger health care system dollars that would be more wisely invested into closing the coverage gap.

Not only does expansion help increase health care system efficiency, residents in Medicaid expansion states reported improved health in comparison with their non-expansion state counterparts. What’s more, they experienced fewer financial obstacles to accessing the health care services they needed. Right now, Texans in the coverage gap are more likely to forego necessary medical care and skip out on prescription drugs because of cost concerns.

Day after day, month after month, and now year after year, the evidence keeps pouring in: Medicaid expansion would be a boon to half a million North Carolinians’ physical and financial health, and it would create jobs and boost the economy. What is Governor McCrory waiting for?

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