Commentary

Isn’t it ironic? The Medicaid blockade prevents health aides from getting health coverage

Obtaining health coverage can be enormously difficult for childless North Carolinians of modest income. In North Carolina, they are not eligible for Medicaid. Add to this the fact that many have a difficult time paying for private insurance and that several jobs do not offer employer-sponsored health insurance and it’s a wonder that any are insured. The General Assembly’s Medicaid Blockade just makes matters worse.

What’s even more frustrating about this situation is that many childless adults in the coverage gap have been mislabeled as undeserving “able-bodied” adults. Opponents of Medicaid expansion ignore the fact that 56 percent of adults in the coverage gap are employed. Thus, they do have “skin in the game.” For families in the health insurance gap, more than 65 percent have a family member working at least part-time.

The explanation for why so many employed people lack insurance are varied, but one of the most obvious is this: their employers don’t want to pay for it. And so instead of employing people full-time, they keep their employees trapped in the “gig economy.” A report in the most recent issue of the journal Health Affairs examines this problem. The researchers note that many employers are shifting to contract workers or other types of temporary employees. So even though someone may have a “job,” he or she may have no access at all to employer-sponsored health coverage.

Dorothy is a home health aide and a classic example of this destructive phenomenon. Though she works hard taking are of vulnerable people, she along with 500,000 other North Carolinians, remain mired in the coverage gap. Legislators who continue to push the Medicaid Blockade should understand that workers, like Dorothy, who actually help provide health care to others, are stuck in the coverage gap. Even though Dorothy takes care of her health and tries to be proactive with prevention, it is obviously not enough. Like everyone else, she needs decent and affordable health insurance.

Opponents of Medicaid expansion should realize that workers need to be healthy in order to keep people working. When North Carolina has a healthy workforce, it will attract more employers and businesses to want to invest in our state and build up the labor market. Unfortunately, the supporters of the Medicaid Blockade continue to prevent North Carolinians from becoming healthy and more productive workers even, as in the case of Dorothy, when they got to work everyday attending to the health care needs of others.

Commentary

Meet another woman whose life the conservative Medicaid blockade is harming

Even though North Carolina’s uninsured rate has fallen to  11.6 percent as a result of President Obama’s Affordable Care Act, the state still gets an average-to-failing grade (a D+) when it comes to women’s reproductive rights and overall health and well-being. And while there are obviously lots of factors that contribute to this poor grade, one of the most obvious is the failure to expand Medicaid under he ACA. As with other southern states, the shortsighted decision of North Carolina lawmakers to block the full implementation of the ACA so that more women can gain access to the health care they need is producing large amounts of unnecessary harm and suffering for thousands upon thousands.

Take Michelle for example. Medicaid expansion would allow her and thousands of women like her to finally have access to the primary and preventive care most people take for granted. Michelle owns her own small business, a hair salon, but considering how business fluctuates, she does not earn enough to qualify for financial help to enroll in Marketplace coverage. Michelle’s eligibility status is further complicated in that even though she is a parent, she makes too much to qualify for Medicaid. Thus, Michelle and many hard working parents like her remain uninsured. In addition to worrying about receiving the primary care she needs to remain a healthy and hard working small business owner, she wants to take care of health care needs in order to be a great parent and role model for her children.

Tragically and remarkably, this bad situation may soon get much worse. While the Medicaid blockade has, despite Gov. Cooper’s recent laudable efforts to overcome it, harmed hundreds of thousands of people like Michelle, the gap will almost certainly widen dramatically if Congress makes good on its threats to replace the ACA. Indeed, as Congress pursues “plans” to replace the significant coverage gains of the ACA with plans that do not account for pre-existing conditions or even making sure there is gender parity for health care, there will be be thousands more moms who are faced with impossible choices regarding their health and well-being.

Happily, all hope may not yet be completely lost. As the debate over ACA repeal continues, more and more states states that have already expanded Medicaid and realized the benefits (many with conservative Republican leadership) are fighting to continue Medicaid expansion as it has benefited thousands of people and state budgets. Let’s hope the logic of this argument finally dawns of North Carolina leaders in the days and weeks ahead.

Commentary

The Medicaid blockade impacts hard working, average North Carolinians

Even though there is court hearing scheduled for Friday to lift the temporary restraining order on Gov. Cooper’s plan to close the coverage gap, leaders at the North Carolina General Assembly want to extend their efforts to block 500,000 North Carolinians from getting health coverage. Yesterday, Senate leader Phil Berger and House Speaker Tim Moore filed court papers inthe case asking the judge to reject Gov. Cooper’s request to lift the temporary restraining order so that veterans, children, parents, and low-wage workers can finally gain access to health coverage. Despite reports of Medicaid expansion’s success, opponents of closing the coverage gap continue to act on their misguided belief that expansion some how dis-incentivizes job seeking and will be costly. In fact, recent reports show that state spending for Medicaid expansion is decreasing just as CMS predicted. What’s more, reports continue to show that 62 percent of adults in the coverage gap belong to families that have either a full-time or part-time worker in their household.

In North Carolina, 56 percent of adults in the coverage gap work for small businesses, like Jerry (pictured at left). Like others in the coverage gap, Jerry is college educated, and like many of us has faced hardships. When he lost his job at a small business, Jerry worked hard to find new employment. He went back to school and even started his own IT business. Unfortunately, lawmakers continue to block Jerry’s path to health coverage. Jerry and thousands like him remain in the coverage gap. They make too little to qualify for financial help to purchase health coverage through the Marketplace and do not meet the eligibility for Medicaid.

The General Assembly’s Medicaid Blockade is harmful. The block on Medicaid expansion hurts real people like Jerry who are working hard to make ends meet and contribute positively to their communities. The Medicaid Blockade prevents hard workers like Jerry from being able to address his chronic conditions like diabetes and sleep apnea so that they can be even more productive. Let’s fervently hope that they legislative leaders changes their minds soon before their policies help to ruin even more lives.

Commentary

Real people are in the Medicaid coverage gap

The numbers are out there. For over three years the numbers have been reported on everything from how many people with diabetes could receive the medications they need to control this chronic condition to the number of jobs that could be created in each county. The numbers even show how some of the most vulnerable like children or even those that served the United States could finally gain access to the care they need if state lawmakers expanded Medicaid.

Unfortunately, the numbers have not influenced leadership in the legislature. Since the numbers and reports did not convince state lawmakers, perhaps the faces and stories of real North Carolinians will help lawmakers understand that the Medicaid Blockade hurts real people.

One real person is Kent. He is a construction worker for a small family-owned business. In fact, reports show that approximately 59,000 North Carolinians in the coverage gap have jobs in construction. Another real person is Roosevelt. He is one of the 12,000 veterans that would benefit is leadership in the General Assembly would expand Medicaid. Both of these men make too much money to be eligible for Medicaid under North Carolina’s current stingy standards, but not enough to be able to afford to but insurance in the marketplace. Roosevelt’s situation is made even more ridiculous and outrageous by the inaccessibility of Veterans Administration healthcare services.

The bottom line: It is a shame that men and women who served the country cannot get the health care they need when they need it. The Medicaid blockade is hard to justify when it impacts up to 500,000 real people. State lawmakers need to acknowledge that real people make up the numbers. They should listen to Roosevelt and others like him when they say, “I’m a human like you. I’m a citizen like you. Please do right by the people who have helped you.”

Commentary

What’s at stake as legislative leaders double down on Medicaid blockade

Last week, conservative leaders at North Carolina General Assembly launched a legal attack against Gov. Cooper’s efforts to expand Medicaid. In so doing, these lawmakers went against the desires of 72 percent of North Carolinians who want to fix the health insurance gap by expanding Medicaid. Suing both the federal and state Department of Health and Human Services to prevent expansion hurts all of North Carolina. Instead of recognizing and accepting the health, social, and economic benefits of Medicaid expansion, state lawmakers are trying to extend the life of the Medicaid Blockade.

It is difficult to understand why policymakers continue to block efforts to close the coverage gap considering that up to 500,000 people could gain health coverage. A study released in 2014 examined both the preventive outcomes of expansion and the adverse health outcomes if North Carolina did not extend coverage to adults in the coverage gap. The study reported that Medicaid expansion could help prevent approximately 1,000 deaths per year. Further, Medicaid expansion could allow for nearly 27,000 people to receive medications to manage diabetes and allow approximately 12,000 women to receive mammograms.

Considering that most state lawmakers want to promote job growth and increase business activity throughout North Carolina, it is hard to believe that they continue the Medicaid blockade despite the projected economic benefits. One report shows that up to 43,000 jobs could be created by 2020, 13,228 of which are jobs in rural counties of the state. North Carolina’s vulnerable and rural hospitals would also experience an economic boost if Medicaid is expanded. In just one year, one hospital group reported a drop of $35 million in uncompensated careArkansas and Michigan are two states that reported decreases greater than 50 percent in uncompensated care. A more recent qualitative study reported that reductions in uncompensated care and the boost to health provider budgets allows for promotes increase in ways to improve on quality of care.

North Carolina has had the opportunity to improve the health and financial standing for children and families, low-wage workers, veterans, and rural residents since 2014. Tragically, state lawmakers continue to block the positive short and long-term impacts Medicaid expansion will have on our state. At some point in the near future, it seems certain that they will regret this decision.