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.

Commentary

NC’s new governor provides a welcome and long overdue initiative to close the Medicaid coverage gap

Since 2013, North Carolina law and policymakers have failed to recognize the health, economic, and social benefits of closing the Medicaid coverage gap for residents of the Tar Heel state. Today however, in a hopeful and inspiring speech, Governor Roy Cooper explained why, in order to achieve a true Carolina Comeback, the state needs to extend Medicaid coverage to the 500,000 North Carolinians in the gap.

Gov. Cooper told business leaders that expanding Medicaid is not just about health care, but about economic growth and security for all of North Carolina. He pointed out that expansion would bring billions of dollars in investment to the state and create thousands of new jobs.

Cooper was absolutely correct, of course. As of today, North Carolina has lost out on more than $5 billion in tax dollars that could have been used to provide coverage to those in the gap. According to a joint report by Cone Health Foundation and Kate B. Reynold’s Charitable Trust, North Carolina could miss out on an additional $21 billion in federal funds between 2016 and 2020. To make matters even more absurd, North Carolinians are already paying millions in tax dollars to close the gap in other states that have embraced Medicaid expansion

Another point that Cooper might have noted had he had the time is that closing the coverage gap will help nearly 15,000 families currently experiencing immediate economic distress due to the mushrooming problem of medical debt.

In addition to taking back Tar Heel tax dollars, closing the coverage gap creates jobs. In fact, expanding Medicaid could lead to 40,000 jobs by 2020. These jobs aren’t just in the urban centers of the state, either. A huge number would be in the state’s 80 rural counties. In addition to providing coverage to over 140,000 rural residents, expansion will create 13,228 jobs in rural counties. Once jobs are created, the same report shows that there will be an increase in business activity as people will start supporting businesses throughout the state. With increased business activity, counties and the state would experience a meaningful rise in tax revenues. The above-mentioned report notes that by failing to expand Medicaid this year, North Carolina could lose $161 million in state tax revenue.

Finally, Gov. Cooper noted that there are other states with conservative leadership that have experienced the health and economic benefits of expansion. While the Vice-President-elect and outgoing Indiana Governor Mike Pence says he is hoping to dismantle the ACA, Indiana’s expansion is estimated to have provided coverage to over 350,000 people. Gov. John Kasich in Ohio also supported closing the coverage gap and his commendable efforts have resulted in the enrollment of more than 400,000 Ohioans. What’s more, costs in that state have actually come in 28.7 percent below the projected budget.

Expansion states have not only experienced greater drops in state uninsured rates, but have been able to report increased access and utilization of preventive care, as well as real benefits to their economies as well.

The bottom line: Governor Cooper deserves great praise for his visionary and courageous act. While it’s clear that his plan will face tough sledding in the days ahead, it’s tremendously encouraging that he has shown himself willing to fight for this critically important cause. Let’s join our new Governor in supporting Medicaid expansion — a plan that would help all 100 counties experience health and economic benefits and do more than any other single available policy option to help spur a genuine Carolina Comeback.