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In 2013 the North Carolina General Assembly rejected new federal funds to expand health insurance coverage in the state, but that hasn’t stopped local governments from urging the Governor and legislators to change course.

Counties such as Mecklenburg and Durham have passed Medicaid expansion resolutions as have cities like Greensboro and Winston-Salem. Even Sen. Phil Berger’s hometown of Eden officially went on record endorsing expansion. The Rockingham County towns of Reidsville and Madison have since joined Eden.

This month three more counties — Nash, Edgecombe, and Chatham — joined the chorus.

As retired cardiologist Jim Foster pointed out to the Chatham Commissioners there are tremendous economic benefits to accepting more federal Medicaid dollars. From news coverage of the resolution:

“Anytime money flows into the economy, it ripples through and multiplies,” Foster said.

He pointed to a George Washington University study that broke down the costs and revenues from expanding Medicaid.

The study broke figures down for the state and for its 100 counties.

In Chatham, for example, the study stated that not expanding Medicaid cost 136 jobs and $6 million in gross product.e study Dr. Foster mentions can be found here.

Approval of the Nash County resolution was unanimous and Commissioners added a call for simultaneous reforms to Medicaid. This makes sense. In fact, nearly every expansion state is also reforming the program at the same time.

There is no reason North Carolina’s leaders can’t learn to walk and chew gum like most other states in the country.

Commentary

News item from the Charlotte Observer:

“The Fort Mill, S.C., Republican who went public Tuesday with his plea for help paying for sight-saving surgery had raised almost $12,000 by Wednesday evening – most of it from self-described liberals and Affordable Care Act supporters saying they hope he’s learned a lesson.

That’s enough to ensure he can get the treatment he needs, said Dr. Andrew Antoszyk, an eye surgeon with Charlotte Eye, Ear, Nose and Throat Associates. After reading Luis Lang’s story in the Observer on Wednesday, Antoszyk said he’d work with Lang and with Novant Health to give him the care at reduced cost.

Lang, a self-employed handyman, declined to get health insurance until he needed expensive surgery for diabetes-related eye problems. His story went viral, spurring blogs and comments, national media commentary, thousands of social media shares and vigorous discussions across the country.

His GoFundMe.com page has been shared on social media more than 1,700 times since Tuesday morning, with more than 600 people making small donations, often with political commentary.

‘No one should be without medical (care) even if they have not made their own best choices in life,’ wrote Steve Kadel, who gave $10. ‘The party of personal responsibility (has) left you hanging on your own consequences. Progressives like me think that’s just cruel. Be well.’”

Whether Lang or other Affordable Care Act naysayers will learn a lesson is unclear at this point — Lang himself, offers rather muddled comments on the subject later in the Observer article — but a few things are clear from all this:

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Commentary

The wonks at the Center on Budget and Policy Priorities are out with a new and powerful report today on the increasingly-evident benefits of Medicaid expansion. Here’s the lead:

“In the short time since states have been able to expand Medicaid to low-income adults under health reform, a clear divide has emerged between states that have expanded Medicaid and those that have not. Since the major coverage provisions of the Affordable Care Act (ACA) took effect in 2014, insurance coverage rates have improved across the country, but the gains are far greater in the states that have expanded Medicaid. As a result, hospitals in expansion states are treating fewer uninsured patients, and the amount of uncompensated care they are providing is declining steeply. Moreover, contrary to critics’ claims that Medicaid expansion is financially unsustainable for states, there is increasing evidence that expansion has saved states money, and these savings are expected to grow over time.

The Medicaid expansion has had an especially dramatic impact in Arkansas and Kentucky, which both had high uninsurance rates and limited Medicaid eligibility for non-elderly adults before health reform. Both states’ uninsurance rates have fallen by half in just over a year, and the expansion is expected to save each state more than $100 million by the time their current state fiscal years end on June 30.

Meanwhile, the states that have not expanded Medicaid are falling further behind. In the non-expansion states, large numbers of low-income people remain uninsured and without access to affordable health coverage. These individuals are caught in a ‘coverage gap’ because their incomes are too high for Medicaid but too low for subsidies to purchase coverage in the marketplace. Hospitals in these states continue to provide large amounts of uncompensated care, and the states are missing the opportunity to leverage billions of dollars in new federal funding through the Medicaid expansion.”

Click here to see the numbers and read more details about how North Carolina continues to fall farther behind as the result of its stubborn and self-destructive refusal to expand the program.

Commentary

Nicole and LindaTomorrow is Women’s Advocacy Day at the North Carolina General Assembly and there are a lot of good reasons for caring women (and men) to attend. The one at the top of my list will be Medicaid expansion – the long-neglected plan to extend decent, affordable health coverage to hundreds of thousands of North Carolinians.

As has been explained repeatedly in countless places in recent months, North Carolina would benefit greatly from Medicaid expansion. The numbers of lives that would be saved and the amount of money that would flow to the state are both huge and more than reason enough for state leaders to act. As a group that has long endured lower pay and benefits, women would also benefit disproportionately from expansion.

For me, however, the motivation for speaking out goes well beyond the numbers. It’s also about speaking out on behalf of people who I know and care about – people like my friend, Linda Dunn (that’s us on the left at the General Assembly last month).

I met Linda back in December at a community forum in Kinston at which Sen. Don Davis, Lenoir County Sheriff Ronnie Ingram and several other community leaders expressed concern about the failure to expand Medicaid and the fact that, in Lenoir County alone, expansion would cover 2,270 residents and create more than 350 desperately needed jobs.

Linda attended the forum along with her adult daughter. I met them just before the discussion was set to begin. She was terribly concerned about her daughter’s lack of access to insurance and medical care.

In fact, she was so concerned that she was later inspired to travel to Raleigh to share her family’s story during last month’s Medicaid Expansion Advocacy Day. Linda held onto the podium in the Legislative Building press room while some in the audience held back tears as she spoke like only a mother could about the devastating impacts of suffering from chronic health conditions without insurance. Read More

Commentary

RWJA new report from Manatt Health Solutions on behalf of the Robert Wood Johnson Foundation finds that states that have tapped federal funds to expand Medicaid are seeing significant financial benefits. By the end of 2015 the savings and revenues across the eight states examined in the report are expected to exceed $1.8 billion.

This is consistent with the county level examination of expansion in North Carolina commissioned by the Cone Health Foundation and the Kate B. Reynolds Charitable Trust. That study, using conservative estimates, found that the savings and revenues more than offset the costs of expansion through 2020.

The states featured in the report — Arkansas, Colorado, Kentucky, Michigan, New Mexico, Oregon, Washington, and West Virginia — had direct budget savings from reduced spending on the uninsured, they experienced increased tax revenue from the new flow of federal funds into the state, and they realized additional savings from switching some existing Medicaid patients into the expansion program.

A source of significant savings, for example, comes from pregnant women. North Carolina has traditionally covered pregnant women in Medicaid up to 185 percent of the federal poverty level. This coverage, however, is only for pregnancy related services. Also, once a woman has the baby she oftentimes loses Medicaid because coverage for parents is quite stingy.

After expansion, pregnant women above 133 percent of federal poverty level would qualify for full Medicaid coverage. And, instead of the lower match rate, the federal government would pay 90 percent of the costs for these women. Once the baby is born many women would then be able to continue coverage through Medicaid. This would result in healthier babies, healthier parents, and major savings for the state.

The report notes that states will also garner savings in behavioral health and among the medically needy population.

States that opted to expand Medicaid early will have the largest benefits, but there are still plenty of positives for states like North Carolina that haven’t hit the leader board yet. The final year for the federal government to pay the full cost of expansion is 2016 so we need to act fast or our people, and our economy, will miss out on a much needed boost.