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Get Covered AmericaThe good folks over at Get Covered America, who have been working tirelessly and with great success to get hundreds of thousands of North Carolinians into affordable health insurance over the last several months despite the mean-spirited obstructionism of the state’s conservative political leadership, issued the following common sense response to today’s competing U.S. Court of Appeals rulings:

Today the Federal Court of Appeals for the Fourth Circuit, which covers North Carolina, ruled in the King v Burwell case that the U.S. Internal Revenue Service does have authority to issue tax subsidies in states with a federally facilitated marketplace such as North Carolina. In a separate ruling today, the federal court in DC ruled differently. The end result, is that nothing changes for the 357,584 North Carolinians that already enrolled in insurance on the federal marketplace and nothing changes for those who can still enroll now. While the legal process takes its course, Get Covered America-North Carolina staff and volunteers will continue to reach out to uninsured North Carolinians and let them know about the financial help that continues to be available to them during the current Special Enrollment Period and the upcoming Open Enrollment Period beginning in November. The financial assistance made available by the Affordable Care Act to help consumers afford health coverage has made a huge difference for thousands of North Carolinia families. In fact, 91% of North Carolinians who enrolled in insurance on the federal marketplace are receiving financial assistance to pay for it. The clear intention of the law is to make health insurance affordable for all Americans. (Emphasis supplied.)

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Health-Reform-SBAs Adam Linker explained last week when he debunked the latest conservative mythology surrounding the Affordable Care Act, the law continues to succeed despite its imperfections and the endless, hysterical attacks of the President’s political opponents.

Today, there’s still more confirmation of this undeniable reality from Washington state. As The Olympian reported this morning, the state’s uninsured rate has been plummeting:

State insurance officials say fewer than 9 percent of Washington residents still don’t have health insurance.

That’s a significant improvement from numbers before the Affordable Care Act went into effect.

The state Office of the Insurance Commissioner counted 970,000 uninsured Washington residents last year. That number is now 600,000 or about 8.65 percent of the state population.

Agency spokeswoman Stephanie Marquis told The Olympian (http://is.gd/p2XsBG ) two factors are driving the improvement: enrollment in Medicaid and sign-ups for private insurance, but inside and outside of the new state health insurance exchange.

The insurance department reports the individual market has grown to more than 327,000 policies. That represents about 81,000 more insured people than before Oct. 1, when Washington’s Health Benefit Exchange opened.

The exchange also helped sign up nearly 350,000 people for free insurance through Medicaid.

Despite the many successes here, at last check, North Carolina’s uninsured rate remains significantly higher.

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nci-vol-2174-300The White House Council of Economic Advisers released a report today detailing the health and economic consequences of refusing to accept federal Medicaid money to expand insurance coverage in North Carolina.

If the state accepted federal funds we could provide insurance coverage to 377,000 more people. This influx of federal money would also create jobs and boost our economy. And reducing our uninsured rate would have salutary impacts on the lives of those able to obtain affordable health care.

For example: 27,000 women would gain access to to recommended health screenings; 90,000 people would gain access to a medical home; 50,000 more people would report that they are in good health. The individual financial impacts are no less dramatic. Closing the coverage gap here would mean 17,000 fewer families facing catastrophic medical bills and 53,600 fewer people borrowing money to finance their health needs.

Some claim that North Carolina can’t afford to extend health coverage to more people. When you look at the numbers it’s clear that we can’t afford not to expand coverage. In 2014 the state is giving up $2.7 billion in federal funds. In 2015 that increases to $3.2 billion. In 2016 it’s $3.6 billion. In 2014 we could create 8,700 jobs. In 2015 we could create 19,400 jobs. If a private company or a new military base opened in North Carolina that created 19,000 jobs, politicians would be elbowing each other to get to the ribbon cutting.

The Council of Economic Advisers calls the decision to refuse new Medicaid funds a “missed opportunity.” That’s an understatement; it’s more like a terrible shame.

 

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The Supreme Court Ruled One Way - Here's How You Fight BackThe US Supreme Court decided today that “closely held” corporations that object to contraceptives on religious grounds can deny this preventive coverage to female employees. There will be a great deal of constitutional banter on this opinion but, not being a constitutional scholar, I will make a few practical points.

First, when HHS wrote this popular regulation ensuring that women have access to preventive health care, the department looked to what most states require as a guide. North Carolina, along with a majority of states, mandate that health plans cover contraceptives. Our state has a reasonable exemption for religious employers, and HHS included a similar exemption in its regulations. I hasten to add that, despite this state law, few employers have argued that our state is impeding their religious freedoms.

Second, if you read the Supreme Court decision the majority opinion spends strikingly little time examining the possible impact on women. Instead, Justice Samuel Alito spends most of his space arguing that corporations are people and should enjoy the same religious rights and freedoms as individuals. In contrast, Justice Ruth Bader Ginsberg spends a great deal of time balancing the claims of the Hobby Lobby owners with the health care needs of female employees.

Third, this opinion opens the gate to whittle away many types of preventive health coverage mandates. Justice Alito says that each of these requirements will have to undergo its own analysis and that the current decision is narrowly tailored, but Hobby Lobby certainly invites a great deal of mischief. We will find out in the coming months and years just how deeply this court is willing to cut into protections for women and families.

Here are some initial links to analysis of the Hobby Lobby decision: ThinkProgress, the National Health Law Program, the American Academy of Pediatrics, and TalkingPointsMemo.

 

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…is highlighted in this fine editorial in the Charlotte Observer entitled: “Expand Medicaid – It has value in NC.” To quote:

“N.C. lawmakers don’t seem inclined to reconsider their unwise decision not to expand Medicaid. But that doesn’t mean we should stop shouting loudly why they should. A new Robert Wood Johnson Foundation report last week underscores the value for the Tar Heel state.

The report looked at the Affordable Care Act’s impact in 14 large U.S. cities. Charlotte was among the seven cities in states where lawmakers opted not to expand eligibility for Medicaid. Even so, the number of uninsured Charlotte residents is expected to drop by 36 percent, or 63,000, by 2016 because of ACA. That was the highest drop among cities with no Medicaid expansion. Among all states, North Carolina has the fifth-highest ACA federal online sign-up.

The report points out that had North Carolina expanded the state’s Medicaid program for low-income and disabled residents, the decrease in uninsured in Charlotte would be even greater – an estimated 57 percent. That would be an additional 36,000, bringing the number of Charlotte residents gaining insurance to 99,000 by 2016. Read More

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