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In a new post this afternoon, Jesse Cross-Call at the Center on Budget and Policy Priorities reports the latest confirmation that North Carolina is shooting itself in the foot with its stubborn and shortsighted refusal to expand Medicaid to hundreds of thousands of uninsured people under the Affordable Care Act.

As a growing number of reports increasingly make clear, a state’s decision whether to expand Medicaid as part of health reform has real-life effects on its residents and its businesses.  In the 26 states and the District of Columbia that have expanded Medicaid (see map), the positive benefits are already playing out.  Here’s some of the latest information:

  • Hospitals are providing less uncompensated care.  In Arizona, hospitals reported that the Medicaid expansion is the chief reason for a 30 percent decline in the amount of uncompensated care they have provided so far this year, compared with a year ago.  The Colorado Hospital Association found a similar decline in charity care through April when it surveyed hospitals in 15 states that have expanded Medicaid and 15 that have not.
  • Medicaid expansion is driving large gains in health coverage.  A survey conducted by the Urban Institute finds that while the uninsurance rate is dropping across the country, states that have expanded Medicaid have seen a drop in the percentage of non-elderly adults who are uninsured by more than one-third — a 37.7 decline — while the uninsured rate fell by only 9 percent among states that haven’t expanded.  A survey from the Commonwealth Fund found a similar trend. Read More

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.

 

Adam O'Neal

Mayor Adam O’Neal – photo credit Twitter.com

“You can’t close hospitals and let people die to prove a point.” So spoke the conservative Republican mayor of Belhaven, North Carolina, Adam O’Neal, this morning at a press conference at the state Legislative Building in Raleigh.

O’Neal’s appearance (and his linking of hands with Rev. William Barber of the North Carolina NAACP) was the highlight of a powerful event at which advocates called on Gov. McCrory and legislative leaders to reverse course and admit that their ideologically-driven decision to refuse to expand the state’s Medicaid program under the terms of the Affordable Care Act is threatening the physical health of hundreds of thousands of North Carolinians and the financial health of dozens of hospitals — especially ones located in poorer, rural communities like Mayor O’Neal’s.

O’Neal’s speech was an especially moving and courageous act by a man who claimed to disagree with Rev. Barber on most issues and who obviously placed any political ambitions he might harbor at risk by so publicly breaking with the leaders of his own party. But it was also obviously heartfelt and genuine — a fact that made it all the more powerful. Read More

Medicaid expansionThe benefits to North Carolina and its citizenry of expanding Medicaid under the Affordable Care Act  have been explained many times, but they definitely bear repeating again today — Medicaid Expansion Lobby Day at the General Assembly (click here for details). Prof. Nancy MacLean of Duke University does the honors with the following helpful and handy list:

If North Carolina Accepts Medicaid Expansion:

  • 500,058 uninsured low-income North Carolinians would finally be protected by health insurance, many for the first time.
  • Each year, 2,840 individuals will live, who would otherwise die due to lack of health care coverage. Doctors will be able to catch their cancers and other illnesses early enough to treat them effectively, and provide treatment for other life –threatening illnesses such as high blood pressure and diabetes. Each one of the people whose lives will continue is a mother or father, daughter or son, sister or brother, friend and neighbor, so their survival will enhance many thousands of other lives and spare them the grief of loss. Read More

Leslie Boyd

Yesterday at the Moral Monday rally on Halifax Mall behind the state Legislative Building, one speaker did an especially good job of pointing out the double standard of many “pro-life” politicians. Leslie Boyd, a person familiar to NC Policy Watch readers, explained that when she was advised to have an abortion because her unborn son had a virus, she “chose life” by opting to carry the pregnancy to term. However, when he later acquired an illness that would prove fatal without treatment, the same politicians who encouraged her to “choose life” deprived him of life by denying him the healthcare he needed. Boyd eloquently proclaimed that his blood was on their hands, and that they were, in effect, responsible for his death.

Boyd is right, of course. If politicians are going to demand that women “choose life” before a child is born, the least they can do is assure that after a child is born, s/he receives the necessary healthcare everyone deserves. Otherwise they are advocating a double standard, and at that a very strange one: the unborn life is treated as more worthy of protection than those who are already living in this world. As long as North Carolina politicians seek to prevent the implementation of the Affordable Care Act and to block Medicaid expansion while also shrinking Medicaid, those of insufficient income for necessary health expenses – as many as 2,800 per year according to some estimates – will suffer the loss of life, whether their own or the lives of loved ones.

Michael Dise is currently a seminary student at Wake Forest Divinity and a summer intern for the NC Justice Center.