Commentary

AIDS Action Network advocate: Medicaid expansion is a life and death matter

PictureChristina Adeleke of the North Carolina AIDS Action Network recently had the opportunity to testify at a North Carolina Department of Health and Human Services public hearing on the McCrory administration’s plan to privatize the delivery of Medicaid services. Afterward, she composed a compelling and personal essay about how the reality of health insurance in 21st century North Carolina and the price people are paying because of North Carolina’s refusal to close the coverage gap.

FYI, there are two more opportunities to speak out at these hearings — tomorrow in Elizabeth City and Monday in Pembroke. Click here for more information.

The moment I realized that Medicaid reform was a “big deal”
By Christina Adeleke, Esq., North Carolina AIDS Action Network

I have to be completely honest, health insurance was not something I really thought too much about until I got older. Like, “you are finally an adult with bills so you need to think about this now” older. As a child, it was not something I actively thought about. One, I was a kid so health insurance was definitely not high on my priority list and two, I was not a “sick kid,” so I only really went to the doctor’s office when I had to get vaccinated or get a physical to play sports at school (which was also rare). It was not until I reached the magic age of 26 that I was faced with the harsh reality that health insurance is necessary. And very expensive.

Like most young adults, my first job did not immediately shower upon me loads of money. I made enough money for bills, essentials, and literally nothing else, including health insurance. When I tried to get coverage under the Affordable Care Act (ACA), the only plans that I qualified for were completely out of my budget. When I tried to apply for Medicaid, I was told that I made too much money to qualify but if I had a child, things would be different, which was puzzling to me. Did the fact that I had a child or not change my very real reality of not being able to afford health insurance? Before I had too much time to seriously weigh those options, I got offered a new job…WITH BENEFITS. To say I was excited would be an understatement. Now, I did not have to load up on vitamins to prevent myself from getting sick or entertain the idea of having a child in order to get health coverage. I assumed that everyone who was struggling to get health coverage was like me and when they found the right job or opportunity, they too, would be covered as well. I was very wrong. Read more

Commentary

Day Three of “Altered State: How 5 years of conservative rule have redefined North Carolina”

altered-state-bannerIn case you missed it, be sure to check out today’s third installment in our new special report: “Altered State: How 5 years of conservative rule have redefined North Carolina.” Today’s story, “Yanking away the ladder: Legislature blocks and cuts programs that help people climb out of poverty,” is written by reporter Sarah Ovaska-Few and it tells the real life stories of average North Carolinians who have suffered mightily as the result of the anti-government policies implemented by the state’s conservative political leadership. Here’s the opening:

“David Turner’s spine and back issues cause him nearly constant pain and distress, keeping him inside his house most days and unable to meet with clients for his web design business or care for his two children.

A medical test would clear Turner for steroid shots to lessen the pain, but the $5,000 price tag is too steep for the Gaston County family with an annual income of less than $20,000 and no health insurance.

The Turners are stuck in what’s known as the Medicaid expansion gap, a hole created when North Carolina’s legislature rejected federal money that would have expanded the program to cover a half-million of the state’s lowest-income adults.

The Turners essentially make too little to qualify for federal subsidies that would make health insurance on the open market affordable and aren’t sick enough to get health care through the existing Medicaid program, which primarily serves low-income children, elderly and disabled persons. (Their children are enrolled in Medicaid.)

‘We’re hanging on by a thread,’ said Karen Turner, who has diabetes but delayed treatment so the family can afford her husband’s pain medications.

If David Turner had access to medical care, there’s a good likelihood that he would be able to work more, earn more, pay more taxes and better support his family. North Carolina is one of 20 states that has not expanded its Medicaid program to cover poor adults, even though the federal government would cover most of the costs. North Carolina accounts for 10 percent of all the nation’s adults that fall into the Medicaid gap, according to the Kaiser Family Foundation.

A central element in the five-year reign of conservatives has been a fundamental change in how state government views and treats its poorest and most vulnerable citizens. The 2013 decision to reject Medicaid expansion is part of a broad effort to cut, limit or eliminate programs that provide ladders to help poor families climb out of poverty and find better futures.”

Click here to read the entire story.

Commentary

This Halloween we’ve had enough of ACA ghost stories and scare tactics

Action NC policy and public affairs director Kevin Rogers has an opinion piece in the News & Observer arguing that the ACA is here to stay, so we should get down to the business of improving the law and fully implementing it in North Carolina.

Open enrollment, he reminds us, starts November 1. Our state is a national leader when it comes to signing up residents for Affordable Care Act plans. The many people who have these policies need added protections, not repeal votes, to make their insurance plans work better. And the working poor need our state leaders to stop blocking Medicaid expansion. This interposition is causing great pain, and unnecessary deaths, all across North Carolina.

You can read the entire editorial here. Rogers concludes with this message to lawmakers:

As we enter the third ACA enrollment period, it is high time for Congress and the General Assembly to accept reality, abandon partisan tricks and move forward to improve the economic and human well-being of our state. Until then, thousands of lives will be lost each year, and billions of dollars wasted that health care consumers, taxpayers and our government cannot afford. The ACA is here to stay – it’s time to start acting accordingly.

If they heed his advice that would be sweet indeed.

Commentary

Medicaid giveaway: An exclamation point on a dreadful legislative session

MedicaidThe endless 2015 legislative session appears, mercifully, to be nearing a conclusion after nine long months. With the passage of the budget early this morning, legislators are now free to wrap up final details and adjourn for the year. Unfortunately, one of those final details will be giving away the state’s award winning Medicaid program to giant, for-profit insurance companies. As Lynn Bonner reports this morning in Raleigh’s News & Observer:

“Legislators have agreed to privatize North Carolina’s $15 billion Medicaid program, a change that doctors and hospitals have been fighting for months, but which some Republican legislators have championed as a remedy for unpredictable spending.

Under House bill 372, three insurers would be given contracts to offer statewide Medicaid managed care plans. The state would have up to 10 contracts with “provider-led entities,” or groups of doctors and hospitals, that would enroll patients in regional managed care networks.

Rather than pay for each hospital visit or medical procedure as it does now, Medicaid would give the companies a fee for each patient when they enroll. The government would not be liable for cost overruns.”

In many ways. of course, this is a perfectly apt conclusion to the session. The 2015 session opened nine long months ago with one obvious and overriding imperative: North Carolina needed to follow the lead of 30 other states and expand Medicaid under the Affordable Care Act. Such an act would have saved thousands of lives per year, pumped billions of dollars into the state’s economy and strengthened an already highly effective program. The state’s feckless governor admitted these facts at times even as he manufactured excuses not to act.

Now, however, the decision has been made to, essentially, do the opposite. Rather than expanding the program to save lives, state leaders will heed the siren song of fat cat corporate lobbyists and give away this enormously valuable public asset to a handful of giant corporations that will, in turn, squeeze profits out of it by denying services to people in need.

The bottom line: More poor people will die, our economy will suffer unnecessarily and wealthy, out-of-state corporations will pad their profits. It’s hard to think of a concluding act that better symbolizes the awful 2015 session.

Commentary

King v. Burwell – what is North Carolina’s plan?

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In January, over half of all those that participated in the Kaiser Health Tracking Poll were unaware of a Supreme Court case, King v. Burwell , that could greatly impact many states’ economic growth and public health. What has made the Affordable Care Act successful is that individuals are able to receive financial help to purchase insurance plans and depending on the outcome of this case, many people may lose this assistance in states that rely on the federal marketplace instead of a state-run marketplace. The decision of the King v. Burwell case could potentially affect 1.6 million North Carolinians’ ability to access affordable health care. Approximately 560,000 North Carolinians have purchased insurance coverage using the federal marketplace and are at risk of losing subsidies that would then make health care too expensive. What is more, the King v. Burwell decision is linked to expanding Medicaid to nearly 500,000 people throughout NC as Governor McCrory has stated that he will wait until the Supreme Court decision before making a formal decision on Medicaid expansion. We also know that a dramatic shift in enrollment will have a major impact on private insurance companies that will likely drive rates up by 43 percent for everyone. Some insurers may pull out of the market altogether.

Leaders in many red and blue states are concerned about the potential impact of losing insurance subsidies, and they are creating response plans. Let’s hope this process is playing out behind-the-scenes in North Carolina as well. The same Kaiser poll reports that 82 percent of Democrats, 63 percent of Independents, and 40 percent of Republicans believe that the U.S. Congress should act to make sure that low-and-moderate income families continue receiving tax credits to purchase affordable insurance even if the Supreme Court strikes down subsidies. However, states do not have to rely on the federal government to pass a law to ensure access to affordable health care; some states are already preparing to develop state-run exchanges. Nationally, 51 percent of Republicans, 63 percent of Independents, and 61 percent of Democrats believe that states that rely on the federal marketplace should create their own state-run market places. North Carolina’s Governor and General Assembly should take the initiative and start constructing our own state exchange. If the Supreme Court decides not to uphold the subsidies for low-to-moderate-income individuals who rely on the federal marketplace, it’s not clear that NC has a plan. Across the U.S., 63 percent of people believe that Republicans do not have an alternative to the ACA. Our state can’t wait on Congress to come up with a solution. Waiting to act until a Supreme Court decision in mid-to-late June is risky and could leave many North Carolinians without health care and our insurance market in ruins.