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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

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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
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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. 

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Medicaid expansionMedicaid — the absurd failure to expand it at federal expense for a half-million low-income North Carolinians and the state Senate’s latest remarkable proposal to slash the program still further– remains front and center in the state policy debate these days. Moral Monday protesters highlighted the issue last night and the real life stories of average working people whose lives are darker and shorter because of legislative leaders’ Scrooge-like behavior continue to pour in. Tomorrow, activists from an array groups will gather at the General Assembly to lift up this most obvious of issues once again.  Here’s yet another story that makes the case from the good folks over at Women AdvaNCe and Planned Parenthood:

Stuck in the Medicaid gap
By Emily Callen

A few weeks ago, while talking to people about Medicaid expansion at a festival in downtown Raleigh, I met Linda. Though she seemed tired after a day at work and was probably eager to change out of her Bojangles uniform, Linda took the time to talk to me. “I really need this,” she said, filling out a postcard urging legislators to take action. “I tried to sign up for Obamacare but it was just too expensive.”

I learned later that Linda, who considers herself generally healthy, had been in a car crash last December. Broken bones kept her out of work for a few weeks, and she still sees an orthopedist because her collarbone hasn’t healed yet. Since Linda doesn’t have insurance, she’s worked out a deal to pay her doctor a little bit each month. It will take her a long time to pay off the bill, and in the meantime she will continue to struggle to make ends meet.

Linda’s experience is not uncommon. She is one of over 300,000 North Carolinians who fall into the Medicaid Gap; Read More

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Last October Gov. McCrory caused a stir, and raised some eyebrows, when he said that the state may be forced to expand Medicaid due to a “new” regulation.

The policy to which he was referring is called presumptive eligibility. Presumptive eligibility allows states to give permission to hospitals and other providers to temporarily enroll certain people in Medicaid. North Carolina, for example, allows presumptive eligibility for pregnant women. That means if a hospital does an initial check and it looks like a pregnant woman is likely to qualify for Medicaid then the hospital can temporarily enroll her and get paid for the services it provides. Meanwhile, an application for full Medicaid can be processed without a disruption in care.

This policy is critical for ensuring that patients get care and providers get paid.

In states with efficient systems that can process Medicaid eligibility in real time, this temporary measure is not as important. In states where parents are having to ration medicine for their children due to a backlog in processing Medicaid applications, presumptive eligibility is a critical tool.

Health reform gave hospitals more latitude to presumptively enroll patients, even if the state has not granted the hospital permission to participate in the program. Other providers, notably Community Health Centers, however, are still not able to use presumptive eligibility to enroll children in Medicaid. The Community Health Centers are still limited to enrolling pregnant women.

Ultimately, the state needs to fix its computer system. In the meantime, we need to get care to children. We could start by granting Community Health Centers, and possibly other providers, the ability to temporarily enroll likely eligible kids in Medicaid while DHHS clears its application bottle neck.

And until the state expands Medicaid to all low-income people we will need every splint and bandage we can find to patch our broken system.