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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

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.

 

 

This morning’s Greensboro News & Record gets it just about right with an editorial entitled “Just the essentials.”

“The legislature’s ‘short’ session convenes today with one essential purpose: to make adjustments to the second year of the biennial state budget.

There’s other work that needs to be done, and some things that should not be done.

In the first category:

* Pay raises for teachers.

Gov. Pat McCrory outlined his proposal last week. It includes substantial raises in starting salaries and for teachers in the first few years of their careers. More experienced teachers also would see increases. The legislature should flesh out and approve a plan to improve teacher compensation and simultaneously revoke its ill-conceived directive for school systems to designate one-fourth of eligible teachers to receive bonuses if they surrender their tenure rights.

* Stricter coal ash regulation.

The massive spill of coal ash into the Dan River near Eden in February alarmed politicians of both parties who had ignored the issue of safe storage for years. Now is the time to set Duke Energy on a course of corrective action and put in place new regulations to protect water.

* Medicaid expansion.

Last year’s decision to reject federal funding to broaden eligibility left an estimated 300,000 or more residents without health care coverage. The legislature should correct this mistake.

* Preschool enrollment.

The legislature last year directed stronger efforts for schools to make sure children can read by the end of third grade but didn’t grant additional resources to get the job done. One way is to pay for more at-risk 4-year-olds to attend prekindergarten programs.

Now, what the legislature should not do…

Click here to read the rest of the editorial.

Medicaid efficiencyThe wonks at the Center on Budget and Policy Priorities released an outstanding little report this week about America’s health insurance program for low-income people and some of the biggest myths that have been perpetuated about it.

The overarching message: Despite the far right propaganda, Medicaid remains an efficient and flexible program that dramatically improves the lives of participants, promotes work and is an outstanding deal for states that expand it under the Affordable Care Act.

Read the entire report by clicking here.

Meanwhile, if you’re looking for the  inside political scoop on the Medicaid battles and the real reason the right refuses to allow its expansion in states like North Carolina, Nobel prize-winning economist Paul Krugman had the answer in yesterday’s New York Times: Read More

Vidant Pungo

Vidant Pungo Hospital
Photo: www.vidanthealth.com

The failure to expand Medicaid appeared to have sealed the fate of Vidant Pungo Hospital in the small town of Belhaven. Now, there appears to be some promising news in the fight to keep services flowing from a hospital that served many lower income North Carolinians. Congrats to our own Adam Linker for his fine work in making this happen. This is from the NAACP:

GREENVILLE, NC -The North Carolina NAACP, the NAACP Branches in Hyde and Beaufort Counties and the leadership of Vidant Health are pleased to announce this morning at 9 am that they have worked out an agreement to keep Vidant Pungo Hospital open.

Vidant Pungo Hospital and its emergency facilities will remain open and operated by Vidant Health through July 1, 2014. Over the next three months, Vidant Health will work with the community to help them establish a representative community-based board that will accept full operating control of the hospital in a transfer by July 1, 2014. Read More