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People fear the unfamiliar. It’s human nature. When a new threat emerges, our minds often race about it — even when the same old threats are far more worrisome.

This is one reason a healthy (heh) number of my friends are anxious about the Ebola virus. Maybe yours are, too. Heck, maybe you are. Well, here’s the good news: while certainly a frightening disease, Ebola is unlikely to be a widespread public health threat in this country.

There’s bad news, however. Another, less flashy threat to public health is far more dangerous to people in North Carolina and states like it. (The additional bad news: it’s also deeply troubling that Americans are more concerned about a disease killing one person inside our borders than the nearly 5,000 Ebola has killed in Africa so far. That’s a topic for another day.)

The real public health threat is the failure of some American states, including the Old North State, to expand Medicaid.

Medicaid expansion would help more of our neighbors get health insurance, which is vital in preventing the advance of disease — and the early deaths that come with that disease. Here in North Carolina alone, about half a million people lack health insurance that would have been covered had we made the choice to expand Medicaid.

What does that mean? It means more preventable deaths every year. A team of researchers for Harvard found that failure to expand Medicaid could mean as many as 1,145 more deaths in North Carolina every year.

Based on those numbers, that’s about three more preventable deaths in North Carolina every day. Think about the math of that. Read More

Commentary

The ideologues on the far right may continue to scream for “repeal” of Obamacare, but the evidence continues to pile up that this is simply not something that’s going to happen. That was the analysis delivered by Judy Waxman of the National Women’s Law Center at this morning’s NC Policy Watch Crucial Conversation breakfast in Raleigh. Waxman noted that amendments to the ACA are certainly likely — indeed, she thinks they are essential — but based on decades of experience in Washington and her numerous political and policy contacts around the country, she believes repeal is simply not in the cards.

Waxman’s analysis is consistent with this AP story that ran on several North Carolina news sites this morning. This is from the version that ran in Raleigh’s News & Observer under the headline “GOP governors don’t see ‘Obamacare’ going away”:

Nine Republican governors have expanded Medicaid for low-income people in their states, despite their own misgivings and adamant opposition from conservative legislators. Three more governors are negotiating with the Democratic administration in Washington.

Rather than demanding repeal, the governors generally have sought federal concessions to make their decisions more politically acceptable at home. That approach is in sharp contrast to the anti-Obamacare fervor of their party in Congress.

Ohio Gov. John Kasich says he doesn’t think there will be a repeal in Washington, even if Republicans win a Senate majority and consolidate their hold on the House in next month’s election.

“That’s not gonna happen,” the Republican governor told The Associated Press during a recent re-election campaign swing.

This take on the situation is consistent with the views expressed recently and repeatedly by the McCrory administration of late that Medicaid expansion in North Carolina under the ACA should and will occur in the near future.

Commentary
Funeral

Photo: NC NAACP

As the North Carolina NAACP holds a “Denial of Medicaid Funeral Procession” today, it’s worth considering some of the facts and data surrounding the impact of North Carolina’s ongoing refusal to expand Medicaid under the Affordable Care Act:

The North Carolina Institute of Medicine’s 2009 Access to Care study begins with this statement: “The lack of health insurance coverage is the foremost barrier to accessing health care services.”

In the report’s introduction it continues:

In a statewide survey of adults, nearly half of the uninsured in North Carolina reported forgoing necessary care due to cost, compared to 10% of individuals with insurance coverage. Lack of coverage also adversely affects health as the uninsured are less likely to get preventive screenings or ongoing care for chronic conditions. Consequently, the uninsured have a greater likelihood than people with coverage of being diagnosed with severe health conditions (such as late stage cancer), being hospitalized for preventable health problems, or dying prematurely. In fact, adults who lack insurance coverage are 25% more likely to die prematurely than adults with insurance coverage.

A Families USA report in 2010 estimated that before the Affordable Care Act passed nearly 1,000 North Carolinians died each year between 2005 and 2010 due to lack of health insurance.

What has changed is that the states now have an unprecedented tool for saving lives. North Carolina now has the opportunity to extend health insurance coverage to nearly all low-income adults, the majority of whom are working. The federal government will finance nearly the entire cost of this coverage expansion. Not expanding coverage is not only morally misguided but it is also fiscally irresponsible. Read More

Commentary

The Alliance for a Just Society along with Action NC released a report today titled “The Promise of Quality, Affordable Health Care for Women: Is North Carolina Delivering?” The answer, in a word, is no.

Overall the report gives our state a C- on women’s health when looking at a range of measures from health outcomes to access. Most abysmal is the state’s ranking on health insurance coverage. There we merited a D-. The uninsured rate among non-elderly women in NC is nearly 17 percent. There are also tremendous racial disparities in uninsured rates. Nearly 19 percent of black women are uninsured in the state, according to the report, and almost 39 percent of Latinas are uninsured. Our state ranks 50 out of 50 for uninsured rate among Latinas.

The grades don’t climb much higher from there. On women’s access to health services we earned a mediocre C and on health outcomes we get a C-. This is a report card we might want to hide in the couch cushions.

But there’s good news that could boost our lackluster scores. As the report recommends, expanding Medicaid would put a major dent in our uninsured rate, help close the health disparity gap, and improve outcomes.

NC lawmakers once famously claimed that Medicaid expansion has nothing to do with women’s health. This report card, and hundreds of thousands of women across the state, beg to differ.

Commentary

Conspiracy kooksThere’s very little that right-wing opponents of President Obama and the Affordable Care Act aren’t willing to claim in public about America’s increasingly successful and transformative health care law. From “death panels” to imaginary massive tax hikes to allegations about global conspiracies and plots to impose martial law and suspend the Constitution, the loony conspiracy theories are as endlessly creative as they are delusional.

As a general matter, the kookiness does seem to be somewhat on the wane of late as the ACA slowly but surely moves millions of new people onto the insurance rolls while helping to contain the growth in health care costs. Heck, even the McCrory administration has finally recognized that North Carolina must expand Medicaid under the ACA.

For a few true believers and unrepentant, whatever-it-takes propagandists, however, the battle is still on and just about any anti-Obamacare claim — however preposterous — will do. For a classic example, check out this post by a staffer over at the Locke Foundation entitled “Medicaid Expansion Could Steer Resources Away From the Most Vulnerable.” Here, as best as can be determined, is the “argument”: Read More