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IMG_0831Last year Mayor Adam O’Neal from the tiny, scenic town of Belhaven, NC, made national headlines as he walked nearly 300 miles from Beaufort County to Washington, DC, to protest the closing of his rural hospital and to urge states to accept Medicaid expansion.

On Monday, June 1, O’Neal left Belhaven to replicate last year’s feat. And this year he is taking along advocates from around the country. As marchers filed out of town yesterday to start the arduous journey they wore shirts advertising their home states. A team of advocates travelled from Texas, some came from West Virginia and Alabama, a rural hospital CEO from Kentucky joined the walk, as did a woman from Seattle, Washington.

The message of the marchers is clear: we must save rural health care.

A key part of that agenda includes expanding Medicaid, as an Episcopal priest from Belhaven reminded the audience during a prayer before the send off. Rev. William Barber from the NC NAACP noted that Jesus made health care a central part of his ministry.

You can follow the march at this website. You can also tweet with the hashtag #savethe283. That refers to a national estimate that 283 rural hospitals are at risk of closing this year.

You can also join the final rally as marchers reach Washington, DC, and gather at the Capitol on June 15 at 10am.

And, finally, you can ask legislators and the Governor in North Carolina to accept new federal Medicaid funds to expand insurance coverage to 500,000 more people in our state.

Commentary

In 2013 the North Carolina General Assembly rejected new federal funds to expand health insurance coverage in the state, but that hasn’t stopped local governments from urging the Governor and legislators to change course.

Counties such as Mecklenburg and Durham have passed Medicaid expansion resolutions as have cities like Greensboro and Winston-Salem. Even Sen. Phil Berger’s hometown of Eden officially went on record endorsing expansion. The Rockingham County towns of Reidsville and Madison have since joined Eden.

This month three more counties — Nash, Edgecombe, and Chatham — joined the chorus.

As retired cardiologist Jim Foster pointed out to the Chatham Commissioners there are tremendous economic benefits to accepting more federal Medicaid dollars. From news coverage of the resolution:

“Anytime money flows into the economy, it ripples through and multiplies,” Foster said.

He pointed to a George Washington University study that broke down the costs and revenues from expanding Medicaid.

The study broke figures down for the state and for its 100 counties.

In Chatham, for example, the study stated that not expanding Medicaid cost 136 jobs and $6 million in gross product.e study Dr. Foster mentions can be found here.

Approval of the Nash County resolution was unanimous and Commissioners added a call for simultaneous reforms to Medicaid. This makes sense. In fact, nearly every expansion state is also reforming the program at the same time.

There is no reason North Carolina’s leaders can’t learn to walk and chew gum like most other states in the country.

News

House lawmakers unveiled their 2015-17 biennial budget Thursday morning—and education proposals were longer on policy pitches than big figure changes, including measures that would affect student assessment & classroom staffing models as well as seven different pilot programs aimed at teacher preparation, workforce development and remediation, among other ideas.

The budget also did not include a much anticipated announcement on teacher pay — that’s to come at the beginning of next week.

Read on for a list of highlights.

K-12 House Budget

School vouchers: Provided the Supreme Court allows the Opportunity Scholarships program to proceed, which provides students with state funds to attend private schools, House lawmakers propose a $6.8 million increase for 2015-16—bringing the annual cost of program to $17.6 million

Disability vouchers: Students with disabilities would be able to use up to $8,000 state funds annually to attend private schools—that’s up from $6,000 annually in prior years. Families could also get tuition funds up front versus having to wait for reimbursement.

Teacher assistants: Lawmakers added $88.9 million compared to the base each year — but the move is just to backfill the loss in lottery receipts and other nonrecurring funds. So the takeaway is that there’s no real change here–funding levels remain the same as ’14-15.

Textbooks & digital resources: $50 million (for textbooks) compared to the base each year, with a cumulative increase during the biennium of $100 million. Textbook funding has been obliterated in recent years. Read More

News

One out of eight teachers in this country is a bad one—and that’s because teachers have failed to safeguard their profession.

So says the American Enterprise Institute’s Rick Hess, an expert in education policy at the conservative think tank who spoke on Monday to a group of North Carolina school leaders at NC State’s Friday Institute about how to empower teachers and principals.

Hess, who was also in Raleigh to promote his new book, The Cage-Busting Teacher, explained that too many teachers are hiding in a ‘classroom cage’ and are not participating in the governance of their schools in ways to make the environment better.

“Teachers…have not done a good job of safeguarding their profession,” said Hess. “When you survey teachers, they will tell you themselves that five percent of their fellow teachers in their district deserve an F and another eight percent of the teachers in their district deserve a D.”

“That is failing to police your profession,” Hess said. “That’s failing to wield that moral authority.” Read More

Commentary

RWJA new report from Manatt Health Solutions on behalf of the Robert Wood Johnson Foundation finds that states that have tapped federal funds to expand Medicaid are seeing significant financial benefits. By the end of 2015 the savings and revenues across the eight states examined in the report are expected to exceed $1.8 billion.

This is consistent with the county level examination of expansion in North Carolina commissioned by the Cone Health Foundation and the Kate B. Reynolds Charitable Trust. That study, using conservative estimates, found that the savings and revenues more than offset the costs of expansion through 2020.

The states featured in the report — Arkansas, Colorado, Kentucky, Michigan, New Mexico, Oregon, Washington, and West Virginia — had direct budget savings from reduced spending on the uninsured, they experienced increased tax revenue from the new flow of federal funds into the state, and they realized additional savings from switching some existing Medicaid patients into the expansion program.

A source of significant savings, for example, comes from pregnant women. North Carolina has traditionally covered pregnant women in Medicaid up to 185 percent of the federal poverty level. This coverage, however, is only for pregnancy related services. Also, once a woman has the baby she oftentimes loses Medicaid because coverage for parents is quite stingy.

After expansion, pregnant women above 133 percent of federal poverty level would qualify for full Medicaid coverage. And, instead of the lower match rate, the federal government would pay 90 percent of the costs for these women. Once the baby is born many women would then be able to continue coverage through Medicaid. This would result in healthier babies, healthier parents, and major savings for the state.

The report notes that states will also garner savings in behavioral health and among the medically needy population.

States that opted to expand Medicaid early will have the largest benefits, but there are still plenty of positives for states like North Carolina that haven’t hit the leader board yet. The final year for the federal government to pay the full cost of expansion is 2016 so we need to act fast or our people, and our economy, will miss out on a much needed boost.