News, public health

North Carolina advocates, health care leaders press again for Medicaid expansion

N.C. DHHS Secretary Mandy Cohen speaks on Medicaid expansion Tuesday in Raleigh (Photo taken by Phyllis Nunn).

Roughly five years after North Carolina lawmakers dismissed calls to join a federally-backed program that would have extended health care access to an estimated 500,000 low-income residents, advocates are making their case to take up the program again with the N.C. General Assembly.

“All of that uncertainty about the Affordable Care Act (ACA) is past us,” N.C. Department of Health and Human Services Secretary Mandy Cohen told supporters Tuesday, as they prepared to converge on the state legislature to press for Medicaid expansion.

“In fact, we’ve never seen more support from the Republican side of the aisle for the Medicaid program,” Cohen added.

Constitutional amendments are expected to dominate the legislative discourse during the final days of the short session, but Tuesday’s advocacy day centered on North Carolina’s myriad health care woes, and Republican legislators’ refusal to opt into the ACA’s Medicaid expansion.

GOP critics worry the expansion, which would require the state to foot the bill for 10 percent of costs, comes laden with unpredictability, despite arguments to the contrary.

Indeed, a report this year from a Wake Forest University law professor and health care expert detailed emerging evidence that costs in the 34 states that bought into Medicaid expansion have not been so erratic after all.

Backers like Cohen—an ex-federal government healthcare administrator under former President Obama who was named to the state DHHS post last year by Gov. Roy Cooper—rebuffed GOP arguments again Tuesday.

“In North Carolina, (Medicaid) has been under budget for seven years now,” said Cohen. “No one can say ‘the program’s out of control, there’s no predictability in their budget.’ Nope.”

Cohen said Tuesday that Medicaid expansion would help to close the gap for poor North Carolinians who make too much to qualify for the government health insurance program.

Cohen also estimated that the program would create more than 40,000 new jobs in the state and generate billions of dollars in new economic activity.

She pointed to other Republican-led states like Indiana, Ohio and Michigan that saw similar results after agreeing to expand Medicaid.

“This does not have to be a political issue,” Cohen said. “This is just about common sense and being pragmatic.”

Tuesday’s advocacy day was also expected to include meetings with state lawmakers, an afternoon press conference and more. It was organized by a coalition of health care advocacy nonprofits, including the progressive N.C. Justice Center’s Health Advocacy Project. [Disclosure: The Justice Center is the parent nonprofit for Policy Watch.]

Meanwhile, Cohen huddled Tuesday with two North Carolinians who say the state’s refusal to expand the health care program cut them off from vital care and medicine.

N.C. DHHS Secretary Mandy Cohen (right) speaks to Burlington resident Marta Concepcion Tuesday about Medicaid expansion. (Photo taken by Billy Ball)

“It’s just really hard that I have to be in pain and I can’t get no help,” said Marta Concepcion, a Burlington resident who said she lost her government health care assistance when she moved from New York to North Carolina in recent years.

Concepcion said she’s been diagnosed with a heart condition, sleep apnea, high blood pressure, depression and bipolar disorder, but she can’t afford medication or regular visits with a doctor.

Concepcion tearfully recalled one recent doctor’s visit where she was told that she needed a more thorough examination by medical professionals.

“She goes to me, ‘you need to get checked, because we see something wrong with you, but it’s going to cost $100.’ Well, lady, you might as well say that I came here to die, because I don’t have that money.”

N.C. DHHS Secretary Mandy Cohen (center) speaking Tuesday to Burlington residents Marta Concepcion (left) and Debbie Smith (right) about Medicaid expansion. (Photo taken by Billy Ball)

Another Burlington resident, Debbie Smith, told the state’s top healthcare official that her husband, a Navy veteran who stripped asbestos from flight decks, can’t afford medication that greatly improved his life.

Smith said her husband, who’s been diagnosed with congestive heart failure, lung disease and diabetes, is mostly confined to his chair these days.

“A lot of times I sleep in the living room next to him,” said Smith. “Because I don’t like if I sleep in the bed, I have to go in there and wake up every morning and see if he’s still alive.”

Smith added that she can’t work either. Smith said she was diagnosed decades ago with severe asthma, and years of steroid treatment severely weakened her bones.

Cohen told Smith and Concepcion that she’s heard many stories like theirs, and that she believes they could receive some relief under expanded Medicaid.

“I’m sorry that you all have gotten caught up in the politics piece of this, because there are solutions here,” said Cohen. “It doesn’t solve everything. There are still issues, but it certainly gives us a leg up.”

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