Other voices: On Medicaid expansion, we must keep pushing

Published 12:00 am Wednesday, July 28, 2021

For several years now, medical authorities, business leaders and faith leaders — along with newspaper editorial writers — have encouraged the state legislature to institute Medicaid expansion. This would provide medical coverage for North Carolinians who earn too much to qualify for Medicaid, but too little to qualify for a subsidy on the health-insurance marketplace, aka via the Affordable Care Act, or Obamacare. Statewide, around 500,000 or 600,000 North Carolinians, many of them low-wage workers with few options, are caught in this trap. The lack of medical coverage hurts them and their children.

Adopting Medicaid expansion would benefit nearly 35,194 residents in Guilford County as well as about 25,500 in Forsyth.

“Of all the policy prescriptions to help these people, closing the gap through Medicaid would, experts agree, be the most comprehensive solution,” Care4Carolina, a coalition of business, civic and faith leaders and organizations, said in a recent statement. “It is also an eminently affordable fix.”

It would also benefit hundreds of thousands who live in rural communities. N.C. Rural Center president Patrick Woodie says that closing the coverage gap “is a human and economic imperative.

“It’s time we worked together — across party lines, and as rural and urban communities. The health of our rural people and our rural economy depend on it.”

In fact, about 75% of North Carolinians, including majorities of Democrats, unaffiliated voters and Republicans, support Medicaid expansion, according to a poll released last September by Care4Carolina.

A vast majority of states — 38 at last count — including heavily Republican states like Arkansas and Louisiana, participate in Medicaid expansion. Once joining, none have decided that it’s not a good idea after all.

For several years now, Republicans in the North Carolina legislature, led by Sen. Phil Berger and bolstered by then-Gov. Pat McCrory (who is now running for the U.S. Senate), have resisted every call to adopt Medicaid expansion, no matter how sweet the deal. This means, among other factors, that some of our tax money benefits other states rather than our own.

It also means that the jobs that would be fueled by expanding Medicaid are going to other states.

Berger has consistently claimed that the proposition is too uncertain. Even though the federal government would pay 90% of the expense, he says that the feds could back out and leave us holding the bag.

This never seems to happen.

In fact, options that reject federal funds, or allow us to back out if the feds back out, have been proposed. But Berger rejected those, too.

In fact, Berger has opposed Medicaid expansion since it was first introduced in 2012 — meaning that we could have benefitted from it for almost a decade now without his prediction coming true.

Children could have grown up under its provisions.

But Berger is unmoved.

So are we. We keep pushing for the increased medical coverage that Medicaid expansion would provide because we care about the state and the people who live here; because health ailments left untreated lend themselves to increased poverty and fewer financial opportunities; and because political dogma — opposing anything with the name “Obama” attached to it — is not a good enough reason to let people suffer. North Carolinians deserve better than they’re getting.

We also push it because it would be good for North Carolina’s business development. As noted last week by the Winston-Salem Journal’s Richard Craver, our deficiency in social areas — which include medical coverage for the poor as well as protections against discrimination — discourage some businesses from locating here.

We keep advocating for it because it’s the right thing to do.

In a recent guest column (“Finally, N.C.’s golden health care opportunity,” July 19), four retired heads of medical and charitable organizations said that now is a unique and beneficial moment in time, in which the pot has been sweetened yet again.

“The American Rescue Plan provides states with a new incentive: a two-year, 5% increase in the federal match rate for Medicaid,” they wrote. “For North Carolina, that would mean an influx of around $1.7 billion over the next two years. Official estimates put the cost of closing the coverage gap through Medicaid at $700 million over that span, which would leave $1 billion for the state to invest in other worthy endeavors.”

If used for nothing else, that $1 billion could sit in the bank, accumulating interest, in case the feds finally do as Berger predicts.

What about it, Sen. Berger? Is that enough yet? What else do you need?

— Winston-Salem Journal