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Lawmakers should expand Medicaid

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Feb. 27 was Medicaid Expansion Advocacy Day sponsored by the North Carolina Justice Center. A coalition of 40 organizations from mountains to coast met to advocate for closing the coverage gap in the state of North Carolina.

Groups met at the N.C. Museum of History to network and hear speakers including state Health and Human Services Secretary Mandy Cohen. Attendees also were honored to hear many impactful stories and voices from the uninsured. One key aspect of the day for the more than 200 attendees was to network and learn about the coverage gap.

The groups then spent the afternoon at the General Assembly meeting with their elected representatives and legislative aides. It’s expected that in this long session, some form of expansion will be passed. So far, Democrats have introduced two Medicaid expansion bills and Republicans are likely to release a bill that address closing the gap in late March.

The coverage gap refers to people who earn too much to qualify for Medicaid but not enough to get help in the private insurance marketplace. A family of four earning $12,000 doesn’t have an income low enough for the parents to qualify for Medicaid in North Carolina; it’s not until they earn $25,100 that will they qualify for subsidies on the health insurance marketplace.

Thirty-seven states have closed the coverage gap by offering some type of Medicaid program to this population, this includes Republican-controlled “red states.” North Carolina is one of 14 states that haven’t expanded the eligibility requirements for Medicaid, leaving our state with the sixth-largest uninsured population in the country.

These people are our neighbors, people whose occupations typically don’t offer affordable health insurance such as service workers, farmers, veterans, child care workers, firemen and small business owners. According the Cone Health Foundation, more than 63 percent of people in the coverage gap are from working families. If North Carolina closed the gap, 400,000 people would get access to affordable, reliable health insurance.  

There were tragic stories of cancer going untreated for months, children losing parents needing to go into foster care, lack of basic health screening and homelessness caused by medical debt and illness. People are basically one illness or one broken bone away from bankruptcy.

Right now our tax dollars are going to Washington and supporting other states that have expanded eligibility requirements for Medicaid. North Carolina has the opportunity this year to bring that money back and use it to care for its own residents. Legislation would be 90 percent funded by the federal government, and the return of investment for North Carolina communities is tremendous.

Closing the coverage gap is good for the state’s economy. It would bring about $4 billion in federal funding into the economy each year. By not providing help to those who have fallen into the coverage gap, the state will miss out on a potential 43,314 new jobs and more than $21 billion in state business activity, according to the N.C. Rural Center.

The U.S. Department of Health and Human Services has found that in most states that have expanded eligibility, even premiums for those with private insurance has dropped, as well as reduced uncompensated care costs to hospitals and providers. Reliable health insurance makes a huge difference for avoiding foreclosures and evictions. In states that have expanded Medicaid, people are 25 percent less likely to miss a rent or mortgage payment. When people can get the health care they need, they live healthier lives and are more productive workers. Making sure more people have health care will help our economy.

Good health care enables people to productive, to take care of their families and to live a full life with dignity. Bad health care or none disables people, perpetuates poverty and negatively affects communities for generations.

Sonya Glavin is chairwoman of the League of Women Voters of Granville County and a member of the group’s health care legislative action team.