The Effort to Expand Medicaid in North Carolina Continues

As the General Assembly’s biennial short session continues, Medicaid expansion continues to be a hot issue for North Carolina.

On May 25, concerned citizens gathered outside the General Assembly for Medicaid Expansion Advocacy Day to demand that North Carolina expand Medicaid and join the majority of other states that have closed the health care coverage gap for their citizens.  Supporters included lawmakers, patient advocates and physicians, as well individuals directly affected by the lack of coverage. The day’s events included education and advocacy trainings around expansion, a Twitter town hall discussion hosted by the Young Invincibles Organization, delivery of signed petitions, a press conference, and opportunities for citizens to meet with their legislators.

Through events such as this, expansion advocates continue to raise up the voice of the 72% of North Carolinians who support expansion while citing the numerous benefits expansion funding would bring to the state. At the start of this legislative session, House Bill 1073 was introduced which would expand Medicaid to all non-elderly adults up to 133% of the federal poverty line or $32,000 annual income for a family of four. The bill, which was co-sponsored by Representatives Ager (D-Buncombe), Fisher (D-Buncombe), Harrison (D-Guilford), and Insko (D-Orange), would bring $21 billion in federal funding into the state over the next four years and expand coverage to hundreds of thousands of deserving North Carolinians. By doing so, federal funding would also flow into the state’s Division of Mental Health, go toward inmate health, and the Division of Public Health’s AIDS drugs assistance program – all existing programs currently funded by NC – which would equate to tens of millions of dollars in reductions in state spending on such programs.

Meanwhile, the majority of state legislators have continued to prioritize partisan politics by rejecting such federal funding.  Ignoring calls for expansion, legislators have focused on a proposal for a waiver to change the way North Carolina’s Medicaid is managed. This proposal has drawn comment and criticism from a number of individuals and organizations questioning the effectiveness of changes which do not  address the half million people without health insurance in this state.

Governor McCrory has said that North Carolina will not consider expanding Medicaid until the legislature secures approval for what he has called “a North Carolina plan, not a Washington plan.”  Indeed, public calls to include Medicaid expansion in proposed waiver have yet to be addressed.

The proposed waiver must be approved by the Centers for Medicare and Medicaid Services (CMS) before implementation at the state level. CMS has not set a deadline regarding when the state will be notified about the waiver proposal. State DHHS representatives have stated that any such changes to Medicaid would take several years to first be approved and then implemented. While our state legislators remain inactive on the matter of expansion, we now know that without expansion, thousands of people will die unnecessary deaths because they can’t get critical medical care, and thousands more will be forced to seek expensive treatment in emergency rooms for conditions that could have been avoided with preventive care. Our current coverage gap will continue to cost the state money, while putting already struggling hospitals and clinics in precarious positions while continuing to willfully disregard the needs of poor and vulnerable populations in this state.

But there is a glimmer of hope. As this issue continues to gain coverage, more people have come forward to share their stories or the stories of family members who have been afflicted by the coverage gap. And as word spreads, more people and organizations have spoken up in support of this cause. The Council of Churches, along with Health Care for All NC and other NC organizations have been successful in extending educational programming and providing open discussion on this topic in  several counties around the state. Petition signatures have continued to amass and many churches and communities around the state have passed their own version of a resolution in support of Medicaid expansion.

Pitt County’s Interfaith Clergy Council, representing several organizations in Greenville and the surrounding area, have banded together to publicly support Medicaid expansion (See list of signers here).  Pasquotank County commissioners passed a similar resolution.  Churches and organizations in several other counties have drafted their own resolutions and the list is growing.

In the words of Senator Floyd McKissick of Durham, “We cannot put the health care needs of 500,000 people on the backburner. Be relentless, because it will not change today. But what we can do is provide a pathway to reconsider where we are.”

For more information on scheduling an educational program for your community or passing a resolution, contact Liz Millar at liz@ncchurches.org or 609-464-3415.