NC’s Medicaid gap widens


The latest data from the U.S. Census Bureau included some frustrating information about North Carolina and it wasn’t just the state’s sluggish below the national average growth in household median income that the think tanks on the right have mistakenly trumpeted as good news.

The data also showed that the percentage of people without health coverage in the state dropped by 1.9 percent from 2014 to 2015. That means 173,000 people are no longer uninsured thanks to the improving national economy and the Affordable Care Act.

But North Carolina’s uninsured rate is still more than 2 percent above the national average — and it’s not hard to figure out why. That is the frustrating part.

North Carolina remains one of 19 states that have not expanded Medicaid under the ACA and the gap in uninsured rates between expansion states and non-expansion states keeps widening.

The Center on Budget and Policy Priorities points out that the Census Bureau data showed that states that have expanded Medicaid have an average of 7.2 percent of their population without health care coverage while the average uninsured rate is 12.3 percent in states that have refused expansion.

North Carolina’s rate is currently 11.1 percent with several hundred thousand low-income adults left without coverage because Gov. Pat McCrory and legislative leaders have refused to consider Medicaid expansion.

The news comes as state officials in Louisiana recently announced that more than 300,000 people have signed up for Medicaid coverage since Gov. John Bel Edwards expanded the program.

And Republican states have expanded Medicaid too. Last month New Jersey Gov. Chris Christie made headlines for vigorously defending his decision to support expansion and cited the 500,000 people in his state that now have health coverage as a result.

Christie said the success of Medicaid expansion has proven naysayers and critics wrong.

Unfortunately, the critics and naysayers in North Carolina include the folks in power, many whom refuse to consider expansion because they dislike President Obama more than they care about providing access to health care for the people they represent.

And it’s not just about helping hundreds of thousands of people, though you would think that would be enough.

Expanding Medicaid in North Carolina would create thousands of health care jobs and bring in more than $11 billion in federal funding for hospitals in the state, many of which are currently struggling to survive — especially hospitals in rural areas.

And as Gov. McCrory and legislative leaders surely know, the federal government will pick up 90 percent of the cost of expansion which means — as a study by the Urban Institute found — that when you take everything into account the state would actually save more than $300 million over the next five years with expansion.

McCrory has flirted with the idea in the past. At one point his HHS secretary was reportedly working on an expansion plan. Then last year McCrory said he was waiting for the U.S. Supreme Court to rule on the constitutionality of health care subsidies in the ACA before he would make a recommendation to the General Assembly.

The court upheld the subsidies and 500,000 people in North Carolina are still waiting on McCrory’s expansion plan that has yet to appear.

Meanwhile, low-income adults in Louisiana, New Jersey, Ohio and 28 other states across the country can see a doctor when they are sick instead of being forced to wait until they have a medical emergency.

That’s what the latest numbers from the U.S. Census Bureau show, that the stubborn ideology and craven political considerations of the folks currently in charge in Raleigh are costing the state’s economy billions of dollars and thousands of jobs and most importantly denying 500,000 access to quality health care.

Let’s hope when the Census Bureau issues next year’s data sets that North Carolina leaders have finally come to their senses.

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Chris Fitzsimon is executive director of N.C. Policy Watch.

Chris Fitzsimon is executive director of N.C. Policy Watch.

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