Advocates call - again - for Medicaid expansion

Democratic House and Senate members have filed bills that would accept the expansion of the program to cover people making 133 percent of poverty level – the original coverage expansion that was envisaged as part of the Affordable Care Act.

Other Republican-led states have accepted the expansion, but North Carolina has not, As a result, people who make between 100 and 133 percent of poverty level are caught in a gap where they don't make enough money to qualify for tax subsidies for health insurance purchased under the law but can't afford coverage without any subsidy.

Advocacy groups brought some 25,000 signatures petitioning state leaders to accept the expansion. They planned to deliver them to the offices of Gov. Pat McCrory.

House sponsor Rep. Gale Adcock, D-Wake, a 30-year nurse practitioner, called it "an exciting day."

"North Carolina has an opportunity to bring more than $2 billion of our tax dollars back to this state every year to take care of our own people and boost our own businesses," Adcock said, explaining that accepting the expansion would increase hiring in the health care sector as more people gain access to services.

"This is a common-sense policy that has gained bipartisan support across the country," she said. "There is no reason why things should be different here in North Carolina."

Senate sponsor Sen. Terry Van Duyn, D-Buncombe, agreed, citing a 2013 Moses Cone study that projected the expansion would bring $3.3 billion in federal money, creating 29,000 jobs. "Taking Medicaid dollars would have a huge economic development impact."

Without the expansion, Van Duyn pointed out, rural hospitals and clinics are struggling to keep their doors open.

"Would you locate a business in an area that did not have adequate access to health care? I think not," she said.

Greene County resident Linda Dunn said her 44-year-old daughter has struggled for 20 years with chronic physical and mental health problems. When those problems forced her to leave her state job, she was left without insurance or income and will lose her house next week.

"She has been stripped of her career, her health, her home and her dignity," Dunn said.

Her daughter has been turned down for both Social Security disability and Medicaid, she said, but she would qualify if North Carolina had expanded Medicaid.

"Our daughter could be receiving the medical and psychiatric care she needs," she said. "We just desperately need a helping hand to save our daughter."

The legislation would set aside about $13.5 million for the state's share of administrative costs for the expansion from January 2016 through June 2017. That money, sponsors say, would draw down about $40 million in administrative funds and about $2.4 billion in federal coverage funds during that same time period.

The legislation is unlikely to get a vote this session. Both House Speaker Tim Moore and Senate President Pro Tem Phil Berger have been steadfastly opposed to expansion, arguing that it could open the state up to a huge financial liability if Congress decides to cut funding for the expansion after the first few years.

McCrory and Health and Human Services Secretary Aldona Wos have both said the state should at least evaluate the option, but McCrory said earlier this year he would not offer lawmakers a proposal until after the U.S. Supreme Court rules on an Affordable Care Act challenge before it. That ruling likely won't come down before late June.