Editorial: Cooper needs to expand Medicaid so more in N.C. have health care

Efforts to revive the hospital in Belhaven in rural Eastern North Carolina are, like a medical patient, on life support. A community-based group, seeking to buy the now-closed facility and reopen at least portions of it, was in a Raleigh courtroom earlier this week trying to save the facility. A temporary court order has, for now, halted demolition of the building.

The hospital was closed in July 2014 by then-owners Vidant Health. Since then, those with medical emergencies must travel a minimum of 3o miles for emergency care.

This week a Wake County Superior Court judge heard arguments regarding the current owners’ desire to demolish the building and sell the site, as well as from those, including Belhaven Mayor Adam O’Neal, who want to return it to use as a medical facility.

The reality, however, is the issue is more than the fate of a tiny hospital in a small town in rural Beaufort County. It is illustrative of the struggle going on in rural communities throughout North Carolina and the nation. In the last six years more than 75 rural hospitals have closed across the nation, half of them in the South and three, including Belhaven, in North Carolina.

Because many people in Belhaven and the rural communities around it are poor (in Belhaven 1 in 3 residents live below the poverty line) they don’t have insurance – which puts the financial viability of any hospital at risk.

If North Carolina had opted to participate in a federally-funded Medicaid program to make health insurance available to the poor, the financial outlook for rural hospitals, like Belhaven, would have improved. North Carolina refused to sign onto the program, missing out on billions of federal tax dollars. Lawmakers blamed concerns over how to pay for the program if federal support ended – which is highly unlikely – and more stubbornly, balked out of partisan opposition to the Affordable Healthcare Act – Obamacare.

Researchers at the University of North Carolina have found that rural hospitals in states that did accept the additional federal funds improved their chances of turning a profit while it didn’t have any impact on urban-based hospitals.

Expanding Medicaid, several studies have shown, boosts local economies and creates jobs. The cost of North Carolina’s partisan opposition to expanding Medicaid has been more than dollars or jobs. Access to adequate health care in rural communities is suffering.  Timely access to emergency care is, quite literally, a life-and-death matter.

Mayor O’Neal has walked 700 miles to Washington to draw attention to the plight of his community’s hospital and hundreds like it around the nation.

He walked 130 miles to Raleigh last year to increase awareness of the plight of his community.

We doubt the General Assembly is any more interested now, than before, in expanding participation in Medicaid – even if it is almost fully federally funded.

But there will be a new governor and new leaders in the Department of Health and Human Services in a few days. We urge Gov.-elect Roy Cooper to explore ways to use the authority and discretion he has to make health coverage more available and ultimately get North Carolina into the federal program.

It will provide much needed health care to those who can least afford it and bring federal tax dollars back to North Carolina instead of sending them to other states. It could also help open a hospital or an emergency care facility in a rural community. That would save lives.