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Medicaid expansion proponents 'die' outside Capitol

Demonstrators say the refusal by state lawmakers to expand Medicaid is killing thousands of North Carolinians.

Posted Updated

By
Adam Owens
and
Mark Binker
RALEIGH, N.C. — Demonstrators say the refusal by state lawmakers to expand Medicaid is killing thousands of North Carolinians.

To illustrate their point, dozens of protesters carrying cutouts of tombstones held a "die-in" outside the State Capitol on Wednesday afternoon before marching to the governor's mansion.

"The denial of Medicaid expansion is a form of political and social violence. People are literally dying who don't have to die, simply because extremists in the legislatures and governor's mansions across the South and even here in North Carolina refuse to expand Medicaid, which is morally indefensible," state NAACP President Rev. William Barber said in a statement.

Barber equated the legislative inaction to "serial murder," which prompted a swift rebuke from the North Carolina Republican Party.

"The 'immoral Monday' crowd has accused Republicans of a lot of things, but murder for not expanding 'Obamacare' is over the top and disgusting," Dallas Woodhouse, GOP executive director, said in a statement.

Protesters were calling on state lawmakers to expand Medicaid in North Carolina.

"Because they have refused to do this, people are dying," said state NAACP Health Care Coordinator, Rodney Sadler.

North Carolina spends roughly $14 billion on Medicaid, the health insurance program for the poor and disabled, and about one out of every five residents statewide receives health care through the program.

Expanding Medicaid would grant coverage to some 500,000 people who fall into roughly two groups:

  • Adults with few health problems who earn less than 100 percent of the federal poverty line. These adults don’t qualify for Medicaid because they’re not among specially covered groups such as pregnant women and children.
  • Certain people whose wages put them above the federal poverty line but too little to be required to buy health insurance on federal Affordable Care Act exchanges.

Estimates of the economic impact of expansion have varied but are significant. A 2014 Robert Wood Johnson Foundation report (http://bit.ly/1Rercny) found the state government is forgoing $39.6 billion in federal payments over the next 10 years, with another $10.6 billion loss in payments to hospitals over that same period. Those figures square with a recent George Washington University report on the same topic that said the cost to the state would be roughly $21 billion between 2016 and 2020 in exchange for just $1.7 billion in state spending. (http://bit.ly/1O7Md5A)

Sadler said that the most important impact of Medicaid expansion is that coverage would be life-saving.

"We have refused to help the people out in need in North Carolina, working people," said Sadler.

Lawmakers and the governor have repeatedly said they don’t want to expand Medicaid while still grappling with what they view as problems within an unstable system that has a history of cost overruns. They also point out that the state could be on the hook for a greater share of the cost burden if Congress changes the Medicaid matching rate. Changes to Medicaid matching are relatively rare, according to health policy experts.

Gov. Pat McCrory can’t expand Medicaid on his own. A 2011 law prohibits the governor from making any move to expand Medicaid without permission from the legislature. His administration will have a chance to ask for that permission when it brings a draft plan to rework how the entire Medicaid system works to lawmakers next year.

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