Editorial: Activate Medicaid expansion now. Lives really are 'hanging in the balance'

CBC Editorial: Thursday, Aug. 10, 2023; editorial #8864

While the General Assembly fiddles, North Carolinians are dying. The legislature can and must act now to save lives and keep North Carolina workers healthy.

In just the four months since Medicaid Expansion was signed into law – but not made effective – as many as 600 North Carolinians have died due to lack of access to health care; 4,000 women have missed mammograms; more than 9,000 diabetics have gone without their medication.

He pleaded to legislators: "Give me one sentence of authority. Shove it in any other bill, and let's get this done, because we can still stick the landing Oct.1. We have got to get it done for people."

Since the beginning of July the legislature has had empty calendars and held do-nothing sessions. Committees haven’t met while hundreds of bills languish in legislative committees that don’t meet. One thing legislators have accomplished – going through the motions so they collect their tax-free per-diem, about $40,000 daily or more than $1.7 million and climbing.

The Republican leaders of the legislature, since 2014, have steadfastly opposed any expansion of Medicaid – one of just eight states yet to do it. While North Carolina legislators relented this year – they did it with a caveat that it will not become effective until a budget is passed. That had been expected to happen in late June or early July. But now legislative leaders are saying it might not be until sometime in October.

That refusal has come as billions of federal dollars that should have come back to North Carolina taxpayers have instead been paying for Medicaid expansion in 41 other states. The federal government is committed to picking up more than 90% of the cost while fees from hospitals and other healthcare providers will fund the remaining 10%. There’s an additional $1.8 billion federal-funded bonus the state will receive when the expansion is implemented.

The unspecified postponement of Medicaid expansion isn’t just having an impact on those 600,000 who have been going without coverage. Each month, about 9,000 current Medicaid enrollees are losing their coverage as COVID-19 emergency health funding is ending. With Medicaid expansion, they’d keep their health care coverage.

"These hospitals and these healthcare providers are businesses. When 30% to 40% of the people walking through your front door have no way to pay, you have no way to stay in business," Kinsley said. "What we see across the country in states that have expanded Medicaid, they've stabilized their infrastructure."

Further, Kinsley said, Medicaid expansion will help the state’s economy to assure a healthy workforce – particularly low-wage earners critical to struggling small businesses and key services such as childcare.

"The people that are working in these businesses don't have health insurance right now because small businesses can't make that work," he said. "Medicaid expansion can close that gap. It helps those individuals to be healthy and well and support their families, and it helps small businesses thrive."

There is no time to waste. Legislators must show their humanity and concern for ALL North Carolinians.

Vote for life. Give the go-ahead now to activate Medicaid expansion.