With the North Carolina legislature’s failure to expand Medicaid, 13,000 local people who would have affordable insurance coverage next year, will continue to go without, according to the North Carolina Institute of Medicine, and the local hospital is suffering the consequences.
Adam Searing and Adam Linker, of the North Carolina Justice Center’s Health Access Coalition, have been traveling the state to let people know how this decision impacts them.
The North Carolina Justice Center is a nonprofit organization started in the mid 1990s with a mission to protect everyone’s right to economic security. It focuses mostly on the economically disadvantaged, but the health aspects of the organization also works with middle incomes. The Coalition focuses on rural counties, working to educate people on the ACA, the exchange markets and what happens because of the decision not to expand Medicaid.
Linker, a policy analyst, said there are tremendous problems ranging from 500,000 people statewide who would have qualified for affordable health care, now will continue to be uninsured to the shut down of community hospitals.
“It’s created a situation where people are too poor to get help,” Linker said.
He explained these people are the working poor — people who work for low wages. The individuals make around $12,000 per year, and family heads of households make around $23,550 per year for a family of four.
Linker said if legislators had expanded Medicaid, these people would have had access to health care in 2014.
“All low-income people would get Medicaid,” he said, adding under the current system Medicaid is strictly for children, pregnant women, seniors and the disabled.
“It’s not just income-based (now). What health reform did, is say (Medicaid) will be income-based.”
Because North Carolina legislators voted against expanding Medicaid, the state will maintain the old system.
The good news is these low income-based people are not subject to penalties for being uninsured.
Searing said rural hospitals, like Halifax Regional, are hit most hard by the decision not to expand. To make things worse, Medicaid expansion was slated to make up for Medicare reductions in hospitals. Because of those cuts, hospitals are having to provide the same amount of services but getting paid less.
“This is creating incredible financial pressure on hospitals,” Searing said.
“Expanding Medicaid would make it possible for the poor to pay their bills, but because there was no expansion, there is no new money.”
As a result, some hospitals are closing. Locally, medical staff members are being laid off and services are being reduced.
“We’re looking at this getting worse the longer this goes,” Searing said.
Will Mahone, CEO/president of Halifax Regional, said North Carolina hospitals are “caught in the middle of significant payment reductions for the uninsured with no expansion of coverage to balance it. This especially impacts rural hospitals with a disproportionately higher share of low income, uninsured patients.”
Mahone said Congress and the President need a strategy to fully implement the Affordable Care Act in America.
“Some state and national politicians may find value in implementing only half of the ACA,” Mahone said.
“But lack responsibility for the unintended consequences.”