Legislature Isn’t Moving on Medicaid Expansion Despite ‘Bipartisan Consensus.’

State Sen. Jeff Jackson, a U.S. Army veteran, says expansion would be a boon for rural hospitals and veterans. 

Medicaid expansion in North Carolina, a progressive wishlist items for years now, isn’t so far off, state Sen. Jeff Jackson says.

“In private, there’s bi-partisan consensus to expand Medicaid,” Jackson told a virtual town hall last week focused on healthcare issues. “In public, the supermajority denies it.”

The expansion, which would be 90% paid for by the federal government, could boost access to healthcare insurance for hundreds of thousands of North Carolinians. But leadership in the state House of Representatives and Senate have long opposed expansion, saying it could lead to a long-term expense in social welfare programs for the state.

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Jackson, a Charlotte Democrat and U.S. Army veteran of the war in Afghanistan, spoke at a summit last week organized by the nonprofit Piedmont Rising, which advocates for accessible health care. 

“I don’t have an answer why North Carolina hasn’t participated in the Medicaid expansion other than politics,”

NC Sen. Jeff Jackson, D-Mecklenburg

Prior to the onset of COVID-19, the organization held town hall meetings both to educate individuals and get them to share their healthcare stories as a means of persuading legislators to vote affirmatively on issues such as the Affordable Care Act and Medicaid expansion. Those physical town hall meetings are now being held virtually.

“I don’t have an answer why North Carolina hasn’t participated in the Medicaid expansion other than politics,” Jackson said. “Medicaid expansion would bring $4 billion into the state and create 40,000 jobs. It would also help shore up a dozen rural hospitals and address a whole host of issues.” 

The cost to taxpayers, he said, would be nothing. Ninety percent would be paid by the government and 10% by hospitals.

Expansion still seems unlikely though, as the progressive outlet NC Policy Watch reported last month. According to Policy Watch, Senate President Pro Tempore Phil Berger maintained his longtime opposition last month, despite healthcare costs associated with the novel coronavirus.

“We are seeing multiple states have to cut their Medicaid programs,” Berger reportedly said. ”The federal government through the various bills that have been passed, has provided North Carolina with funds to make sure anyone who is affected or thinks they are affected by COVID-19 can get themselves tested and it doesn’t cost them anything.”

Last week’s meet was hosted by Piedmont Rising Executive Director Casey Wilkinson, who focused on how Medicaid expansion and the potential gutting of the Affordable Care Act (ACA)will impact veterans. 

“North Carolina is home to approximately 667,000 veterans, one of the largest veteran populations in the country,” said Wilkinson. 

Citing research from the Center for American Progress, he adde: “The majority of them do not get their healthcare coverage through the Department of Veteran Affairs, but through supplemental insurance and Medicaid.”

According to the progressive Center on Budget and Policy Priorities, nearly one in ten non-elderly veterans have Medicaid coverage, with 40% of those relying solely on Medicaid. The ACA, it said, led to significant gains in coverage for those non-elderly veterans, with the largest gains taking place in states that expanded Medicaid.

One of the greatest concerns Wilkinson shared is the potential elimination of the ACA, something both North Carolina Senators Thom Tillis and Richard Burr have voted to repeal.  

In March, the U.S. Supreme Court accepted an appeal by 21 state attorneys general to rule on whether the ACA should remain in place. The Supreme Court will be issuing a decision in late 2020 or 2021. If the ACA is repealed, Wilkinson said 27,000 North Carolina veterans could lose their coverage. Those numbers don’t include family members. 

“Lawmakers love to pledge allegiance to America’s veterans, yet voting records speak louder than words,” Wilkinson said. “Our U.S. senators must stop voting to repeal the ACA and jeopardize health care for our veterans and their families.”

At the state level, Wilkinson is also eager to see Medicaid expanded. According to the progressive non-profit North Carolina Justice Center, 30,000 veterans and 23,000 family members living in the state are currently uninsured. “It’s estimated that 12,000 veterans fall into the Medicaid gap and could gain access to healthcare if Medicaid was expanded,” Wilkinson noted. 

“I’ve heard the stereotypes of who they think will be getting Medicaid assistance,” Jackson told virtual attendees of the town hall. “The information presented here busts that stereotype.” 

Given the lack of movement in the legislature, Jackson believes it’s vital for individuals to share their healthcare stories to try and push legislators to focus on expanding the program. “We can’t get through to them with logic,” he said. “They’ve ceded that point.”