Medicaid expansion: 9,000 Randolph residents fall in coverage gap
By Chip Womick, The Courier-Tribune, Asheboro, N.C. | |
McClatchy-Tribune Information Services |
Based on income levels reported in census data, that's how many adults may have been eligible for the program, according to figures from the
But not getting access to
Many of those
"They are truly caught in that gap -- it's really a gap," said
People who do not have health insurance typically ignore health concerns small and large, typically seeking treatment only when a sickness or ailment gets so bad it is impossible to ignore -- and is usually more difficult and costly to treat.
But the medical assistance portion of the program, for which eligibility is based on income and assets, covers only part of the population: Adults 65 and older or individuals who are blind or disabled; families with children under 18, individuals 19-21 and pregnant women.
"The expansion would have opened a new category," said
That category would have been for adults ages 22-64.
The federal government pledged to subsidize 100 percent of
N.C. Gov.
McCrory signalled in July that he was open to revisiting expansion under certain conditions. On Wednesday, Dr.
Of the 163 employees in the
As of
According to Park, the average amount of
Payments go directly to health-care providers -- hospitals, doctors, dentists and drug stores -- not to
The economic impact ripples through a local community.
Health-care providers say
Under the Affordable Care Act,
"I'm not here to judge," Eblin said, "but had
That's how much Eblin said the hospital could have collected in
As many as one-quarter to one-third of those who come to the hospital for health care are uninsured. Patients are treated, regardless of their ability to pay. "We're not complaining about providing the care," Eblin said. "We always have and always will provide the care."
Still, Eblin calls the
The hospital is the second-largest employer in the county with 1,200 full-time and part-time employees. When the hospital is in the black, profits are returned to operations, such as providing new services and hiring people for high-paying jobs to staff those new services. When it's in the red, something has to be cut.
Last year, the hospital cut 81 positions.
"Two-thirds of the hospitals in the state lost money last year," Eblin said. "We were one of them."
The hospital will lose money for a third year in a row, he said, but "much less" than the previous two years.
Instead, physicians, employees and volunteers have been pro-active in quality enhancement and in changing the business model, with less emphasis on volume and more on outcomes -- how well the hospital does in treating patients.
"Our medical staff and employees are doing a phenomenal job of making that shift," Eblin said.
Randolph Family Health Care at MERCE is a private, nonprofit community health center in north
But 55-60 percent of their patients are uninsured. And that percentage has gone up the last two years, due in part to job losses from plant closures.
Many adults who fall in the doughnut hole -- those who did not qualify for insurance subsidies under the ACA but who would have been eligible if
If those individuals did have
"It would make all the difference in the world to our bottom line and the amount of patients we can see," said
The future of reform?
"It's important in
Griffith noted that, on a small scale, StayWell Senior Care, which will open in the coming months at
The idea is to improve participants' health and quality of life and to allow them to continue living at home.
"If it's provider-led and providers are at risk," Eblin said, "there's going to be a whole lot more collaboration."
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