Care delayed is bad for NC: Expand Medicaid ASAP

To the Editor:

Doctors know that care delayed can have major, even catastrophic consequences. Once properly assessed, it is better to move quickly on a condition than to wait.

But in North Carolina, hundreds of thousands of our friends, family members and neighbors are waiting for Medicaid expansion. Specifically, waiting on the NC General Assembly to pass a budget so that we can finally close our state’s deadly health insurance coverage gap.

It’s not that policy makers are still assessing the merits of Medicaid expansion. Our lawmakers did their job and diligently weighed evidence before overwhelmingly approving expansion earlier this year. On March 27, Gov. Roy Cooper signed the legislation in a beautiful, bipartisan ceremony that included doctors from around the state.

So what then is preventing approximately 600,000 North Carolinians in the coverage gap from seeking the care they need? The answer is politics. Our elected office holders approved state officials to begin expanding the life-saving benefits of Medicaid only after they – our politicians – agree on a budget.

No doubt budgets this size are complicated. And we can all appreciate the concentration and conversation our lawmakers put into it. Now, after several months of such effort, it is time for our politicians to move forward on Medicaid expansion.

First and foremost, people’s wellbeing hangs in the balance. These are folks who earn too much to qualify for Medicaid, but too little to qualify for a subsidy. Many report to jobs day after day, but they don’t receive health insurance from their employers. Some of these working people fall below the federal poverty line, which is around $26,000 for a family of four.

People in the coverage gap need preventive care and treatment when they get sick. But without insurance, the bill is often out of reach, and sometimes crushing. This leads to needless suffering, more bills and sometimes death. As in the case of a mother who could not afford to see a doctor when she noticed signs of something amiss, and when she finally could afford a visit discovered that her cancer was inoperable.

The health of our rural hospitals is also at stake. Rural hospitals are most at risk of financial stress and closure due to lower rates of private health insurance and higher rates of uninsured. In January, for example, ECU Health announced it is closing five clinics, including its inpatient behavioral health unit. Our people simply cannot endure a further erosion of care.

The NC Department of Health and Human Services agrees, as do so many others on both sides of the aisle and has set October 1 as the start date to expand Medicaid. This announcement comes after the department worked to obtain a compromise from the Centers for Medicare & Medicaid Services that will allow the department to move forward with the required public notices for beneficiaries, counties and providers while still awaiting authority from the NC General Assembly.

This is good news as it goes — certainly better news than not moving forward at all — but it seems unnecessarily complicated for the professionals on the front line.

As a doctor, I encourage our politicians to do their part by approving a budget as soon as possible. The need is great; care can’t wait.

Dr. Johnny L. Williams

Dr. Williams is president of the Old North State Medical Foundation. He lives in Eastern North Carolina.