EDITORIAL: It’s time to get on board with Medicaid expansion

May 31-- May 31--The Republican-led N.C. Senate unveiled its proposed 2019-21 state budget on Tuesday, which does not include expansion of the state's Medicaid program.

Expanding Medicaid has been a top priority for Democratic Gov. Roy Cooper. Proponents on both sides of the aisle say it will help at least 500,000 residents who currently cannot afford health insurance and do not qualify for Medicaid under the existing rules.

The issue has been hotly debated and rekindled long-held animus among diehard conservatives over the Affordable Care Act, driven by lingering opposition -- and in some cases downright resentment -- of former President Barack Obama.

But at what point do we forsake political stubbornness and divisiveness and look at what's best for our residents as a whole?

The Affordable Care Act gives states the option to expand Medicaid eligibility. It's an effort to close a widening gap in health care coverage.

The ACA initially mandated that all states cover people who have incomes that are too high to qualify for Medicaid but still cannot afford adequate health insurance. But the law was altered following lawsuits and a 2012 U.S. Supreme Court decision that made the mandatory Medicaid expansion voluntary. North Carolina is one of only 14 states in the country that so far has opted out of the Medicaid expansion. Three states have adopted the expansion but have yet to have it implemented.

In North Carolina, a family of four has to make less than $34,248 to qualify for Medicaid.

We're not talking about freeloaders taxing the system. We're talking about working families in low-income jobs who don't have access to adequate health care for themselves and their children. Cooper says many of these families come from rural areas.

And, not only are we hurting the working poor in North Carolina, we're hurting the very hospitals they need. The financially struggling Randolph Hospital is an example right here at home. Now facing what appears to be imminent closure, the facility has buckled under the strain of having to treat uninsured patients who must turn to hospital emergency rooms for needed care. In fact, Randolph Health, which operates the hospital, has adopted a resolution in support of expanding Medicaid in North Carolina.

Some North Carolina Republicans are warming to the idea, which is an encouraging sign. Under the administration of President Donald Trump, states are able to set their own guidelines for expanding Medicaid. Some states have incorporated work requirements, mainly for adults with no physical limitations who aren't primary caretakers of children. Similar proposals have been floated in this session of the N.C. General Assembly, and Cooper has said he's willing to compromise.

Like it or not, the Affordable Care Act is what we are operating under now. With no alternative yet in sight, it makes sense to allow the current system to help as many people as it can. It makes no sense to be against the expansion. As Cooper said on a recent visit to Randolph Hospital, we all pay federal taxes, so we're already paying for the expansion in other states while receiving no benefit here.

It's should not be an issue of left or right. It should be a human issue, an issue of life and death, both for rural hospitals and the working poor. It's time to take the politics out of health care and come together for all North Carolinians.

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