Orth attends governor’s Medicaid roundtable discussion

Courier-Tribune (Asheboro, NC)

April 26-- Apr. 26--RALEIGH -- A roundtable discussion on Medicaid expansion, hosted Wednesday by Gov. Roy Cooper and Secretary Mandy Cohen of the Department of Health and Human Services, included Angie Orth, CEO of Randolph Health.

She and six other executives of rural hospitals shared their challenges dealing with uninsured patients that seriously affect their bottom lines. Five of the hospitals, including Randolph Health, submitted resolutions asking the N.C. General Assembly to expand Medicaid.

"It was a great experience and I felt honored to be there," Orth said Thursday. She said they all talked about "the challenges they face in delivering high-quality, low-cost care, and how expanding affordable insurance coverage to people without insurance would help rural health systems and their communities.

"I had the opportunity to talk about Randolph Health and Randolph County," Orth continued. She acknowledged the efforts of Cooper and Cohen to expand affordable health insurance, and how it would help Randolph County citizens.

She said 16 percent of the population of the county is uninsured. "Some of those could get health coverage under Medicaid expansion," Orth said. "A single diagnosis can create a great struggle (for a family) because of the cost of medication and treatment. With insurance, a family can spend money on food and clothes."

Orth said she focused on the emergency room at Randolph Health, where 25 percent of the patients admitted don't have insurance. "It's a challenge to continue to provide low-cost quality care when we're not compensated."

Legislation has been presented in the General Assembly for expansion, which includes work requirements of the insured as well as premiums to pay, Orth said. Cooper has come out against the requirements but has said he wants to work with legislators to hammer out details of Medicaid expansion.

Orth said the reason for the talks about expanding Medicaid is that some people don't qualify for subsidies under the Affordable Care Act (ACA) exchange and also don't meet guidelines for Medicaid. She said they're looking at ways to close the insurance gap for those people.

According to a press release from the governor's office, 37 states (including the District of Columbia) have helped close that gap by expanding Medicaid. Under the ACA, for states that agree to expand Medicaid, the federal government will pay 90 percent of the cost, leaving the other 10 percent up to the state.

The press release also made the following claim: "Currently, a family of four with working parents must earn less than $9,000 to qualify for Medicaid. The same family's income would have to exceed $25,000 to qualify for a federal subsidy to purchase health insurance. That leaves many families who earn too much for Medicaid and too little for a subsidy without health insurance."

It's estimated that expanding Medicaid in North Carolina would boost the state's economy by $4 billion and create 13,000 jobs in rural counties within five years. It's also believed that it would significantly help the bottom lines of rural hospitals.

Orth brought up the issue of economics that Medicaid expansion would affect. "I mentioned that we're the center of the state with the N.C. Zoo and the Greensboro-Randolph Megasite," she said. "Not only are rural hospitals at risk, but it's connected to the economic impact on our town.

"Our survival is also about important economic initiatives," Orth said. "The State of North Carolina would benefit from an automaker at the megasite. Without a hospital, it would be hard to attract (such a tenant).

"The zoo is also a major attraction," she said. "It needs a health care system here."

The other hospital executives at the roundtable discussion were:

* Jeffrey Stickler of Chatham Hospital in Siler City.

* Mark Kimball of Erlanger Western Carolina Hospital in Murphy.

* Tom Siemers of Dosher Hospital in Southport.

* Chris Lumsden of Northern Hospital of Surry County in Mount Airy.

* Michael Nagowski of Cape Fear Valley Health System in Fayetteville.

* L. Lee Isley of Nash UNC Health Care in Rocky Mount.

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