Study: Medicaid expansion would mean $20M for Sampson

Jun. 27--A study released this week shows North Carolina would see $11.7 billion in increased business activity and add 37,000 jobs by expanding Medicaid. In Sampson County, the local economy would grow by $20.5 million between 2020 and 2022, the analysis estimates.

The study, conducted by the Center for Health Policy Research at George Washington University (GWU), indicates that expanding Medicaid this year will lead to greater economic activity and employment because billions of additional federal dollars will flow in to support the costs of insurance expansions.

North Carolina remains just one of 14 states yet to expand Medicaid under the Affordable Care Act, and according to experts at GWU, Medicaid eligibility requirements in North Carolina are the ninth most restrictive in the country. As a result, nearly 1 million North Carolinians between the ages of 19 and 64 are uninsured.

If North Carolina expands Medicaid, about 464,000 more people will gain Medicaid coverage in 2020, a figure that will rise to 634,000 low-income people in 2022, the study shows. It would also increase state and county tax revenues by over $600 million over that time.

In Sampson, specifically, the projected $20 million boon would come as a result -- 5,492 more will get Medicaid, 97 new jobs would be created and $379,200 in county tax revenues would be generated from 2020 to 2022, according to estimates.

The non-partisan report George Washington University researchers was funded by Greensboro-based Cone Health Foundation and the Kate B. Reynolds Charitable Trust. Both organizations have aimed to increase access to care and improve health outcomes

Expansion of Medicaid will not only help more people get access to affordable health care, it can serve promote economic development and job creation across the state, proponents maintain.

About half of the 37,000 jobs created would be in health care (such as hospitals or clinics), while almost half would be in other sectors, such as construction or retail and wholesale trade. This ripple effect occurs because Medicaid funding received by hospitals, clinics or drug stores is used to pay workers' salaries and to buy other goods and services. In turn, those funds are used to pay for mortgages or rent, buy food and pay state and county taxes.

Almost half the job gains -- 17,900 jobs by 2022 -- will occur in six large counties (Buncombe, Durham, Forsyth, Guilford, Mecklenburg and Wake Counties), while the other 19,200 new jobs will be distributed across the rest of the state, including rural areas, the study shows.

In addition to the new jobs created and the hundreds of thousands of uninsured residents gaining coverage, the researchers estimate that the state would increase its business activity by $11.7 billion in just three years, between 2020-2022. It's money that could be spent on education, infrastructure and other needs.

"Medicaid expansion is a job creator and can extend health coverage to thousands of previously uninsured North Carolinians who are falling through the gaps in our current system," said Susan Shumaker, president of the Cone Health Foundation. "States that have already expanded Medicaid are better equipped to tackle critical health care concerns like opioid addiction and infant mortality rates, issues that need to be addressed here at home in North Carolina."

The new analysis updates a 2014 report, providing a county-by-county look at the number of jobs, new Medicaid enrollees and economic growth that would result from the state expanding Medicaid. With nearly one in six non-elderly adults in North Carolina uninsured (16 percent) -- a rate that is above the national average of 12 percent -- every county, urban or rural, stands to benefit.

"This report confirms what we're hearing from families across the state -- increased access to quality health care and economic opportunities helps communities thrive, and research shows that expanding Medicaid delivers both," said Dr. Laura Gerald, president of the Kate B. Reynolds Charitable Trust. "Every community stands to benefit from Medicaid expansion. The evidence shows that closing the Medicaid gap will improve population health, support vulnerable North Carolina families and boost the economy across the major sectors."

Since 2010, 36 states and the District of Columbia have used a provision in the federal Affordable Care Act to pay for expanded Medicaid coverage for people with household incomes below 138 percent of the federal poverty line.

North Carolina currently covers parents with incomes up to 42 percent of the poverty line and generally does not cover adults without dependent children. The expansion would lift income criteria to 138 percent of the poverty line for adults 19 to 64 ($29,400 for a family of three).

The Republican-led state legislature passed a bill in 2013 that effectively prohibits expansion without the legislature's approval.

Back in April, a group of Republicans introduced HB 655, the N.C. Health Care for Working Families Act, which would cost $4.7 billion and cover 543,000 people, launching in July 2020.

A number of health advocacy organizations have since united to voice opposition to provisions in HB 655, noting work reporting requirements and 2 percent premiums will fail to deliver health care for working families.

"This bill is not Medicaid expansion and it will not provide the benefits that our state has been losing out on ever since the General Assembly's first decision to reject Medicaid expansion in 2013," the 16 N.C.-based groups stated in the joint open letter back in April.

"HB 655's 2 percent premium is an affront to working families barely making ends meet given their current incomes. To charge people earning 50 percent of the Federal Poverty Level -- as little as a single parent earning approximately $700 a month -- will force families to choose between putting food on the table and health care. This bill does not improve access to care for working families."

The study done by GWU researchers said the economic gains to be had would also be diminished under HB 655. The study specifically addressed the consequences of Gov. Roy Cooper's proposal to expand Medicaid beginning November 2019, not the proposed House Bill, which has received minimal attention from lawmakers in that past two and a half months.

"We are not aware of detailed analyses of that bill and cannot conduct a comparable analysis," the researchers stated. "This bill would also increase Medicaid participation and federal funding flowing into the state, compared to current law. However, when compared to the expansion proposed by the governor, the premiums and work requirements would depress participation. Enrolling fewer North Carolinians would yield lower federal revenue and reduced economic and employment gains."

Editor Chris Berendt can be reached at 910-592-8137 ext. 2587.

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