Shirley Fulton, a retired Superior Court judge from Charlotte, presided Monday over a mock grand jury hearing designed to shame North Carolina legislators into expanding Medicaid.
Activists assembled in the legislative office building at noon to make arguments for extending government health insurance to impoverished adults who lack access to Medicaid or subsidized private plans.
The Rev. William Barber, president of the N.C. NAACP, said the process is partly to draw attention to the issue and partly to prepare for real legal action. “There is a possibility we’re going to bring a constitutional case,” similar to the longstanding Leandro suit alleging that the state failed its constitutional obligation for public education, he said.
The N.C. Medicaid Expansion Coalition, which had planned four hours of testimony, adjourned early with forecasts calling for dangerous driving conditions. Organizers plan to bring people back in about two weeks to continue sharing personal stories of how citizens and the state’s economy are affected by having hundreds of thousands without access to insurance they can afford.
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Fulton will rule on whether to “indict” the General Assembly. Hint: The smart money is on yes.
The issue: The Affordable Care Act provides federal money for states to expand Medicaid health coverage for low-income, able-bodied adults. Twenty-two Republican-led states, including North and South Carolina, have declined to participate.
Who’s affected: Many adults earning less than 100 percent of the poverty level ($11,670 for one person) don’t qualify for Medicaid or subsidies to buy health insurance on the ACA exchange. Estimates range from 357,000 to 689,000 North Carolinians who fall into the gap.
The case for opting out: State leaders say they don’t want to expand a system that has a history of cost overruns and inefficiency. They also voice doubts about whether Medicaid coverage would lead to better health for the poor and say many who would qualify already have insurance.
The case for expanding: Advocates say North Carolinians are paying billions in taxes to support Medicaid expansion and getting no benefit when the state declines the federal money. They say expanding coverage would save lives, improve productivity of low-wage workers, stimulate jobs in health care and related sectors, and reduce bad debt and charity care at hospitals, which is passed along to taxpayers and insured patients.
The middle ground: Gov. Pat McCrory has talked to President Obama about getting a waiver to use the federal money to create North Carolina’s own plan to cover people in the gap. It’s a path some other Republican governors have taken, but it’s unclear whether McCrory can get support from the federal government or state lawmakers.