Health Care Act

NC Medicaid battle pairs hard numbers and human stories

The N.C. Medicaid Expansion Coalition is seeking personal stories of people who can’t get health coverage.
The N.C. Medicaid Expansion Coalition is seeking personal stories of people who can’t get health coverage. Ann Doss Helms

Originally published Feb. 6, 2015.

The groups fighting for North Carolina to expand Medicaid this year are taking a two-pronged approach.

In news conferences in Charlotte and Raleigh this week, the N.C. Medicaid Expansion Coalition urged people to share their stories at NCLeftMeOut.org. They're looking for personal tales from people like Charlotte's Dana Wilson, whose multiple sclerosis limits her to working a few hours a week at an antique shop. Wilson doesn't earn enough to qualify for subsidized health insurance and isn't eligible for Medicaid.

But the coalition, led by Action NC and Progress NC, is also taking a more hard-nosed approach, focusing on jobs and tax revenue that would be generated by accepting the federal money to expand Medicaid coverage.

A recent report by George Washington University's Milken Institute School of Public Health, commissioned by the Cone Health Foundation and the Kate B. Reynolds Charitable Trust, projects that if state lawmakers were to approve expansion this year, the decision would generate about 43,000 jobs by 2020. About half would be in health care, the report says, with the rest spread among sectors ranging from construction to retail "as health care workers use new income to pay their mortgages, buy groceries, pay taxes and so on."

"At county levels, if Medicaid is not expanded by 2016, Mecklenburg and Wake Counties would create about 4,500 fewer jobs each by 2020," the report says. "Mecklenburg County’s total economy (gross county product) from 2016 to 2020 would be almost $1 billion lower."

"Lawmakers like to talk about fiscal responsibility," Wilson said in Charlotte Thursday. "It's just common sense."

The Affordable Care Act includes money to expand Medicaid in all states – and levies taxes that everyone is paying, regardless of whether the state accepts the money or not. A handful of Republican-led states that initially said no have gotten permission to craft their own version of coverage. Indiana was the most recent in late January, and N.C. Gov. Pat McCrory has signaled some interest in crafting a North Carolina plan.

"As we review continue to review health care options for the uninsured, we are exploring North Carolina-based options that will help those who can't help themselves, and encourage those who can," McCrory said in Wednesday's State of the State address. "If we bring a proposal to cover the uninsured, it will protect North Carolina taxpayers. And any plan will require personal and financial responsibility from those who would be covered."

As the pro-expansion advocates noted, that's still far from a specific plan. And there's still little sign that Senate President Pro Tem Phil Berger or newly elected House Speaker Tim Moore are on board for any kind of expanded coverage.

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