Will coronavirus create urgency to expand Medicaid? NC legislative debate has new life.
As coronavirus adds another medical concern for many people with underlying health conditions — and as widespread job losses cause many to lose their health insurance — there’s a renewed debate in state government about expanding Medicaid.
“We can no longer sit here and allow $4 billion of your tax dollars to sit in Washington,” said Rep. Sydney Batch, a Holly Springs Democrat, on Wednesday.
“We need to bring that money back to our state.”
Her $4 billion figure refers to one estimate of how much Medicaid expansion would boost the state economy.
In addition to the economic argument, Batch also pointed to the more than 700,000 North Carolinians who have lost their jobs due to coronavirus.
She said more than 300,000 of those newly jobless North Carolinians likely lost their employer-sponsored health insurance, citing a study from the Economic Policy Institute, a liberal-leaning think tank.
And while not all of them would qualify for Medicaid even if the state did approve an expansion, Batch said many would. And that’s on top of the 500,000 uninsured North Carolinians who state officials say would be able to get health insurance through Medicaid expansion.
Rep. James Gailliard, a Democrat from Rocky Mount, noted that grocery store workers typically don’t get health care benefits. But because they’re now on the front lines of the COVID-19 pandemic, he said, they’re at greater risk of getting sick and spreading the disease.
“Keeping working people sick is just bad public policy,” Gailliard said.
However, many of his Republican colleagues would say that’s too short-sighted — or just plain wrong.
A controversial political question
In a 2019 op-ed for the News & Observer, Republican Senate leader Phil Berger wrote that the benefits touted by supporters of Medicaid expansion are “too good to be true.”
“A full accounting of the facts leads to the inescapable conclusion that expanding Medicaid would be a mistake that not only will fail to solve the problems its proponents claim it solves, but will create new problems and rekindle problems that have just recently been put to rest – such as Medicaid cost overruns and yearly budget deficits,” Berger wrote.
And while GOP leaders in the N.C. House are now supporting a limited Medicaid expansion specifically for coronavirus, Berger does not agree that it’s necessary.
Medicaid expansion is a hot-button political issue, and a main reason the Republican-led General Assembly and Democratic Gov. Roy Cooper never came to an agreement on the state budget for this year.
Cooper vetoed the budget in large part because it didn’t expand Medicaid. Republicans later offered to negotiate some changes, like higher teacher pay, but didn’t budge on Medicaid expansion. Nor were they able to convince Democrats to turn against Cooper and override the veto.
But now as state lawmakers debate how to respond to the COVID-19 pandemic, the House of Representatives is considering a limited expansion of Medicaid, which would only apply to coronavirus patients.
Speaker of the House Tim Moore, a Republican from Cleveland County, has come out in support of the proposal.
“If you have folks who have tested positive for this, it should pay for that treatment and of course pay for the testing as well,” Moore said earlier this month, the News & Observer reported.
But the state Senate didn’t include a similar proposal in its spending plan.
Lauren Horsch, a spokeswoman for Berger, said they believe the federal government will take care of people’s coronavirus-related costs — and that a better use of state dollars would be to fund community clinics and health centers.
“The Senate’s COVID-19 relief bill includes $10 million for free and charitable clinics, and another $5 million for community health centers to help treat COVID-19,” she said. “These clinics and health centers are integral in the fight against COVID-19 because they’re local and the core of their mission is caring for uninsured patients.”
Most states have expanded Medicaid
But with House GOP leaders apparently on board for a limited expansion, Democrats are seizing on that support to call for an even broader expansion of Medicaid — something that all but 14 states, mostly in the South and the Great Plains, have already done.
Rep. Verla Insko, a longtime Democratic politician from Chapel Hill, said Medicaid expansion will “have a better chance in the House this year than it has before.”
Several House Republicans have introduced variations of Medicaid expansion bills in past years, but none of them ever made it through the N.C. Senate. Insko said the Senate will continue to be the biggest obstacle this year.
Help for rural hospitals?
Rep. Scott Brewer, a Democrat who represents the rural areas of Montgomery, Richmond and Stanly counties between Charlotte and Fayetteville, said he sees Medicaid expansion as not just helping people get insurance, but helping rural areas stop their economic decline.
Many rural hospitals in North Carolina have gone bankrupt in recent years. Brewer said the hospitals in Richmond and Stanly counties are the second and third biggest employers in the counties, and he doesn’t want those jobs to go away.
He said Medicaid expansion “would help keep hospitals open and would help keep good-paying health care jobs in our communities.”
The News & Observer reported earlier this month that rural hospitals are losing $145 million per month due to coronavirus — in part because they canceled many non-essential surgeries and other procedures “because of the lack of personal protective equipment and to stop the spread of the virus.”
This story was originally published April 29, 2020 at 3:11 PM with the headline "Will coronavirus create urgency to expand Medicaid? NC legislative debate has new life.."
