The last recession hit North Carolinas economy hard, and its still wobbling with one of the nations highest unemployment rates at 9.4 percent. But loss of work wasnt the only blow. Many North Carolinians also lost their health insurance because of layoffs, because their employers couldnt afford the high cost of providing a plan or because they couldnt afford their share of the premium.
The result, according to a new report from the Robert Wood Johnson Foundation, is that the portion of North Carolinians under age 65 with employer-sponsored insurance declined from 69 percent in 2000 to 56 percent in 2011. The change increased the number of uninsured in North Carolina by 220,000 and brought the overall number to 1.5 million people nearly 1 in every 5 state residents.
Behind those numbers is widespread suffering from untreated or improperly treated illness. The numbers also include hundreds of thousands of people who may be healthy now but see each day as the one that may bring them injury or illness and a need for care they cant afford.
Such a grim situation is what President Obama addressed in pushing through the Affordable Care Act. And such a situation is what most Republicans have turned their backs on, mocking the law as Obamacare and taking every opportunity to nullify it in the courts and in state legislatures.
Numbers tell story
Now come these numbers, and there is no hiding from them. Given a choice between helping the uninsured and indulging their political animus, Republicans chose the latter. It may make lawmakers feel good, but it has left many others to worry each day about how theyre feeling.
North Carolinas Republican leaders from the governor through the General Assembly have been particularly hard-headed and hard-hearted because they preside over a state where the plight of the uninsured is particularly acute. Only four other states saw a higher percentage of their residents join the ranks of the uninsured during the period covered by the foundations report.
North Carolinas state government could have lent those people a hand. The Affordable Care Act would have extended Medicaid to 500,000 more people. The federal government would have covered 100 percent of the cost over the first three years and 90 percent thereafter.
In addition, a state-commissioned study determined that Medicaid expansion would create 23,000 jobs through 2021, along with an additional 23,000 spin-off positions (many, presumably, with affordable health care plans), and inject more than $1 billion into the states economy.
But Republican Gov. Pat McCrory and GOP legislative leaders oppose the expansion. They say that it will be too costly to the state or that the promised federal funds wont come through or that the state Medicaid program is broken and cant expand, but the real reason is plain: They dont want to participate in the landmark initiative of Obamas presidency because they oppose the president.
Whats worse is that some Republicans even said the expansion would sharply reduce the ranks of the privately insured as lower-income residents switched from private insurance to Medicaid. That change, they said, would hurt hospitals by reducing the number of payments hospitals get from private insurers and force them to take lower payments from Medicaid.
The Robert Wood Johnson Foundations numbers shatter that justification. There are not hundreds of thousands of North Carolinians poised to jump off private plans to get on Medicaid. Rather, there are hundreds of thousands who have lost their insurance and have nowhere to turn. And, among those who lead their state, they have no one who will turn to them.