Over the last seven months, we’ve been a small part of a coalition of statewide voices speaking out across North Carolina in support of the Affordable Care Act (ACA) and Medicaid. We’ve collected petition signatures at public events and met with congressional staff about our health policy concerns. We’ve spoken at press conferences and joined thousands of others across the state in raising our voices throughout critical points of the health care debate. Our fellow activists hosted die-ins outside of office buildings, traveled to D.C. to get arrested, and even protested in a flotilla outside of Senator Tillis’ lake house.
Though Sen. Burr and Sen. Tillis did not vote to protect our health care, we’re proud to be part of a national conversation and effort that helped prove the importance of the ACA and Medicaid. More important, we’re proud of North Carolinians’ efforts to make sure between 15 and 32 million people kept their health insurance.
The Senate vote on the morning of July 28 was a victory for all Americans. And while talk of future plans to repeal the ACA will likely never go away, let’s hope our political leaders in Washington, D.C., and here in North Carolina will turn toward some common-sense bipartisan, efforts to improve the health of all Americans, such as:
Close the Medicaid coverage gap in North Carolina.
For years North Carolina has lagged behind 31 states and Washington, D.C., in extending coverage to veterans, low-wage workers, students and those living in our state’s rural areas. Closing the gap is not just good for our physical well-being but the financial health of our state as well. Analysis from the Cone Health Foundation and Kate B. Reynolds Charitable Trust shows the North Carolina workforce could grow by more than 43,000 jobs by 2020 and the state’s economy could gain tens of billions of dollars in business revenue if the state expanded Medicaid-eligibility requirements.
Earlier this year, Rep. Donny Lambeth introduced HB 662, which would increase health insurance options for North Carolinians in the gap. This bill was the first meaningful piece of legislation introduced by Republican leaders of the General Assembly that would have moved our state closer to expanding Medicaid. The bill isn’t perfect – its work requirements are bureaucratic nightmares to enforce and would only increase red tape – but the framework is a good starting place for conversations. With Gov. Cooper making closing the Medicaid gap a signature part of his legislative goals during his first year in office, let’s hope Democrats and Republicans can work together to do the right thing in 2018.
Improve and strengthen the ACA.
Contrary to ideological rhetoric, reports show the marketplaces have been stabilizing and continue to move toward profitability. In fact, Blue Cross and Blue Shield of North Carolina reported that uncertainty regarding cost sharing reduction payments led it to originally ask for a 22.9 percent premium increase instead of 8.8 percent in 2018. (Note: Blue Cross and Blue Shield of North Carolina lowered the requested rate increase to 14.1 percent.) North Carolinians need the Trump Administration and Congress to listen to the requests of insurers, insurance commissioners and providers, and make a strong commitment to bolstering marketplace stability with cost sharing reduction payments.
Maintain and support current programs that serve those most in need, even as Medicaid transforms.
North Carolina is currently in the process of transforming its Medicaid program. Approximately 2 million North Carolinians – including our state’s most vulnerable residents, such as children, people with disabilities and older adults – depend on Medicaid coverage to get the health care they need. As the state’s program transforms, we need our lawmakers and administrators from the Department of Health and Human Services to ensure Medicaid beneficiaries do not get hurt in the process. Leaders should establish committees and working groups, or create platforms so that beneficiaries can connect about barriers to accessing and utilizing care during the Medicaid transformation. Commercial plans need to be evaluated not just on cost but on beneficiary experience and held accountable if they do not address beneficiary concerns in a timely manner. We hope that state leaders work to ensure beneficiaries are protected and continue to get the care they need throughout the reform process.
Our political leaders in Raleigh and D.C. have a historic moment to come together in a bipartisan way to improve the health of our residents. Let’s hope they take it.
Ciara Zachary is a health policy analyst for the N.C. Justice Center’s Health Advocacy Project. Lee Storrow is the executive director of the North Carolina AIDS Action Network.