The ACA, Medicaid expansion and the care our NC veterans deserve

An ROTC cadet looks at a miniature version of the Vietnam Veterans Memorial during Veterans Day ceremonies at the State Capitol in Raleigh.
An ROTC cadet looks at a miniature version of the Vietnam Veterans Memorial during Veterans Day ceremonies at the State Capitol in Raleigh. N&O FILE PICTURES

Many of our elected leaders beat the drums of patriotism when they send our troops to fight their wars but then refuse to fund vital programs to support them when they return home.

Here in North Carolina, Gov. Pat McCrory and the GOP-controlled General Assembly have turned their backs on N.C. veterans who would be eligible for Medicaid expansion funding. In fact, a study by the Robert Wood Johnson Foundation and the Urban Institute concluded that at least 23,300 North Carolina veterans would be eligible for Medicaid if the program were expanded. Refusing to accept those funds, already paid for by N.C. tax dollars, means many veterans in need of vital physical and mental health care services must go without.

Meanwhile, in Washington, North Carolina’s GOP congressional delegation has wasted five years of taxpayer money fighting to repeal the Affordable Care Act. Their 61 votes to repeal the ACA is an affront to our veterans, who believed they were fighting to protect our American way of life, which includes equal opportunity for all, rich or poor.

The reality is that NC veterans’ families are benefiting from the ACA. Their spouses now have access to affordable health care through the insurance exchange, their adult children can retain health insurance coverage, and pre-existing conditions now are covered, to name but a few of the major benefits they now enjoy.

Many people erroneously assume that all of our nation’s 12.5 million non-elderly veterans receive health benefits through the Department of Veterans Affairs. However, only two-thirds of veterans actually are eligible for VA health care, and only one-third are enrolled.

The VA considers a veteran’s active duty status, condition of discharge and length of service in determining eligibility and uses a priority enrollment system to facilitate the delivery of health care services. There are eight priority groups, and different status categories to determine eligibility. Veterans in lower priority groups may face restrictions on new enrollment or lose their eligibility.

Uninsured veterans have substantial medical needs. Uninsured veterans have a disproportionate number and complexity of health issues, while more than 40 percent of uninsured veterans report having unmet medical needs. Approximately one-third of uninsured veterans have at least one chronic health condition, and more than 15 percent have untreated physical, mental or emotional health problems.

Nearly half of our currently uninsured veterans would be receiving the coverage they need had McCrory not turned away Medicaid expansion funds in 2013.

Veterans living in rural areas often have no VA facilities near them. Proximity to VA facilities increases the likelihood that veterans will seek health services. If these veterans had additional coverage through Medicaid, they would be able to access local providers and get regular care. It is ironic that every one of the GOP state House and Senate members from rural areas voted against Medicaid expansion funding. As a result, four of North Carolina’s rural hospitals have been forced to close.

For some veterans, expanding Medicaid would improve their standing in the VA’s priority system. Veterans eligible for Medicaid benefits can be placed in a higher priority group in the VA’s priority enrollment system. Therefore, if North Carolina were to expand Medicaid, many veterans would gain improved access to health care through the VA system, as well as through the Medicaid program itself.

North Carolina proclaims itself to be America’s most military-friendly state. If that is true, then surely our veterans deserve no less than equal access to the same health care benefits that taxpayers provide to the elected officials who send them off to war. We must hold our policymakers accountable and give them the opportunity to reduce costs and make care more affordable by closing the coverage gaps created by their refusal to expand Medicaid in North Carolina.

Douglas H. Ryder is a veteran and member of Veterans for Peace, Eisenhower Chapter 157, in Durham.