HAMLET — Gov. Roy Cooper was in the Seaboard City on Wednesday for a roundtable discussion on the long-awaited — and still waiting — expansion of Medicaid in North Carolina.
Cooper was joined by Kody Kinsely, secretary of the N.C. Department of Health and Human Services, along with several individuals from the community during the meeting in the rotunda of the Hamlet Depot.
The main talking points centered around gaining access to health care for residents who currently fall between the cracks and providing mental health services.
The governor applauded the “strong bi-partisan commitment” from the N.C. General Assembly to expand Medicaid. However, he lamented how the deal was intertwined with the state’s budget — which has yet to be passed by legislators.
“Since we passed this thing…in March, we’ve turned away about $2 billion dollars in money from the federal government that could go to provide health insurance for our people,” Cooper said. “In fact, every month that goes by, we’re turning down $521 million dollars.”
According to Cooper, the expansion of Medicaid will provide health insurance to more than 600,000 North Carolinians.
The governor also said that since the deal was reached, some of those who were on Medicaid have been kicked off with the sunset of a federal emergency order because they no longer qualify.
“They would have qualified if … Medicaid expansion was in effect,” Cooper said, adding that accounts for about 35,000 people.
LACK OF INSURANCE
Dr. Tammie Gainey, CEO of Sandhills Best Care in Rockingham, said her staff has seen a decline in patients — who are now going without care — over the past few months due to the patients losing Medicaid.
Gainey, who has been practicing health in a variety of fields for nearly two decades, says uninsured clients are choosing to not seek health care.
“And by the time I see them, it’s too late,” Gainey said, relaying an experience of one patient who had stage 4 cancer by the time of the visit. “Unfortunate, because that could have been prevented.”
Gainey said access to health care and coverage is important, so patients can afford not only see a provider, but also pay for the medications for treatment.
Hamlet Councilwoman Abbie Covington echoed Gainey’s sentiments.
“There’s a choice there: they can seek care knowing they have no compensation available, or they can decide to postpone the care,” Covington said. “Which is, to me, worse than seeking care in an uncompensated matter … The consequences then turn out to be much more expensive.”
The former Hamlet mayor said she hears about this issue mainly from those who work for small businesses that can’t afford to provide employees with health benefits and don’t qualify for Medicaid because they’re working.
“Sometimes they’re forced to say, ‘OK, I’m just not going to work anymore because I’m better off not working than I am working,’” Covington said.
According to Kinsley, residents in rural communities are three to four times more likely to be uninsured.
“Eighty percent of those who would benefit from expansion are working families,” Kinsley
Aleacia Lambert, owner of Busy Bees Academy and Learning Center on Biltmore Drive in Rockingham, said expansion would “be great” for small business owners, in part, to retain staff.
According to Lambert, many workers are leaving the early education field and going to school systems where they can possibly get health insurance.
Jeff Smart, chairman of the Richmond County Board of Commissioners, has seen the effects from multiple angles.
As owner of Mabry’s Drug and Home Care, Smart said it was a “big deal” when co-pays increased from $3 to $4: “There were some people who just couldn’t get their medicines.”
From the county government side, Smart, a Republican, said Medicaid expansion “is not political to me.”
“It’s something that our county needs,” Smart continued. “We’re at 45 percent, currently … with people on North Carolina Medicaid. So that tells you where we are.”
Smart estimates 3,000-5,000 county residents would be able to take advantage of the expansion.
Cooper said there are many uninsured who fall in a “hole” between qualifying for Medicaid and subsidized coverage from the Affordable Care Act, who could benefit from expansion.
Sarah Goodwin Shepherd says she and her family fall into that gap.
Shepherd said when her husband was diagnosed with brain cancer in 2018, they applied for, and received, Medicaid coverage for the entire family.
Three years later, Shepherd says she was diagnosed with colon cancer, but is currently cancer-free.
“Medicaid has been a blessing,” Shepherd said, adding that they’ve been under the family plan and that she has continued to work except when it was necessary to take off for either her or her husband’s surgeries and recuperation.
“Medicaid has been something I didn’t have to worry about, with our health care needs … anything that we needed, I knew it was going to be covered.”
However, Shepherd said she received a letter Monday that coverage for both her and her husband will be ending at the end of the month due to their household income.
“So now, the coverage that’s been such a blessing is now going to be removed, which leads me to having to find elsewhere coverage for myself,” Shepherd said. “This is definitely a huge issue — not just for our family but for many families throughout North Carolina that have health concerns and issues…”
‘EXPAND MEDICAID NOW’
Cooper said Shepherd was one of thousands of North Carolinians getting similar letters “who don’t necessarily have to get them because we’ve all agreed on something that can help them, we just haven’t had the chance to turn the key to start it.”
Shepherd added that she’s had to be cost-conscious with rising prices rising due to inflation, including with vehicle payments.
Kinsley told Shepherd that he recalled seeing his own parents having to make similar financial decisions.
“I think what breaks my heart the most is that while you’re being incredibly judicious to manage every penny you spend, we have the General Assembly being so incredibly cavalier with getting the money,” Kinsley said. “This is not a controversial issue. We need to have it done.”
Kinsely said about 9,000 residents per month are being dropped who would have been able to keep their coverage if expansion was in place.
The secretary added that 300,000 would be eligible for the family plan on day one when Medicaid expansion does go into effect.
Social Services Director Robby Hall said the department will likely have to hire three to four new workers and a supervisor with expansion.
“One unfortunate thing with the delay itself is that it takes around six months or more to train a Medicaid eligibility worker,” Hall continued. “So, any delay that we have will potentially delay the service … and with the market the way it is for employment, trying to bring in staff … is a big challenge.”
Gene McLaurin, chairman of the Economic Development Partnership of North Carolina, recently penned an op-ed encouraging the General Assembly not to wait any longer to pass the budget.
The former Rockingham mayor and state senator said expanding Medicaid will add more than 30,000 jobs, particularly in the healthcare field.
“We will be able to provide more people opportunities for employment all across the state,” McLaurin said.
McLaurin encouraged all those at the meeting to contact their legislator to “expand Medicaid now. Don’t wait. Get it done now.”
According to McLaurin, estimates show a 10-12% decrease in premiums for those on private insurance plans pending expansion.
“So there’s a direct economic benefit: jobs creation, lower health care costs for those who do have health insurance …it’s a no-brainer,” McLaurin said. “We should have done it years ago — 39 other states have done it. We’re being left behind, folks.”
(Note: The RO will have more on the mental health part of the discussion in a later story.)