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By Taylor Knopf

“Medicaid expansion” has become a politically charged term in Raleigh over the past six years. But to the hundreds of advocates who descended on the capital Wednesday, Medicaid expansion is personal.

After a morning of listening to speakers at the history museum across Jones Street from the legislative building, and then fanning out to talk to lawmakers at the General Assembly, the advocates gathered in the legislative press room to share their stories. Tears were shed as the group quickly became emotional.

Carrie McBane, a restaurant worker from Jackson County, told her story of unexplained ailments that led her to specialists she couldn’t afford. She had to decide between paying her electric bill or seeing a doctor.

“I’m a hard-working woman,” she said. “I don’t qualify for Medicaid because I’m always making $80 too much.”

If North Carolina had expanded Medicaid, McBane said she could have had health insurance for the last six years.

McBane said she paid dearly out of pocket to see three specialists who each gave her another referral. Finally, she got into a local community health clinic, where she said the medical staff took the time to ask her questions and got to the bottom of her symptoms: She has type 2 diabetes.

“Not being able to afford health care insurance has impacted every aspect of my life. In my worst, most trying moments, it made me feel that the state I live in doesn’t have my best interest at heart,” she said.

“Especially when it felt like my life was on the line and it really was. It’s demeaning, and it puts a price tag on my life when there shouldn’t be a price on a human life.”

Number one priority

Prominent North Carolina Democrats, such as Gov. Roy Cooper and Health and Human Services Sec. Mandy Cohen, have thrown their weight behind Medicaid expansion this year. Democratic lawmakers say it’s their number one priority.

N.C. Democrats have been calling for Medicaid expansion since 2013. So what’s different about this year?

Reidsville family physician Stephen Luking held up study after study that shows supportive evidence for Medicaid expansion. Photo credit: Taylor Knopf

Rep. Graig Meyer (D-Hillsborough) said it’s because more and more Americans believe that government has a role in helping people have affordable health care.

The idea behind Medicaid expansion is to offer health insurance to the hundreds of thousands of North Carolinians who make too much money to qualify for Medicaid, but don’t earn enough to qualify for subsidies to buy an insurance plan on the Affordable Care Act marketplace. People who qualify for Medicaid include low-income children, some of their parents, low-income pregnant women, poor elderly and people with disabilities.

North Carolina is one of only 14 states that have not taken up the federal offer of more robust reimbursement for enrollees who would be added under the measure.

Meyer said that health care affordability was the number one issue for voters in the 2018 election and polling data before and after last November’s election bolstered Meyer’s argument.

Democrats broke the Republican supermajority at the state legislature, and Meyer credits a large part of that to Democrats running on Medicaid expansion.

And Meyer said that this year, expansion could be a bargaining chip for other policy issues as the legislative session progresses.

“I think that expanding Medicaid would allow us to stabilize the health care market,” he said. “Stabilizing the market would allow us to take on a number of other policy issues that we’ve been avoiding. If taking on some of those other issues allows us to expand Medicaid, I’m willing to have those conversations.”

As he read his testimonial of his and his wife’s illnesses over the past decade, Charlotte resident Allan Jolly was overcome with emotion. Photo credit: Rose Hoban

Sen. Gladys Robinson (D-Guilford), a co-sponsor the Senate version of the bill to expand Medicaid, said that all North Carolinians should have access to the same quality of health care that state lawmakers have.

“People who are sick are unproductive,” she said. “So in North Carolina, we have 500,000 working people who are one illness and one major injury away from bankruptcy. When the working poor are out of work due to illness, not only can they not pay for their medical care, they can’t pay rent, they can’t pay utilities, they can’t even buy food.”

Series of unfortunate events

Allan Jolly of Mecklenburg County shared the series of maladies that have fallen on his family over the past several years, including two car crashes, multiple broken bones, and an antibiotic-resistant staph infection.

To pay for the care, Jolly, a short-haul truck driver, exhausted his savings and 401K savings. The family ended up on Medicaid.

His family’s doctors said physical therapy would key to his and his wife’s recoveries. But the number of physical therapy sessions covered by North Carolina Medicaid was cut to three per year, he said. The Jollys instead started going to the YMCA to practice self-therapy, and that’s how his wife re-broke her leg.

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“Because of these cuts, I was forced into a life of total disability,” said Jolly, a self-described “former Republican.”

“I see my family’s experience as a failure of the North Carolina representatives,” he said, tearing up. “I had a chance to get out and get better. My doctors told me that with physical therapy I would be able to get back to work and be a productive tax-paying member of society. I had a chance to support my family. You took that from me. I’m stuck and will never get out.”

By the time he was done speaking, the floor next to Dr. Luking was littered with copies of studies showing positive benefits to people who were able to receive care as a result of Medicaid expansion. Photo credit: Rose Hoban

Reidsville family physician Stephen Luking also got emotional talking about a number of his patients who could have been helped by Medicaid expansion.

“You won’t see the words on a headstone ‘killed by no Medicaid access,’ but nonetheless, they are dying,” Luking said.

Two of his patients are a mother named Angela and her 23-year-old son.

Luking helped deliver her son by cesarean section because his head was twice the size of a normal newborn. The 23-year-old has lived his entire life with a severe disability.

“That child’s mother is a saint. She has slept in a cot outside her son’s room in a small doublewide trailer for over 20 years,” he said.

Because her son has a feeding tube, a tracheostomy and takes 30 prescription medications, Luking said she is up and down all night to administer feedings and give medications.

“Angela is considered able bodied by our General Assembly, one of 500,000 able bodied,” the doctor continued. “They wouldn’t dare point a crooked finger at her. I feel that she is serving society well. She’s certainly serving that child well.”

Correction: This story originally stated Graig Meyer represented Durham.

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Taylor Knopf

Taylor Knopf writes about mental health, including addiction and harm reduction. She lives in Raleigh and previously wrote for The News & Observer. Knopf has a bachelor's degree in sociology with a...

2 replies on “For many, Medicaid expansion is personal”

  1. I am appalled at the way NC lacks common sense when it comes to using federal and state funds to provide basic services and needs to NC. I have worked in healthcare management for 15 years and every year these services get reduced, the providers’ payments gets reduced but the lawmakers “a.k.a holders of the change purse” including the “medical directors” whose knowledge of the wide variety of populations in dire need, their clients actual needs are not meet and redundant, poorly executed policy and procedure thrown out as a “bigger picture business model” to be managed an ordinary health insurance policy with these LMS/MCO. Please, someone, stop and consider, for as much news coverage as there is about healthcare rising cost and the racketeering likeness shown. Who always gains? Certainly, not the patient or the patients family, not the providers following the guidelines and their oath to do no harm. The more restrictions and ill-advised credentialing process aimed to get the best is doing more harm to the patients and putting private practices who specialize and want to treat these populations in need are being refused. Meanwhile back at the state paid for exercise and board room where the “big dogs” collect $225k a year to make judgment calls on people they would not see while they were actually practicing medicine. It is also very honorable the state and nation have become compassionate to those with less pleasant diagnostic needs but take Medicaid for instance. Their prior authorization ruse to cost wise get the best medication for the patient for various things as ADHA, various tic disorders, ADD and two of the greats anxiety and depression. I have tried many times to find the data on the authorization process with opioids and other highly addictive medications from the last 7 years love to see any comparison of time. …

    I along with others in this community are tired of promises being made in Raleigh and here in Pitt County that is not meet and seems to have no repercussion. I have tried to find the name or group at DHHS who disburses funds and hears the bids for contracts so they could see there should be an addendum to the yearly statical and budget report with is loosing interpreted data.

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