By Anne Blythe

As North Carolina lawmakers focused on health care policy on the home-front for much of Tuesday, Josh Stein, the state attorney general, honed in on what’s happening on the national stage.

Oral arguments began earlier that day in a federal courtroom in New Orleans over a Texas-based lawsuit that could ultimately bring an end the Affordable Care Act and cause mass upheaval in the health care industry.

“That law is on life support in New Orleans today,” Stein said at a news conference just outside his office early Tuesday afternoon before it was clear whether the state House would approve Medicaid expansion, a debate that has been so long-running in North Carolina that he has weighed in on it as a state senator and now the attorney general.

Stein said he supports Medicaid expansion, saying it could go a long way toward helping the state in its fight against the opioid crisis.

“But I’m not here to talk about expanding Medicaid,” Stein said. “I’m here to talk about the Affordable Care Act as a whole, and how that law enriches and saves lives.”

In April 2018, Republican attorneys general from Texas and 19 other states filed a lawsuit in the U.S. District Court for the Northern District of Texas.

In December 2018, Texas-based U.S. District Court Judge Reed O’Connor struck down the entire act just a day before the Obamacare open enrollment period for this year was ending.

Back in a 2012 Supreme Court ruling justices ruled that the mandate requiring people to buy health insurance or pay a penalty was a form of a tax. But in the 2017 tax overhaul, Congress shrank the penalty down to zero. The judge ruled since Congress had essentially done away with the penalty and nullified the individual mandate, there was no more tax in the law, making it completely unconstitutional.

ACA impact in NC

In June 2018, the Trump administration announced it would no longer defend key provisions of the ACA and agreed with the Republican attorneys general’s lawsuit. In response, Democratic attorneys general, led by California’s Xavier Becerra, decided to defend the ACA. Stein joined the group of Democratic attorneys general appealing O’Connor’s decision early this year.

Stein reeled off numbers to show the impact the Texas’ judge’s decision could have on North Carolina:

  • Nearly 5 million residents have benefited from the ACA’s protections for people with pre-existing conditions.
  • Approximately 1.8 million seniors in the state save more than $1,000 a year on the cost of their prescription drugs because of the law.
  • More than 500,000 people were able to purchase health insurance on the online marketplace between 2010 and 2015.
  • Another 70,000 young people gained insurance through their parents’ policies because of the law.

“If the other side prevails,” Stein said, “the protections for millions of North Carolinians with pre-existing conditions will be gone. The cost of prescription drugs for more than one million senior citizens will increase, and hundreds of thousands of North Carolinians will lose their health insurance coverage in its entirety.”

Not being histrionic’

Kara Konrad, a mother of a special needs child in Mecklenburg County, joined Stein at his press conference. Konrad is a member of Little Lobbyists, an organization that works to protect the rights of children with complex medical needs and disabilities.

a woman stands at a podium, a man stands next to her and a woman on the other side sits in a wheelchair, both are listening.
Stacy Staggs describes her twin daughters’ health problems at a press conference held Tuesday in Raleigh to express support for the Affordable Care Act. Photo courtesy: @NCAGO twitter page.

Instead of talking about her child, though, she chronicled her own health care challenges, which include a disease that attacks her spinal cord. That deterioration has caused surgeons to essentially build a cage with rods and screws to support her spinal cord.

She has had eight surgeries, which have added up to at least one million dollars in claims. She needs low-level chemotherapy and could require more surgeries to stave off paralysis and death.

“I’m not being histrionic,” Konrad said. “I’m being factual. It’s important, I believe that people see just the facts behind all of this.”

Stacy Staggs, a 42-year-old Charlotte mother and also a member of Little Lobbyists, became teary-eyed, her voice choked with emotion, as she described the birth of her twin girls, Emma and Sara, five and a half years ago.

Emma weighed one pound, nine ounces, and Sara was only slightly bigger at two pounds.

In the years since, the family has lived under the constant threat of elimination of the Affordable Care Act and the possibility that lifetime caps on insurance spending could be reinstated.

Emma has a number of medical issues stemming from her premature birth, including bilateral vocal cord paralysis that means she cannot speak or make sounds. Her claims already have topped $2 million, her mother said.

Neither girl can attend school, and Emma’s room looks like a hospital room.

“The Affordable Care Act explicitly stopped the insurance industry from being able to pick and choose their participants,” Staggs said. “My family and millions like us have been living under the constant threat. We chose life and we choose life.”

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Anne Blythe, a reporter in North Carolina for more than three decades, writes about oral health care, children's health and other topics for North Carolina Health News.