And not using a Medicaid extension in NC, folks face robust selections

I am a single working mother of two teenage boys. Even though I work full time, I don’t have health insurance, which makes the struggle to support myself and my sons much more difficult.

I am one of millions of Americans in the Medicaid coverage gap. I live in a state that hasn’t expanded Medicaid to people like me, who earn too much to qualify for regular Medicaid but still earn too little to be able to afford private insurance.

On my last job, I was stopped at gunpoint and robbed. I would have benefited from a subsequent consultation, but I cannot afford such treatment without health insurance. In fact, the majority of my health advice without insurance comes from the internet, family and friends. I often rely on my grandma’s home remedies, which sometimes work but cannot treat some conditions, such as my heart murmur or depression.

But now there is a new way to finally get help for people like me. Congress has already taken initial steps to approve President Biden’s “Build Back Better” package, a program that would fill the funding gap at Medicaid and expand healthcare to millions of people. It is of vital importance to my family and countless others that this provision be part of the final bill of Congress and allow us to finally get health insurance.

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Right now, the policy of Medicaid reporting stands in the way. North Carolina is one of 12 states that have refused to expand Medicaid because of partisan opposition to the Affordable Care Act, which has really nothing to do with helping people stay healthy or treating illness. For a decade, lawmakers in states like mine have continued to put politics above health care and oppose the expansion of Medicaid, despite increased federal government funding during the implementation of the ACA and additional incentives created earlier this year by the US rescue plan.

Even during a pandemic that left over 13,600 dead, North Carolina lawmakers refused to extend coverage to 207,000 eligible for insurance under the program. The failure of our state lawmakers to expand Medicaid has had devastating consequences. Since I don’t have health insurance, I have to make difficult decisions every day between basic health care and other important things like rent and food.

Without health insurance, I only have the emergency room if I have an acute medical problem. After a recent visit to the emergency room, I had to spend my last few dollars on a prescription they provided me so I had no money. I ran out of gas on the way home and then got an astronomical bill from the hospital.

There are hundreds of thousands of people like me in North Carolina. They may not look like these kinds of decisions from the outside, but many make decisions about which bills to pay in full, which bills to partial payment on, and what to forego to make ends meet get.

President Joe Biden signs the American rescue plan in the Oval Office of the White House March 11th.  The measure includes incentives for states that have not expanded their Medicaid programs.

The coverage gap is long overdue and has already caused unnecessary suffering, hardship and even death for some people. If lawmakers in our state had expanded Medicaid years ago, we could have prevented the deaths of 1,400 people aged 55 to 64 between 2014 and 2017 alone.

According to the Senate’s proposal, people in the coverage gap could get affordable coverage with no co-payments. Of those eligible, 65% live in working-class families like mine and almost half are colored. There are 7,000 children in North Carolina.

Closing the supply gap would not only give people vital access to health, it would also improve economic security and address the persistent racial health disparities that persist in our state. We can’t build better while leaving millions of people behind and perpetuating the same unfair patterns.

No matter where someone lives, what they look like, or how much money they make, we should all have access to the health care we need to support ourselves and our families. Since our General Assembly will not do this, Congress needs to close the coverage gap for millions of Americans who have been denied coverage by getting them passed with the Build Back Better package.

Christine Burk is a member of Action NC’s Race and Gender Equity (RAGE) initiative. She lives in Fayetteville.

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