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Coronavirus reveals vulnerabilities within states like N.C. that rejected Medicaid expansion

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Uninsured people within the 14 states, including North Carolina, that have not expanded Medicaid under the Affordable Care Act, could face numerous challenges as COVID-19 cases increase.

Almost 5 million people across the country are without access to health care coverage and states that have turned down billions of federal dollars that would have come with the expansion, are left without adequate resources.

From NBC News:

“This outbreak is going to bring to light and highlight really strongly the types of disparities and the gaps in our health care system that leave people vulnerable,” said Jennifer Tolbert, the director of state health reform at the Kaiser Family Foundation, a nonprofit that researches health care issues.

Since the start of the outbreak, many governors — such as North Carolina’s Roy Cooper, a Democrat — have requested and received waivers from the Trump administration to give their Medicaid programs more flexibility amid the disaster. Many state legislatures and governors, however, are still waffling or arguing over whether to pursue expanded coverage, leaving a huge number of people uninsured while the disease continues to spread.

Without medical coverage, those who remain uninsured may skip a doctor’s visit until it’s far too late because they fear the cost of going to the hospital. The Kaiser Family Foundation reported the average cost for coronavirus treatment could be more than $20,000. Meanwhile, the same organization concluded that prior to the outbreak, more than half of Americans avoided going to the doctor because they feared the price tag.

“People who live paycheck to paycheck can’t miss work,” said Hyun Namkoong, a health policy advocate with the North Carolina Justice Center. “People who do not have paid leave can’t miss work. This is a really serious issue that for so long the people in power at our general assembly thought that the coverage gap didn’t really affect them, that it doesn’t affect our public health, but this moment really shows how connected we all are in society.”

In North Carolina, Medicaid expansion would have provided coverage to more than 500,000 North Carolinians that need to get care for chronic conditions, prevent illness and disease progression.

For North Carolina rural areas, resources are desperately needed as NC is 11th in terms of number of vulnerable rural hospitals.  The Chartis study found that 15 out of 50 rural hospitals in NC, are considered as vulnerable to closing because of potential financial shortfalls, according to the national study.

The North Carolina Republican-led legislature’s refusal to expand Medicaid has denied the state from receiving an estimated $40 billion worth of federal funds since 2014.

For uninsured individuals and community hospitals, the pandemic could prove devastating for many. With lack of resources and health coverage for thousands, many North Carolinians have been left vulnerable for years as the legislature continues to block the expansion of Medicaid.

Politics needed to have been set aside months ago as the impending health crisis swept across the nation. People are in need of adequate health care coverage and resources, and the legislature should come together to protect everyone. Not just themselves. 

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Alanna Joyner

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