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Get off our duffs and get the money, most say at Medicaid expansion town hall

By MJH Keathley. March 21, 2019. BOONE, NC — North Carolina has over one million people not covered by health insurance announced newly-elected State Democratic Rep. Ray Russell (D- 93) to a packed crowd Thursday night inside the Watauga Medical Center auditorium.

But solving this problem “…may not be as realistic as we think,” Republican State Sen. Deanna Ballard (R. 45) cautioned the crowd gathered for a town hall meeting to discuss the pros and cons of expanding Medicaid in North Carolina. 

Discussions about how to increase access to health insurance coverage and its potential impact on the state — including the impact on local communities — dominated a 5-person panel of community health care providers and protective service leaders gathered in the shadow of two vital state legislative bills.

More than half a million North Carolina residents are entangled in the healthcare insurance gap.

Both pieces of pending legislation are aimed at solving a gap in care with the Affordable Care Act, otherwise known as Obama Care. After the act was implemented, the U.S. Supreme Court ruled that states had the right to decide for themselves whether they wanted to expand Medicaid to include groups of people that fell through the “gaps” of coverage.

People who made a penny too much or a penny too little to qualify for traditional Medicaid; people who are single, without children;  or have been imprisoned and have served their allotted time; parents, whose children qualify, but they (the parents) don’t; mothers, who are pregnant and don’t know it or that it’s two months and one day past their care window and they need help; people…who are your neighbors and friends and your gardeners, school bus drivers, waitresses — and maybe even you. 

Erica Palmer Smith, director of Care4 Carolina, a 40-organization coalition of care providers such as the American Red Cross and AARP (the American Association of Retired Persons) presented a comprehensive picture of 500,000 N.C. residents entangled in this gap. 

Mollie Mellishrenrencken, of the Watauga County Sheriff’s Office, shared the tragedy of releasing a man into homelessness because he had no way to access the system.

37 U.S. states have expanded Medicaid coverage. North Carolina is not one of them.

Jennifer Greene of AppHealth  talked about how people coming through an opioid crises needed access to health care and that it impacted entire communities. 

Stephanie Greer of the Appalachian Regional Health Care System,  said that one in four people would be diagnosed with a mental health care issue in their lifetime and there just weren’t enough hospital beds. And worse, many have very limited access to health care.  

Alice Salthouse of the High Country Community Health non-profit agency reported that her organization serves more than 7,000 people in three counties. She noted that they do a great job with primary care until someone needed gall bladder surgery and then the burden fell on the hospitals to absorb the costs of the care.

Crystal Kelly of the children’s Council of Watauga County reminded the group that closing the gap takes care of the next generation.

Sen. Ballard asked the group to consider reducing the waiting lists and taking it “first things first”.  She promised to continue the dialogue. Rep. Russell believes all of North Carolina “would be better off” with expanded Medicaid.  

Currently, 37 states have expanded Medicaid coverage.  North Carolina does not.

One couple, who had driven in from Mitchell County, entertained a practical viewpoint: “We should  just get off our duff and get some of that money” — referring to the 90 per cent federal government contribution to fund the expansion.


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