How does COVID-19 change the need to close the insurance coverage gap?
Even before COVID-19, there were compelling reasons for North Carolina to join 37 other states and expand Medicaid. Roughly 400,000 people would gain health insurance. In states that have expanded Medicaid, many measures, including greater access to care, improved control of chronic conditions such as diabetes and hypertension, and reduced infant mortality rates have been reported.
Insurance premiums average 11% less in states that have expanded Medicaid, as there is less cost-shifting when there are fewer uninsured. George Washington University, in a study sponsored by Cone Health Foundation and Kate B. Reynolds Charitable Trust, showed improved health outcomes and the creation of 37,000 jobs over the next three years if North Carolina expanded Medicaid.
The COVID-19 pandemic is adding stress to both the health and the livelihoods of North Carolinians. We are seeing huge increases of new unemployment claims and a daily uptick in positive test results. Emergency regulations, such as the shutting down of elective procedures and surgeries, will deprive hospitals of a dependable source of income. The edict that tests for COVID 19 are free for patients translates to greater unreimbursed expenses for providers.
Donning protective equipment takes time, and if there are many patients in isolation, more caregiver hours will be necessary. Overcoming shortages of protective equipment and ventilators will be costly. Stress from families cooped up at home has resulted in increased domestic violence calls for law enforcement, and Medicaid expansion would provide needed mental health care. Many North Carolina hospitals, particularly in rural areas, were in a precarious financial way before COVID-19, and the pandemic increases their vulnerability.
There is speculation that the federal share of expanding Medicaid, currently at 90%, might climb to 100% for the next three years. Whether the state share is 0% or 10%, it is now imperative that North Carolina stop sending our tax dollars to Washington, from whence it gets distributed to 37 other states. COVID-19 makes taking this important step a health and economic emergency.
The writer lives in Greensboro.