Contributed by Joel Gallagher, of Greensboro, NC
Medicaid expansion is of vital importance to me, as a physician specializing in Asthma, Allergy, and Immunolog. It’s important to the patients I serve, and to the rural hospitals that are the lifeblood of our communities. In a handful of days, the North Carolina 2022 legislative short session will close. The question is, will the NC General Assembly pass Medicaid expansion or will 600,000 people in our state have to wait for yet another legislative session to access life-changing and life-saving care?
Our representatives must do more than signal their willingness to expand healthcare. We need an expanded Medicaid now. Our rural hospitals depend on this decision. Aside from providing healthcare to those within their communities, they are often among the largest employers, pumping money into the local economies. They provide facilities to accommodate both general practitioners as well as specialists. In my practice as an asthma/allergy specialist, we often have to send asthmatics to the hospital for more intensive treatments. Without a local hospital to provide medical treatment, patients are often faced with longer trips to get the care they need, frequently resulting in additional, often life-threatening complications.
Rural hospitals are closing at an alarming rate in our state. Even before COVID19, hospitals in the Triad were showing signs of financial strain which puts them at higher risk of losing some of their departments or closing altogether. Since 2005, eleven community hospitals in North Carolina have closed. Eleven hospitals, the lifeblood of our rural communities, providing both healthcare and jobs, closed. Studies have demonstrated that the vast majority of hospital closures across the country have closed in states that did NOT expand Medicaid after the ACA passed in 2010. Medicaid expansion would provide a much-needed boost to these facilities by bringing in $4 billion in federal dollars and creating 43,000 jobs.
Our medical advancements make this an exciting time for me as an asthma specialist. There are phenomenal injectable biologics that target specific subtypes of asthma; I have seen firsthand how life changing these medications can return an asthmatic patient to a more normal life. Unfortunately, my uninsured patients are not eligible to obtain these medications at all without paying thousands of dollars out of pocket. Without access to these medications, they are destined for multiple courses of steroids instead, which have many adverse side effects. This inequitable distribution of healthcare is immoral.
Primary care and other specialties are affected in similar ways. The state’s inaction on Medicaid expansion affects all of us – both in higher premiums for commercially insured patients as well stress for both those who are uninsured and their families. I was talking to one of my patients affected by this the other day. She is fortunate to be insured through her work, however she is on a very tight budget. Her son has a severe psychiatric disorder which can be controlled with expensive medications. This patient has mortgaged her house in order to continue paying for her son’s medications. Her son – who is in his 30s – is uninsured now, but would be covered by Medicaid expansion, if it were to pass.
We are SO close to finding a way forward that would advance our abilities to serve 600,000 more ailing and suffering people. I offer an urgent plea to our senators and legislators to pass Medicaid expansion now, and lift up our abilities to serve the good people of North Carolina.
