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Opinion Letters Should N.C. expand Medicaid?

I believe all N.C. citizens including our governor and state legislators would agree with the Declaration of Independence that "all men ... are endowed by their Creator with certain unalienable rights, that among these are life, liberty and the pursuit of happiness.” There are currently 1.5 million N.C. citizens with no health insurance coverage. Research shows that these people without insurance have a 40 percent higher risk of death than their insured counterparts (2009, American Journal of Public Health). That is over 3,000 people in N.C. that will die every year if the legislature and governor do not expand Medicaid as currently prescribed in the Affordable Care Act covering an estimated 500,000 new low income citizens. Senate leader Phil Berger apparently believes that every citizen does have the right to life, when he writes, “Senate Republicans are committed to ensuring every North Carolinian receives the highest-quality care and outcomes.” Maybe they are just unaware that not expanding Medicaid would result in the pointless loss of life of so many of our fellow citizens or maybe they believe that we simply cannot afford expanding the current program.

Governor McCrory wrote in Asheville Citizen-Times that, “As your governor I wake up every day with North Carolina's economy as my No. 1 priority." So what is the economic cost to the citizens of N.C. to expand the current Medicaid program. First, hundreds of millions of dollars are currently spent every year providing emergency coverage at the state and local level, and by health care providers that receive no reimbursement for these services to uninsured citizens. The provisions in the Affordable Care Act and expansion of Medicaid would insure that almost all of these current massive expenses would be eliminated. The N.C. Institute of Medicine that over the next ten years after taking into account all new expenses and savings we would net saving $65 million. In addition, all of us that have private insurance would have a two percent lowing of our own insurance premiums according to The American Academy of Actuaries.

Senator Berger has said Medicaid expansion would be a job killer that ultimately ends up costing N.C. taxpayers (WRAL.com). Perhaps Berger was unaware of a report from the N.C. Department of Health and Human Services that the new Medicaid funds would result in doctors, drug makers, pharmacies and medical equipment companies creating 23,000 new jobs that would add about $1.4 billion to the N.C. economy (Regional Economic Models Inc.). The federal government will pay the entire cost of expansion for three years then 90 percent of the cost after that. If we do not accept these funds our federal taxes would not be reduced, what we will pay anyway will simply go to another state, perhaps Virginia or Tennessee which would make N.C. less competitive in attracting new industries to our state.

So, in summary, expansion of Medicaid will save thousands of N.C. lives every year, add billions of dollars and 23,000 new jobs to our economy, and will not cost N.C. anything for three years and result in tens of millions in savings over the next ten years. For the good of all N.C. citizens I urge everyone to contact our governor and legislature to implement the expansion of Medicaid in N.C.

Ed Morris, MD — Franklin, N.C.


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