LAURINBURG — The president of the county’s NAACP hopes that the petition delivered to Gov. Pat McCrory this week by the association’s top leader in the state will convince North Carolina legislators to reconsider their decision to opt out of the Medicaid expansion as part of the Affordable Care Act, a move that left nearly 30 percent of the county uninsured.
The Rev. William Barber II, president of the state NAACP, delivered the petition Tuesday, saying as he did so that he wanted to remind the governor over the Thanksgiving holiday of the 500,000 North Carolinians who would be stuck in a coverage gap between the cutoff points of Medicaid and the Affordable Care Act — and the more than 100,000 whose jobless benefits would run out as Christmas approaches.
According to Scotland County NAACP President Terrence Williams, 27 percent of the county’s population— about 9,000 residents — would have been covered if the expansion, coming in the way of federal dollars, had been accepted. Federal money would have paid for three years of the extended coverage, and 90 percent of the costs in 2020.
“Their reasoning was that in the long run, eventually we will be at a disadvantage and further expand our debt,” Williams said. “I’m not sure how much validity we should give to that because we are already seeing jobs being lost.”
The lack of expansion has proved to be a negative for public, rural hospitals that serve lower-income patients who depend on public assistance to pay medical bills — a relationship that has made rural hospital systems dependent on the state for payment. Southeastern Health recently cut 5 positions and reduced pay for 95 nurses, saying their hand was forced by the state’s decision. Hospitals in Surry, Randolph, Columbus, Buncombe, Beaufort, Halifax, Cumberland and Guilford have cut a combined 550 jobs since the expansion was not accepted.
Scotland Memorial cut a handful of jobs from its staff, CEO Greg Wood said in an interview earlier this year. But, he said, the hospital went through a “pretty significant restructuring of folks,” moving them to different departments “where resources were required.”
“We are working very hard to continue that process,” he said, “to fill vacancies from within. We want our workforce to be stable. We don’t expect to grow extensively and we don’t expect any more declines.”
Wood said businesses offering insurance to employees are raising deductibles, raising copays, or shifting more employees to part-time to avoid the mandate.
“If you’re deductible goes up your out-of-pocket goes up,” he said. “And the amount that we collect from copays and deductibles is pitiful. So if more and more people are seeing increases then we are going to see less money.”
Wood patients who expect the “latest and greatest” care did themselves a disservice by voting for Republican legislature who continues to cut back on public funds.
But Mark Schenck, chairman of the county’s Republican party, says he is tired of the public only hearing one side of the story.
“Over the years (Medicaid) has grown to a massive size,” he said. “As with most government programs, it too has been allowed to be misused and abused.”
McCrory rejected federal dollars, said, because the Medicaid program needs reform, and because there were concerns about the strings that would be attached to such funds — like an enlarged federal bureaucracy that would have far too much say in how North Carolina spent the money it received.
“By receiving federal funds, North Carolina would be obligated to abide by laws and regulations that may not be in the best interest of the citizens of North Carolina,” he said. “As we have recently witnessed, what the Federal Government promises you in the beginning is not always what you get in the end.”
President Obama has been under heat from Republicans for saying Americans would be able to keep their current insurance plans if they liked them, not clarifying that they would not be able to keep plans that were not up to the Affordable Care Act’s standards. The insurance company Blue Cross and Blue Shield has said they will raise rates by as much as 24 percent next year to offer services that meet the act’s requirements.
Williams said the president should have been “more aggressive” in the rollout of the Affordable Care Act, especially when addressing what policies Americans would and would not be able to keep.
“A lot of those plans were literally were not doing what they should or had all the type of nuances in it that would be in the company’s favor,” Williams said. “I think once people really start looking at their policy and seeing how competitive the market could be and how well situated they could be with their new policy they would embrace it.”
Williams, like Schenck, believes media coverage of the act has been unfair. But Williams says news outlets harp on difficulties potential customers have had when attempting to sign up for coverage — giving Republicans an issue over which to hold “the President of the United States hostage.” Williams said he went through the process and had no problems reaching the point where he would sign up, but did not follow through because he could not believe his eyes when he read his premium would cost him nothing.
“I think if we can put the political rhetoric aside and really concentrate on what’s going on then we will hear more good stories that are now being pushed under the rug,” he said.
Schenck said previous administrations have used social programs such as Medicaid to buy votes and sustain politician’s “power structure,” creating “bloated inefficient liability instead of the asset that it was intended.”
“This will require some ‘tough love’ and bipartisan team work to redirect Medicaid back to the proper direction,” he said. “This can and should be done by North Carolinians.”
But Williams said Republican policies only serve to drive the lower class further into poverty, fostering a cycle of hopelessness and desperation.
“I’m no conspiracy theorist but we might want to start preparing for martial law,” Williams said. “At the end of the day, when poor people are turned into a permanent lower class, what they can’t earn they will steal and we have to be prepared for more and more violence in our community.”