Doug Sea and Madison Hardee, of Legal Services of Southern Piedmont in Charlotte, lay out the case for Medicaid expansion in an Op Ed in the News & Observer. Sea and Hardee outline the economic and fairness reasons for expanding Medicaid in North Carolina. Their piece is well worth reading.
One important point that isn’t addressed in this piece: even if Medicaid isn’t expanded in North Carolina, another major component of the Affordable Care Act will be implemented — the Exchange. This marketplace will allow individuals who aren’t offered adequate, affordable employer-based coverage to purchase insurance that will meet quality standards. Generous subsidies will be available for purchase of Exchange coverage, but only for people between 100% and 400% of the federal poverty level.
So the cruel irony of saying no to Medicaid expansion will be that people at or above the poverty level will be able to access subsidized insurance, but the very poor will be excluded. Those who currently experience the least access to care and the greatest health disparities will be left out. They will continue to burden safety net hospitals, local health departments and the mental health system.