Opinion: Closing North Carolina's health care gap by expanding Medicaid – Triangle Business Journal – The Business Journals

Opinion: Closing North Carolina's health care gap by expanding Medicaid – Triangle Business Journal – The Business Journals

Closing the health insurance gap in North Carolina is an admirable goal that would yield many benefits. Studies suggest that one potential benefit would be lowering health insurance premiums, or materially mitigating the pace of premium increases.
What does “coverage gap’’ mean? The gap refers to people who earn too much to qualify for Medicaid, but earn too little to qualify for a premium subsidy under the Affordable Care Act (ACA). This means they cannot purchase coverage through the ACA Marketplace. As a result, they remain uninsured.
Prior to the pandemic, approximately 400,000 of our fellow North Carolinians lacked access to affordable health insurance. The Kaiser Family Foundation estimates this number has now grown to over 600,000. The coverage gap continues to widen.
What can North Carolina do to address this growing health care challenge? We can look to the 38 states that have closed their coverage gap by expanding Medicaid and do the same.
The benefits are many, including allowing people who need the care to receive it in a timely way and in an appropriate setting. It will diminish the need for people to flood hospital emergency rooms for non-emergency services because they have nowhere else to go.
There is compelling evidence to suggest that closing the coverage gap helps to slow the persistent increase in health insurance premiums.
It is clear from the experience of states who have expanded Medicaid that there was a beneficial impact on private insurance premiums. Health Economics published a study showing that in states where Medicaid was expanded, premiums for coverage sold on the ACA Marketplace were 11-12 percent lower than states declining expansion.
Why does closing the gap help make private insurance cheaper? There are many reasons. Expanding Medicaid means that more people have coverage, thereby reducing the losses medical providers incur for uncompensated care and ultimately recouping from private insurance premiums.
Virtually all experts agree that expanding Medicaid would benefit our rural communities, hospitals and medical professionals. Many of our rural hospitals and providers have the highest percentages of uninsured patients. Closing the coverage gap would help sustain the economic viability of rural hospitals and clinics, ensuring they can remain open to help the people of their service area.
For a vivid picture of what the coverage gap means in your backyard, Care4Carolina, a 145-member coalition of health, business and faith organizations, created a county-by-county search engine.
In Caldwell County, where I had the privilege of practicing law for 14 years before moving to Raleigh, approximately 16.6 percent of workers are uninsured, higher than the state average of 13.8 percent.
Whether you’re in an urban area like Mecklenburg or Wake, or a rural area like Caldwell, Rockingham, Yancey or Jones, you have friends and neighbors who are uninsured and part of the coverage gap. These working parents, food service workers, veterans and health care workers need coverage and, in many instances, they could get it if North Carolina expanded Medicaid.
Now is the time to expand health insurance coverage to include 600,000 of our neighbors. Now is the time to support our hospitals and clinics by lowering the number of uninsured they must serve.
Brad Wilson served as CEO of Blue Cross Blue Shield of North Carolina. he can be reached at b.wilson6723@gmail.com.
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