Expand Medicaid for military families and the opioid epidemic

Expand Medicaid for military families and the opioid epidemic

Image: Adobe Stock

Fayetteville is my hometown more than any – I was born here to military parents, this is where my grandparents retired from the military, and I moved back over 7 years ago as a military spouse. My community has done much to improve quality of life here, but still desperately needs expanded healthcare access.

Our city ranks 18th in the nation for opioid abuse, and our current efforts to combat it, while literally life-saving, are putting a Band-Aid on a gushing wound by focusing on reversing overdoses, but not preventing or treating addiction. Fifty percent of those heading to the ER for an overdose don’t have health insurance, and neither do an estimated 90 percent of those rotating through our medication assisted treatment (MAT) clinics. Our neighbors don’t want addictions, but don’t have the resources to stay in treatment long enough for it to be effective.

Speaking of neighbors, many of mine are veterans, and 30,000 veterans in North Carolina don’t have healthcare. Only those who serve over 20 years have access to Tricare once they get out, and the VA prioritizes those with service related injuries. One in four veterans who served in Iraq and/or Afghanistan are without coverage, according to a 2016 study by Wake Forest University School of Law. Even if the veteran is able to gain care through the VA, it doesn’t necessarily follow that care is accessible to the rest of the family. They, too, fall into the coverage gap of making too much to qualify for Medicaid, but too little for subsidies on the market.

Fayetteville is full of entrepreneurs, many of them veterans or military spouses — we have an excellent small business resource in the Center for Economic Empowerment and Development (CEED) and even a co-working space with accessible on-site childcare! But thanks to particulars with Multiple Employer Welfare Agreements (MEWAS), those entrepreneurs cannot band together for the sake of a shared healthcare plan, and even entities like Revolutionary Co-working cannot offer plans until they’ve been in existence for 5 years.  Accessible healthcare helps drive entrepreneurship, innovation, and small business while also increasing worker productivity, but we keep treating it like a privilege instead of a public good.

Why is there a healthcare gap? Because the ACA was intended to work in conjunction with Medicaid expansion, but the courts ruled that states had to be the ones to give the green light to expand Medicaid, not the Federal Government. Our General Assembly has resisted, despite D.C. covering 90% of the additional costs. Studies plainly show the costs of expansion are almost immediately recouped by the massive benefits, such as creation of well-paying jobs, decreased uncompensated costs to hospital ERs, increased business activity and tax revenue. The benefits only become clearer as the years go by and we have a solid track record from states that expanded Medicaid. Many, even those “red” or “purple” states, have seen reduced costs.

It is well past time for our General Assembly to stop ignoring the health needs of our state and community. Fayetteville’s City Council passed a resolution in favor of expanding healthcare access to low-income residents in May 2018, but the only representatives who cared were in the minority party, unable to work against the outgoing super majority. Fellow North Carolinians, we must push our state legislature to finally address expanding healthcare access when they meet in January 2019.  Call your representative and consider joining the coalition of organizations advocating for expansion. Learn more at ClosetheGapNC.org, and make your voice heard!