After Robin Jordan’s daughter Jessica died of a drug overdose last summer, it brought about the hardest days that she and her family had ever faced.
If Jessica would have had health insurance, she might have been able to get the professional care she needed.
Last week, Jordan, who is also a registered nurse, shared her experience on Medicaid expansion at a hearing at the Wake Forest School of Medicine in Winston-Salem. The event was organized by two Forsyth County Democratic lawmakers: Sen. Paul Lowe and Rep. Evelyn Terry.
Jessica’s life had not been easy. After she was raped on campus her freshman year, she became withdrawn and stopped attending classes. She lost the drive and sense of purpose she’d had going into college – eventually dropping out and moving home. She first attempted suicide at age 19.
No longer a college student, she didn’t qualify for her parents’ insurance in the days before the Affordable Care Act. Her parents drained their savings and accepted loans from friends to pay for her treatment, as depression and drug addiction overtook her. Jessica was repeatedly hospitalized and committed for treatment. But her parents couldn’t afford the longer-term care, and without insurance, Jessica was often discharged within 72 hours.
Jordan knew people without insurance didn’t get the same consideration as their insured counterparts. But seeing it up close, as her daughter fought her mental health struggles and addiction, was heartbreaking and infuriating.
Jessica had a hard time keeping a job and was homeless a number of times. When she gave birth to a daughter in 2007, it gave her new hope and a reason to turn her life around, but ultimately she lost custody of her child.
“It devastated her,” Jordan said. “She wanted so hard to be the mother her daughter needed, but by this point addiction had taken over and her mental illness only continued to get worse.”
When the end came – in a local motel, after a massive overdose of cocaine and fentanyl – Jordan couldn’t escape the thought that the situation could and should have been different. As a mother, she felt she had failed Jessica. But she knew the system had failed her, too.
“There is no doubt in my mind that if my daughter had qualified for Medicaid, she would be sitting here beside me today,” Jordan said.
Jessica lived and died in a health care coverage gap in which more than 500,000 low-income North Carolinians now find themselves, Jordan said. Many of them face the same struggles that overtook her daughter.
“We are losing a generation of people to the opioid crisis,” Jordan said. “As you know, an average of five North Carolinians die every day of an opioid overdose. Only one in 22 young adults that are addicted to drugs and alcohol get treatment and nearly 80 percent of Americans addicted to opioids aren’t receiving treatment. Currently, 150,000 uninsured North Carolinians with substance abuse disorders and mental illness, like my daughter Jessica, have no health care coverage.”
Lowe said Jordan’s story is sadly too common. While 37 states have expanded Medicaid coverage, Lowe said, North Carolina has not done so — and badly needs to.
“People in this state, people in this country are dealing with a lot of health challenges,” Lowe said. “And one of the big challenges is how to pay for it all and the need for insurance.”
North Carolina is now in a prolonged budget stand-off with Medicaid expansion at its epicenter. Gov. Roy Cooper vetoed the budget passed by the General Assembly in late June. He offered a compromise budget, of which a key piece is Medicaid expansion – a priority for Democratic lawmakers who have pledged to sustain his veto.
The Republican majority in the General Assembly doesn’t have the votes to overturn the veto, despite more than a month of trying to woo Democratic lawmakers to join them.
Leighton Ku of George Washington University, author of the new report “The Economic and Employment Benefits of Expanding Medicaid in North Carolina” was also on hand at Friday’s hearing. He made the case that the potential benefits to the state go beyond the suffering it could alleviate.
“We know in many cases when the topic of Medicaid expansion comes up, it can often be controversial,” Ku said. “People say, ‘Gee, we understand that a lot of people can’t get health insurance, can’t get health care because of that…but gosh, it’s going to be so expensive. We’re going to break the bank. We’re going to go bankrupt.’”
His study shows the exact opposite, Ku said.
“In fact expanding Medicaid is an economic boon to North Carolina,” Ku said. “It is the kind of thing that will bring billions of dollars into the North Carolina economy. Because of this, not only will more than a half a million people get Medicaid coverage, but in addition to this, we expect to see thousands of new jobs created all across the state, in every county in North Carolina. There will be more state tax revenue because businesses will have more money; they’ll be better off and in fact there will be some local tax revenues.”
Using data from states that have expanded Medicaid as well North Carolina-specific numbers, the study estimates the Gross State Product would increase by $1.9 billion in 2020 and $2.9 billion in 2022. It estimates $500 million in increased state revenue from 2020 to 2022 and $100 million in county revenue over the same period.
The report estimates 24,400 jobs would be created in 2020, increasing to 37,200 in 2022.
New federal funding will rise by $2.8 billion in 2019 and increase to $4.7 billion by 2022 with the federal government paying 90 percent of Medicaid costs for newly eligible adults, Ku said. It would mean an $11.7 billion gain in federal funding, according to the report.
Lynne Pierce, a 50-year-old single mother from Graham, spoke at Friday’s hearing, despite a longstanding distaste for how this issue has been politicized.
Pierce works as the director of a nonprofit food pantry in Alamance County. Like many of those she serves, she struggles to cover her family’s living expenses on what she makes. But she makes too much to qualify for Medicaid without an expansion.
“Just last month I felt like my blood pressure was elevated and I couldn’t go to the community health center because I couldn’t afford the fee before I got paid,” Pierce said. “Lack of health care means that I must ask myself, ‘If I get this medication or go to the doctor, what will I have to take away from my daughter, Addie Kate?’ The first thought I would have if forced to go to the emergency room is, ‘Will this be my mortgage or my car payment?’ My decisions, unfortunately, have to be based on financial and not medical needs. This isn’t just a surface emotion – this is the gut level feeling that almost makes you sick with fear.”
Cassanda Brooks said she also knows that fear. The owner of two five-star childcare centers in Wake and Johnston counties, she has seen the families she serves, as well as her employees have to make the same calculations when deciding if they can see a doctor.
“I have lost two teachers who loved children and families,” Brooks said. “They were both in the field for over 20 years. Unfortunately, both of them passed for a preventable condition that led to a heart attack. Mrs. Cathy Faulkner and recently Mrs. Brena Pernell were wonderful educators.”
Brooks said she believes if the two had had access to affordable health care, they would still be here today.
“I know there are Cathys and Brendas all across the state,” Brooks said.
Rep. Terry said she could relate to their powerful stories. As a cancer survivor and diabetic, she said there have been times when she did not have health insurance and instead participated in medical studies in order to get treatment.
“Medicaid expansion must be,” Terry said. “The Affordable Care Act was not perfect. It still isn’t. But North Carolina and all of us who live here must allow ourselves to use it so that these situations that you have testified about do not need to exist in this state.”