You’d think the emergence of the coronavirus would, at long last, have shamed North Carolina’s political right into an embarrassed silence on the topic of Medicaid expansion. After all, it’s one thing to blithely claim that hundreds of thousands of hard-working people would be better off without health insurance coverage when the nation isn’t in the middle of a dangerous health epidemic. To do so at a moment like the present, however, is enough to raise serious concerns about the mental wellbeing of those issuing such utterances.
After all, when COVID-19 comes to call on their communities – particularly in rural areas that have watched their healthcare infrastructure evaporate in recent years because of the failure to expand Medicaid – people across North Carolina will need more than the conservative recipe of expanded “telemedicine” and “market-driven” price reductions.
At such moments, people want, need and deserve the right to visit a competent health care professional who will provide them with quality, in-person care at a price that will not threaten their financial wellbeing or dissuade them from seeking care in the first place.
Not only is universal health coverage a moral imperative in 2020; it’s a common sense public health imperative – especially right now, when the last thing we need is for people to be waffling on whether to contact a doctor about their nagging respiratory illness for fear of being unable to pay the bill.
Unfortunately, for the unrepentant inhabitants over on Trump Avenue, embarrassment is an emotion that they apparently foreswore long ago. And so it has come to be in recent days – a time in which the seminal policy question ought to be about how fast our state can finally implement Medicaid expansion – that the Right has launched a new and coordinated series of attacks designed to keep more than one-in-ten people uninsured.
Among the new/recycled and readily debunked claims:
- The cockamamie assertion by a group that calls itself the Carolina Partnership for Reform that Medicaid expansion would somehow cause two million North Carolinians currently covered by private health insurance to abandon their coverage in a mad rush to get on the “welfare” dole;
- New claims from the Civitas Institute that bringing hundreds of millions of federal dollars into the state to expand Medicaid will not create new jobs or aid rural hospitals; and
- In keeping with the repeated assertion that it would be wrong to expand the program until it’s fully “reformed,” a new John Locke Foundation broadside claiming that the Cooper administration is not exercising adequate oversight of the current Medicaid program.
The truth, of course, is that Medicaid expansion has been an enormous success in the 37 states in which it has been implemented. As an in-depth literature review conducted by the Kaiser Family Foundation explained last August, “Research indicates that the expansion is linked to gains in coverage; improvements in access, financial security, and some measures of health status/outcomes; and economic benefits for states and providers.
What’s more, the notion advanced by the Carolina Partnership for Reform – a shadow political group that lacks the courage even to list its staff (or the authors of the articles it publishes) on its website – has been repeatedly debunked by experts.
Has Medicaid expansion been flawless? Of course not. Medicaid expansion has involved the relatively rapid growth of an imperfect public program that exists within a gargantuan, hyper-complex public-private health care system. As anyone who has ever tried to deal with their private heath insurance company can attest, big bureaucracies are tough to run – especially ones that serve millions of people, oversee billions of dollars and deal with hundreds of complex rules and regulations.
The same could be said for any number of large public and private institutions. The public schools are certainly imperfect, but does that mean that we shouldn’t enroll any new students until we’ve completely “reformed” them? By the “logic” expressed by the Medicaid expansion naysayers, scores of essential public services would remain in a permanent state of suspended animation.
But, of course, the Trumpian right isn’t really interested in making Medicaid a success or helping the program to fulfill its mission of providing access to health care for millions of Americans. As researchers at Georgetown University reported last month, the latest Trump budget proposal would slash federal Medicaid spending by “at least” $1 trillion over the next decade – a proposal that would prove devastating to the program and the people it serves.
The threefold bottom line: a) now more than ever, Americans need access to affordable health care, b) increasingly, they appear disposed to support political candidates who will work to secure it for them, and c) as it has in so many other areas of policy discourse for so long, when it comes to Medicaid expansion, the Right has latched itself onto yet another lost cause.