If you’d like to understand how utterly illogical and cruel the political right’s stance on closing the state’s lethal health coverage gap has become, consider the following two scenarios:
#1 – Wanda is part-time clerk at a convenience store who works the morning shift before heading off to clean houses in the afternoon. Recently, she has developed a fever, severe cough and other classic symptoms of COVID-19. After much agonizing (since she falls in the health insurance gap and lacks coverage), she decides to visit her local hospital emergency room. After determining that she has pneumonia, the hospital admits her, conducts a COVID-19 test and isolates her in a special ward. A few days later, the test comes up negative and, within a few more days, Wanda responds to medication and is discharged.
#2 – Russell is the night clerk at the same store who comes in after a day spent mowing lawns. He too has developed COVID-19-like symptoms, is uninsured and seeks emergency room care. He too is hospitalized with pneumonia. Unlike Wanda, however, Russell tests positive for COVID-19. Happily, after a week of care, Russell rebounds and is well enough to be discharged.
Naturally, both individuals accrue huge hospital bills amounting to tens of thousands of dollars.
Now, here’s where things get interesting.
For years, it’s been the position of Republican leaders in the North Carolina General Assembly that both individuals should be on their own in paying such bills. The thinking has been that both should have scrimped and saved in order to buy some form of private insurance coverage or, perhaps, created “health savings accounts.”
(Looser health regulations and expanded telemedicine, they’ve also assured us, would also drive down the cost of care – though, for someone like Wanda or Russell, it’s hard to see how even a pie-in-the-sky price drop of, say, 30% would make any real difference.)
Interestingly, though, a change to this cramped view of things could soon be under consideration. According to North Carolina’s Republican House Speaker, Tim Moore, legislation should be considered during the legislative session that convenes today that would allow Russell to receive help from Medicaid with his bill.
Moore told a committee studying responses to the COVID-19 pandemic recently, that he supports expanding the state’s Medicaid program to aid low-income folks in the coverage gap, but only to cover individuals stricken with COVID-19.
Wanda (and the hospital that served her) would remain out of luck.
To which, all a body can say in response is: a) “huh?” and b) “why?”
There’s nothing of substance to distinguish these two individuals. They’re both hard-working, low-wage workers doing their best to get by. The notion that the richest nation in the world would condemn one of them to years of debilitating debt simply for having the lousy luck to get sick from the wrong virus is profoundly illogical and immoral.
But, of course, the same thing can and should be said about the current situation – which condemns both Wanda and Russell to years of debilitating debt.
And it’s scenarios like these that illustrate the shortsightedness and inadequacy of the legislative session that we are likely to see in Raleigh this week. As best as can be determined from the wisps of smoke emanating from the office of Senate President Pro Tem Phil Berger (a politician with a serial aversion to open process and public input), the General Assembly will convene today for what can best be described as an unambitious “tinkering around the edges” legislative session. Lawmakers will redirect federal aid coming from Washington, make some modest state budget appropriations (like those proposed by the Governor), alter a number of rules related to matters like school calendars and DMV deadlines and then, well, that’s about it.
And while one must admit that such a session – coming, as it has, with talk from Berger of bipartisanship and promises not to try any more dirty, budget override tricks – would be a darn sight better than what we’ve witnessed in recent years, it’s still vastly less than what is needed.
As numerous observers have noted in recent days, the current moment of profound and unprecedented crisis, is not one for mere tinkering.
Now is the moment, if ever there was one, to “think big” and tackle the massive policy shortcomings that that are stymying progress, undermining democracy and causing widespread suffering. That means fixing the state’s broken, bottom-of-the-national-pack unemployment insurance system, addressing the crises in our underfunded and overcrowded prisons and jails, wrestling with the state’s huge gaps in broadband internet coverage, raising wages for frontline workers, aiding small businesses, addressing shortcomings in the state’s voting systems to prevent voter disenfranchisement this November, dramatically improving childcare and, yes, fully expanding Medicaid.
Anything less will assure that the Wandas and Russells of our state will continue to suffer unnecessarily.