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Roadblocks in North Carolina

Melissa Hassard  |  Issue: January | February 2014

The state’s unpopular General Assembly is making it hard for people without health insurance to get it

One out of every six people in North Carolina doesn’t have health insurance — the people least able to pay for doctors, medicine, and hospitals when they need them. And that’s not counting the undocumented immigrants.

Bucking the national and global tide, North Carolina is not even close to giving all these people access to heath care. Prior to the Oct. 1 launch of the federal Affordable Care Act (ACA) — also known as Obamacare — confusion surrounded how it would impact insurance rates, who would be eligible, and what it would cover. Specific details on plans were not available.

The ACA began as an idea of universal care for all Americans. Across the globe, healthcare is a basic human right.

In Mexico, the right to health care is written into the constitution. Mexico’s healthcare system is a mixture of private insurance funded by payroll taxes and a universal health insurance, Seguro Popular.

Ten years after Seguro Popular began, it has enrolled 53 million people. They pay for their insurance based on their income, and they all receive preventative care, reducing costs. No one is denied.

Before embarking on Seguro Popular, the Mexican government found that four million people every year were being driven into bankruptcy by illness, a huge drag on the economy. In the U.S., some 45,000 people actually die each year from a lack of health insurance.

Since ACA rolled out October 1, many North Carolinians have faced frustration. That’s because the Republican-held North Carolina General Assembly, along with its Republican Governor, in a fit of resistance and anti-Obama sentiment, barred the state from participating in the rollout.

Where other states embraced the opportunity to control their state healthcare exchanges, and build nimble systems that best met the needs of their citizens, federal funds earmarked for this purpose were declined by North Carolina’s GOP leadership. A state exchange was not created, and citizens were left to the vagaries of the glitch-ridden federal site if they wanted to apply.

NC Insurance Commissioner Wayne Goodwin had been eager to attract new insurance companies and more competition to the state.

Without incoming competition, Blue Cross Blue Shield has held on to its status as the only statewide provider.

As a result, not only did its rates not decrease effective October 1, they went up, with some small businesses seeing increases as high as 284 percent.

In one stroke, the NC GOP turned down billions of federal funds in Medicaid expansion as well as additional millions toward aiding the state in creating and controlling its own state healthcare exchange. That included an additional $27 million in federal funds earmarked to help educate and assist the million-plus North Carolinians expected to shop for insurance.

Goodwin has publicly voiced his disapproval, as residents across the state find signing up nearly impossible.

To be eligible to purchase and use ACA coverage through its Health Insurance Marketplace, you must be a U.S. citizen or be “lawfully present” in the eyes of the government. The status of each member of your family is determined separately. The new law does not cover immigrants without papers, even though they also pay taxes and need health insurance.

Our contrary and unpopular politicians in Raleigh have put roadblocks in front of the North Carolinians who both qualify for Obamacare and need it badly. And they’ve raised insurance costs in the process.

That’s not good morally, not good politically, not good economically. It’s time for a change.

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