LAURINBURG — Last week’s U.S. Supreme Court ruling on King v. Burwell, which upheld the Affordable Care Act’s extension of federal health insurance subsidies to residents of all 50 states, came as a relief to more than 515,000 North Carolina residents who stood to lose needed assistance in paying for health insurance.
The case contended that residents in states with federally run exchanges should not be eligible for those subsidies due to the language in the law. North Carolina is one of 27 states with a federally run exchange, while exchanges in the other 23 are run in some capacity by the state government.
But those who have never qualified for insurance subsidies by virtue of too-low income are likely to remain in the lurch for the foreseeable future. Many of the patients at the Scotland Community Health Clinic, which serves adults living at or below 150 percent of the federal poverty level, are excluded from coverage under either source.
“Patients at the clinic remain ineligible for coverage under the Affordable Care Act as their income is less than the amount necessary to receive subsidies and they cannot afford to pay the premiums or the deductibles for insurance even if they were eligible,” said clinic director Andy Kurtzman.
On Thursday, N.C. Senate leader Phil Berger, R-Rockingham, and House Speaker Tim Moore, R-Cleveland, said that they continue to oppose the expansion of Medicaid to cover many state residents who remain unable to afford regular medical care.
The Affordable Care Act provides for the expansion of Medicaid to cover those living at or below 138 percent of the federal poverty level, a move which Gov. Pat McCrory said earlier this year he may recommend, pending the King v. Burwell ruling.
But State Rep. Ken Goodman, D-Richmond, who represents Scotland County and is an advocate for Medicaid expansion, doesn’t expect the Supreme Court ruling — or the governor’s position on expansion — to benefit those who are too poor to receive subsidies yet make too much to qualify for Medicaid.
“I would welcome the governor’s endorsement of Medicaid expansion, but I’m not sure it would change the dynamic very much,” Goodman said. “I really don’t believe that the governor really has much influence with the General Assembly; there hasn’t been much evidence of it. He’s vetoed I think five bills since he’s been governor and every one of them has been overridden.”
The Affordable Care Act committed the federal government to covering 100 percent of the cost of adding new Medicaid recipients through 2016 and at least 90 percent thereafter. A majority of North Carolina lawmakers have refused, claiming that Medicaid costs consistently exceed spending forecasts and shouldn’t be expanded.
In addition to the 500,000 state residents who would have access to regular health care, Goodman said that Medicaid expansion would create 25,000 jobs in the state and provide a boost for struggling rural hospitals.
“We’re paying the taxes, we’re sending the money to Washington, we’re just not accepting it to come back; it’s a mystery to me why we haven’t already done that,” Goodman said. “That would be a great thing for the economy of the state, it would be a great thing for the people that need it, and it would be a great thing for rural providers.”
Mary Katherine Murphy can be reached at 910-506-3169.