Democrats in the legislature renewed their press for Medicaid expansion, saying a Tuesday news conference that getting more people insured will reduce racial health disparities and help the economy.
Sen. Mike Woodard, a Durham Democrat, said there are signs that Republicans in the legislature who have long opposed Medicaid expansion are willing to talk about it.
“I think there are glimmers of hope,” he said. “I think there are frameworks for us to move forward.”
North Carolina is one of a dozen states that has not adopted Medicaid expansion as allowed under the Affordable Care Act. Last session, Senate Republicans said they did not like an expansion-like proposal called Carolina Cares that House Republicans crafted. The Carolina Cares bill never got out of the House.
Expansion is a top priority for Gov. Roy Cooper, and he once again has included it in his budget proposal.
Estimates for how many more people in the state would be insured with expansion start at 500,000. Many are childless adults younger than 65.
The most recent federal relief package includes financial incentives for more states to expand Medicaid. North Carolina would see a net gain of $1.2 billion, according to a Kaiser Family Foundation estimate.
Senate leader Phil Berger, an Eden Republican, told the Associated Press that the extra federal money is time limited and that coverage gaps could be addressed without “creating a whole new level of entitlement in the state of North Carolina.”
Senate Republicans this year have shown interest in allowing adults who use Medicaid to keep it under limited circumstances.
Three Republican senators, including Sen. Joyce Krawiec, one expansion’s fiercest opponents, are the main sponsors of a bill filed Monday that would allow women who use the government insurance program while they’re pregnant to keep the coverage for a year after giving birth rather than have it cut off after 60 days.
House Democrats, including Rep. Verla Insko of Chapel Hill, filed a similar bill last month.
The American Rescue Plan allows states to expand what’s called pregnancy Medicaid to 12 months postpartum.
Doctors, policy experts and others say that 60-day cut off doesn’t give some mothers time to have their postpartum medical visits or seek treatment for postpartum depression.
The American College of Obstetricians and Gynecologists has made extending postpartum Medicaid coverage a priority, saying it will help reduce the rate of maternal deaths. Medicaid pays for more than half the births in North Carolina.
At their press conference, Democrats highlighted the racial disparities in maternal and infant deaths to make their case for Medicaid expansion.
The latest state data, from 2019, shows that Black and Native American babies in North Carolina are more than 2.5 times more likely to die before their first birthdays than white infants.
“The longer we wait to expand Medicaid, the more babies we will see die unnecessarily, particularly Native American and African American babies,” said Rep. Charles Graham, a Democrat from Robeson County who is Lumbee. “This is not acceptable.”
At 6.8 deaths per 1,000 births, North Carolina has the 12th highest infant mortality rate in the nation, according the Centers for Disease Control and Prevention.
The CDC reports wide racial disparities in maternal mortality.
Black and Hispanic adults are more likely to fall into what’s called the coverage gap, where they make too much to qualify for Medicaid and too little to qualify for subsidized premiums in the health insurance marketplace, according a 2020 report from The Commonwealth Fund.
The same report said that states that expanded Medicaid had helped reduced the racial disparities in health care coverage so that Black residents in states that expanded Medicaid were more likely to have health insurance coverage than white residents of non-expansion states.
The uninsured rate in North Carolina varies wildly by race and ethnicity, said Sen. Natalie Murdock, a Durham Democrat. Nine percent of Asian -American residents are in the coverage gap she said, while 12% of Black residents and 31% of the Latinx population are in the gap.
At the press conference Insko said military veterans are among those who would benefit from Medicaid expansion.
“We should look at the broad picture of what we’re doing and who we’re hurting by not expanding Medicaid,” she said. “We’re hurting the uninsured, we’re hurting their families, we’re hurting the state because it increases the cost for everyone.”
Expanding Medicaid ensures that essential workers can live free of medical debt and fear, said Rick Glazier, executive director of the NC Justice Center. (NC Policy Watch is a Justice Center project.)
”Medicaid expansion is one of the best policy interventions the General Assembly can take to reduce health care disparities, and make sure communities of color can get the care they need particularly during a time when communities of color have borne the brunt of the COVID epidemic,” he said.
THE ROBESONIAN: Lumberton’s Rep. Charles Graham says he’ll run for North Carolina’s 9th Congressional District
LUMBERTON — Rep. Charles Graham’s announcement that he won’t seek reelection to the N.C. House and instead will run for Congress may have come as a surprise to most people, but not to the chair of the Robeson County Democratic party.
“I spoke with him about two weeks ago,” Pearlean Revels said Tuesday.
Graham, a Democrat who is in his sixth term as the representative of House District 47, announced on Monday his intention to run for North Carolina’s 9th Congressional District. The United States House of Representatives seat currently is occupied by Rep. Dan Bishop, a Republican. Bishop won the seat by defeating Democrat Dan McCready in a September 2019 special election. Bishop defeated Democratic candidate Cynthia Lee Wallace, of Charlotte, to win reelection to the seat.
Revels said that when she spoke with Graham the lawmaker only told her of his intent to run for the U.S. House seat. Graham didn’t ask for permission because he didn’t need it, Revels said.
“That’s his decision,” she said.
She does not know if any other Democrats have announced their candidacy for or expressed an interest in running for the congressional seat, Revels said.
“Not to my knowledge,” she said.
Graham said Monday he has been considering running for the District 9 seat for several years.
“I just feel like this is the right time,” he said.
It’s clear that Graham’s seat in the N.C. House is vulnerable, said Phillip Stephens, Robeson County Republican Party chairman.
“It’s a good time as his last race was terribly close,” Stephen said.
Graham edged out Olivia Oxendine, a Republican, in his bid for reelection to the state District 47 seat. Graham won 14,470 votes to Oxendine’s 13,126
The timing follows a recent attack Graham launched against Bishop that seems to position himself more left than the district typically leans, Stephens said. The 9th District fluctuates from toss-up to leaning Republican.
“Recall that McCready trounced (Christian) Cano in the Democratic primary,” Stephens said. “Though there wasn’t a huge difference in their positions, McCready did attempt to position himself closer to the center ideologically during his campaign than Cano. Graham’s positioning seems an attempt to appeal to Charlotte primary voters as he would need those big-city precincts to make it out of the primary.”
McCready defeated Cano in the Democratic primary for the 9th District on May 8, 2018.
“Graham will certainly benefit from his service in the N.C. House in terms of resume,” Stephens said. “But we still don’t know what heavy hitters Charlotte will come up with before it’s over. Having a lot of Democrat challengers would be to his favor.”
Graham’s biggest challenge will be getting out of the Democratic primary, Stephens said.
“It’s a tough campaign for a Democrat in the East up against more left-leaning big-city precincts,” he said. “His biggest hope will be for a crowded field from Charlotte, with him as the lone candidate from the East. That’s the only way he survives the Democratic primary.”
The State Board of Elections has not announced filing dates for candidates running for state and federal offices in the 2022 election, according to the Robeson County Board of Elections. The filing period for candidates seeking municipal offices will be in June or July.
In his announcement statement issued Monday, Graham said he wants to offer voters a choice in a candidate who understands the needs of rural counties and has worked as a bipartisan representative.
“After considerable thought, I’ve made the decision not to run for reelection to the North Carolina House of Representatives District 47, Robeson County,” Graham said. “It has certainly been an honor and privilege.”
Graham pointed to his 10 years of service in the House and on numerous standing committees, including being chair of the Federal Relations, Indian Affairs Committee.
“Legislation I’ve sponsored and co-sponsored has had a positive impact on the lives of Robeson County citizens economically, educationally and environmentally,” he said. “Also, I have received recognition by North Carolina Commerce as a ‘Jobs Champion’ and the North Carolina Sheriffs Association as ‘A Friend of Law Enforcement.’”
If elected to the U.S. House, he will take his experiences in the N.C. General Assembly, as a business owner in Robeson, Scotland and Richmond counties and as a retired educator to Congress and use them to work for the best interest of the people in 9th Congressional District to advance prosperity and rebuild the economy, Graham said.
“The knowledge I have of Robeson County, and rural counties in general will be a strength to advocate and legislate for programs, funding and services rural counties need,” Graham said. “I make this announcement not for personal gain, but for duty, service, and commitment to give all citizens a voice and a resource that will be of benefit economically throughout the 9th Congressional District.”
Attempts to reach Rep. Bishop’s office for comment were not successful.
RALEIGH — Lumberton’s resident member of the state House of Representatives is a primary sponsor of legislation that would expand Medicaid coverage in North Carolina.
Rep. Charles Graham’s name is first on House Bill 470. The legislation was filed in the House on March 31 and referred April 1 to the Committee on Rules, Calendar and Operation of the House.
According to a summary, the legislation would expand coverage eligibility to people with a modified adjusted gross income at or below 133% of the federal poverty level, are 19 years old or older and under age 65, are not entitled to or enrolled in Medicare benefits under Part A 35 or Part B of Title XVIII of the federal Social Security Act, and are not otherwise eligible for Medicaid coverage under the North Carolina state plan as it existed on Jan. 1, 2020.
The legislation also says the state General Assembly’s intent is to call upon hospital providers to pay the supplemental assessment or base assessment under Article 7A of GS Chapter 108A, a Medicaid Coverage Gap Assessment that will pay for the state’s share of the program and administrative costs associated with Medicaid expansion.
Graham did not respond to an emailed request for comment.
When asked about HB 470, a UNC Health Southeastern representative said leaders of the health care provider had no comment at this time.
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