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Republicans refusal to compromise on Medicaid expansion leaves out vulnerable, often forgotten, North Carolinians

The refusal of Republican lawmakers to come to the table on Medicaid expansion not only attacks health care access of many residents planning to enroll or re-enroll in Medicaid in November but also puts vulnerable North Carolinians at serious health risk.

North Carolina received a D in women’s health via a state commissioned report The study found that women in NC face higher rates of mortality than in most states, and mortality rates are even higher for Black women.

There are no similar studies that examine health outcomes for LGBTQ+ people in North Carolina. LGBTQ+ people are constantly marginalized, not just in health care. They also face greater complications pursuing employment and housing discrimination.

People with pre-existing conditions and disabilities would also be left vulnerable in a budget without Medicaid expansion. Disabled people have not been included in considerations about Medicaid expansion, yet comprise a big part of the umbrella of people who benefit from Medicaid. While some disabled people currently qualify for Medicaid, the requirements don’t cover people who have been disabled for less than a year, nor does it cover disabled people who make over what is considered a “gainful income” by Social Security.

There’s also the sad reality that one in five early childhood education teachers lack health insurance. Coupled with a history of Republican budgets that fail to fund pre-K, early childhood educators without health care access have to navigate even more barriers to doing their jobs.

Some House Republicans offered a “compromise,” that would extend Medicaid expansion to people with jobs and would require participants to pay a premium for coverage. H655 ignores the challenges of many marginalized populations who face job and housing insecurities, often due to discrimination. (Notably, some of these needs were also stressed in Governor Cooper and Democratic lawmakers’ opposition to the budget.) With the omission of Medicaid expansion, a budget without a clear path to increased access to affordable health care could lead to an increasing strain on a medical system that is already struggling to meet the needs of all of its citizens.

These substantial gaps in health between women and men, Black women and white women, or cis and trans North Carolinians will continue to widen until health care becomes a funding priority. The conversation about Medicaid expansion should not be delayed for the political convenience of lawmakers privileged to receive adequate health care when many of their constituents have already suffered consequences. 

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