Fayetteville mom: With no Medicaid expansion, people like me face tough choices

I’m a single working mother of two growing boys. Although I work full time, I don’t have health insurance, which makes the struggle to support me and my sons that much harder.

I’m one of the millions of Americans in the Medicaid coverage gap. I live in a state that has not expanded Medicaid to cover people like me who earn too much to qualify for regular Medicaid, but still make too little to afford private insurance. 

At my last job, I was held up at gunpoint and robbed. I would have benefited from counseling afterwards, but without healthcare coverage, I can’t afford that kind of treatment. In fact, without insurance, most of my healthcare guidance comes from the internet, family and friends. I often rely on my Grandma's home remedies, which sometimes work but can’t treat some conditions, like my heart murmur or my depression. 

But now, there’s a new opportunity to finally get help for people like me. Congress has already taken its first steps toward approving President Biden’s Build Back Better package, which includes a program that would close the Medicaid coverage gap and extend healthcare coverage to millions of people. For my family and countless others, it’s crucial that this provision be part of the final bill passed by Congress and gives us an opportunity to finally get health insurance. 

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Right now, politics is standing in the way of Medicaid coverage. North Carolina is one of 12 states that have refused to expand Medicaid because of partisan opposition to the Affordable Care Act that really has nothing to do with helping people stay healthy or treating sickness. For a decade, lawmakers in states like mine have continued to put politics over health care, rejecting Medicaid expansion despite increased funding from the federal government during implementation of the ACA and additional incentives created by the American Rescue Plan earlier this year.

Even during a pandemic that has claimed over 13,600 lives, North Carolina lawmakers refused to expand coverage to 207,000 who would be eligible for insurance under the program. The failure of our state lawmakers to expand Medicaid has had devastating consequences. Because I don’t have health coverage, I have to make tough choices every day between basic health care needs and other essentials like rent and food. 

Without health insurance, my only option is to go to an emergency room when I have an acute medical problem. After a recent visit to the ER, I had to spend my last few dollars on a prescription they provided, leaving me with no money. I ran out of gas on the way home and then got an astronomical bill from the hospital.

There are hundreds of thousands of people like me in North Carolina. They may not look on the outside like they are struggling with these kinds of choices, but many are making decisions about which bills to pay in full, which bills to make partial payments on, and what they are going to forego to make ends meet.

Closing the coverage gap is long overdue and has already caused needless suffering, hardship and even death for some people. Had legislators in our state expanded Medicaid years ago, we could have prevented the death of 1,400 people aged 55-64 between 2014 and 2017 alone.

Under the Senate’s proposal, people in the coverage gap could receive affordable coverage with no copays. Among those who would be eligible, 65% are in working families like mine and nearly half are people of color. In North Carolina, 7,000 are children. 

Closing the coverage gap would not only provide people critical health access, but also improve economic security and address the sharp racial health disparities that persist in our state. We can’t build back better while leaving millions of people behind and continuing the same unfair patterns.

No matter where someone lives, what they look like, or how much money they make, we should all have access to the healthcare we need to take care of ourselves and our families. Since our General Assembly won’t do it, Congress must close the coverage gap for millions of Americans who have been denied coverage by passing it with the Build Back Better package.

Christine Burk is a member of Action NC's Race and Gender Equity (RAGE) initiative. She lives in Fayetteville.

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