Medicaid expansion in North Carolina approaches finish line after budget agreement
When legislators approve a state budget this week, about 600,000 North Carolinians will gain access to Medicaid. Lisa Franklin of Forest City is one of those people. She suffers from cirrhosis of the liver and ascites.
“Ascites is where your abdomen fills with fluid, for those who don't know,” Franklin explains.
Because she can't afford the full treatment she needs, she instead does stopgap measures like draining the fluid.
“Every three weeks I have to go for a treatment called paracentesis,” Franklin says. “So, they put a large catheter in me and drain about 12.5 liters of fluid. So, it's about 30 pounds that I have removed every three weeks. It's expensive, too.”
Because of her health condition, Franklin is unable to work and doesn't qualify for assistance on the Health Insurance Marketplace. She has strong family support and has received help through a GoFundMe. But what Franklin really needs is a new liver, and she can pay for that only when she's on Medicaid. She had coverage while her son was a minor, but he turned 18 in January.
She's one of hundreds of thousands of North Carolinians who will get Medicaid once it's expanded. That was supposed to have happened already, but got delayed when Republican leaders in the House and Senate couldn't agree to a budget.
The situation became even more dire earlier this week when legislators proposed that Medicaid expansion be linked to a bill allowing casinos to operate in the state. Late Tuesday, that was decoupled, and legislative leaders said they had the framework of a budget deal, again putting Medicaid expansion on track. Franklin says the fight is not over.
“I am relieved that the N.C. General Assembly is not going to be gambling with my life by using Medicaid expansion as a bargaining chip to force a vote on casinos and video slot machines,” Franklin said in a statement Wednesday from the North Carolina Justice Center. “But I still want them to know how important it is to expand Medicaid as quickly as possible for people like me who get stuck in the middle of these political games.”
Advocates with the liberal-leaning North Carolina Justice Center have been pushing for the state to accept the federal government’s coverage for hundreds of thousands of low-income adults since the passage of the Affordable Care Act in 2010. For more than a decade, the Republican-led General Assembly rejected expansion, until Senate leader Phil Berger (R-Rockingham) reversed course this year.
Justice Center deputy director of the health advocacy project Hyun Namkoong says more North Carolinians could have benefitted if the state had expanded earlier.
“Some people have died with us on this journey,” Namkoong said.
Once the budget passes, Namkoong says she will work to get all 600,000 newly eligible North Carolinians signed up.
"I think that's when I will really realize that this is real,” Namkoong said.
Final budget votes could happen as soon as late Thursday night, which would finalize Medicaid expansion in North Carolina.