As I continued to make my way through the crowd, I saw signs about Medicaid Expansion. They reminded me of the nationwide healthcare debate that arose as President Obama and Congress passed the Affordable Care Act, commonly referred to as “Obamacare”. North Carolina chose not to comply with the ACA’s plan to provide affordable insurance to all Americans, making North Carolina 1 of 26 states to refuse to expand Medicaid. (1) However, this seemed more like a policy issue than a moral one. I wondered what brought these protesters to the Moral March and what made Medicaid Expansion a moral issue to them.
(1) Adam Searing, "How NC (surprisingly) became a leader in ACA enrollment", newsobserver.com (Jan. 28, 2014).
A major goal of the Affordable Care Act was for uninsured Americans to sign up for subsidized insurance plans via government insurance websites. Although North Carolina refused to participate in the ACA, citizens were still able to go online and register at www.healthcare.gov. In fact, by January 2014, 107,778 North Carolinians had signed up for one of these insurance policies. (1)
Healthcare costs- paying doctors and hospitals, buying prescription medications, etc- are incredibly expensive without insurance. However, not all North Carolinians can afford to purchase insurance policies. Under the ACA, individuals were to be subsidized based on income. Those with incomes below a certain level were to receive Medicaid under the new expansion. But because North Carolina didn't expand Medicaid, 318,710 citizens are left with no means to purchase insurance. These are the people that traditional Medicaid leaves out: childless, non-disabled adults below 138% of poverty level who are too poor to purchase insurance plans on their own. These people make up 28% of North Carolina's uninsured population. (2)
I walked up to a healthcare provider at a Planned Parenthood table and asked, "What happens if an uninsured person gets sick or hurt and requires healthcare or hospitilization? How do they pay?" She explained to me that hospitals and emergency rooms are required by law to give care to the uninsured. Medicaid funds are paid to hospitals afterward as reimbursement for this care, yet another reason that many healthcare providers feel Medicaid should be expanded. (2)
Republicans in Raleigh, including North Carolina's Gov. McCrory, are generally against Medicaid because they see Medicaid as too expensive and don't want to expand an already large goverment program. However, by refusing to expand Medicaid, there are thousands of North Carolinians left without access to healthcare. This policy issue is also a moral issue because it raises the question: "Do all North Carolinians have the right to affordable healthcare?" If the answer is yes, then many would say that North Carolina isn't meeting a moral obligation to its citizens under the current system.