GOP senators say expanding Medicaid in NC is OK. How about adding: ‘Sorry for the delay’?
The day after the Republican-led state Senate ended years of opposition and approved a bill expanding Medicaid, I called a doctor who has long been outraged by the human cost of lawmakers’ refusal to expand the health insurance program for low-income people.
Despite the Senate vote, he’s still outraged.
Dr. Pradeep Arumugham, a Kinston cardiologist who generously treats uninsured patients, welcomes the Senate’s support for expansion, but he knows Republicans in the state House still oppose it. While the impasse drags on, some of his patients continue to die for want of health insurance.
Two months ago, it was a 29-year-old female uninsured patient who died. Now he’s fearful for the life of a 23-year-old man with “a very weak heart” who lost his job, his insurance and his access to the drugs and procedures that could save him.
“He needs medicines, then he needs to have a defibrillator put in. That’s about $100,000. Then he may need to be put on a heart transplant list, but no one will put you on the list without insurance. It’s a Catch-22,” he said. “It’s just sad.”
Republican lawmakers “had no good reason to wait,” Arumugham said of the nearly decade-long refusal to expand Medicaid. “The situation has only gotten worse with the pandemic.”
Now there is a crack in the Republican lawmakers’ resistance, mostly because Senate leader Phil Berger has had an epiphany after opposing expansion since 2013. He now sees what is obvious to anyone with a calculator and a heart – Medicaid expansion makes sense in financial and human terms.
Arumugham has heard the eerie toll of the legislature’s resistance through his stethoscope. He has listened to the damaged hearts of uninsured patients who won’t be able to get the help they need. It’s hard for him to forgive the legislature’s callous resistance even as the Senate has finally relented.
“What I would like to do is scream and say, ‘You guys killed a lot of people along the way,’ but I don’t want them to get pissed and not do [expansion],” he said.
Supporters of expansion don’t want to discourage Berger’s new view by bringing up how his conversion now proves his past reasons for opposition hollow. His main worry was that the federal government would renege on its promise to cover 90 percent of the cost of expansion, but that concern could have been resolved by making expansion contingent on federal funding not decreasing. He also said the state’s recent shift to managed care for the Medicaid program made it better prepared to accept expansion now, though the program has been running a surplus every year since 2014.
Remarkably, Berger said he was also moved by a fellow Republican who told him that a single mom with two children making around $25,000 would have too high an income to qualify for Medicaid unless it is expanded. “That’s one thing my perspective has changed on,” he said, adding: “Life just beats her down. And if there’s something we can do to keep that from happening, we ought to take that opportunity.”
People have been telling Berger about people in such circumstances for years. Was he listening?
Thirty eight other states have taken the opportunity to help by expanding Medicaid. In November, South Dakota will vote on becoming the 39th.
Before the Senate’s turnaround vote, Sen. Mike Woodard (D-Durham) opened the session with a prayer that pointedly referred to the road to Damascus where Saul of Tarsus, a persecutor of Christians, heard the voice of Christ and went on to become St. Paul.
St. Paul embraced his new faith by repenting. It would be nice if those longtime skeptics of expansion who’ve now become believers would also show contrition.
Certainly, an apology is owed to the families of those who died or those who suffered unnecessarily when access to Medicaid was what they needed. Yet, year after year, GOP senators blocked the way, and Republicans in the House now appear likely to continue that shameful obstruction.
