Rejoice at NC’s Medicaid expansion. Mourn that it took so long | Opinion

I should be celebrating that Medicaid expansion is now just a governor’s signature from becoming law in North Carolina. But I’m having trouble corralling my anger knowing this should have happened 13 years ago. I can’t ignore the untold number of lives we lost, the unnecessary suffering caused by rank hypocritical politics that kept necessary health care from reaching maybe 600,000 North Carolinians.

There was no good reason to deny the billions of federal dollars that have been on offer since the passage of the 2010 Patient Protection and Affordable Care and Act colloquially, and sometimes derisively called Obamacare. The federal government vowed to pay 90 percent of the expansion to help the neediest residents in North Carolina and throughout the country. During covid, they upped that to 95 percent. When all the accounting is done, the state might see $8 billion in additional funds a year for health care with expansion.

And yet, the Republican politicians who think themselves “pro-life” knew it was better for their political fortunes to gin up phony outrage about phony “death panels” and false claims of a federal takeover of health care. Even Utah Sen. Mitt Romney, who helped create a universal health care system in Massachusetts when he was governor of that state, all about disavowed his own program in order to secure the 2012 Republican nomination for president.

What’s more is that Obamacare reduced the number of abortions by the hundreds of thousands annually, which is one of the primary reasons the abortion rate hit an all-time-low when Barack Obama was in office before seeing an increase for at least two consecutive years after Donald Trump took office and began trying to dismantle it. That’s right. There is a way to reduce the number of abortions without turning over a pregnant woman’s body to the state for nine months. That’s why those political decisions must be considered among the most callous in recent memory, particularly because Republicans used the irrational fear of the people who would have been among Medicaid expansion’s primary beneficiaries – the white-working class – to subvert health care reform.

Still, I guess I should applaud North Carolina Republicans who are now accepting what they should have 13 years ago given that most of our Southern neighbors continue refusing that life-saving care. South Carolina and Georgia still haven’t expanded Medicaid. Tennessee, Alabama, Florida, Mississippi and Texas are among the 10 states who will remain mired in this political ugliness after Medicaid expansion in North Carolina becomes an on-the-ground reality maybe next year.

It will be easier for residents of North Carolina to prevent conditions from becoming chronic, or chronic diseases from worsening beyond the point of no return. Hundreds of thousands of lives will be improved every year, while thousands will be saved. It will give more people a realistic chance of successfully fighting or avoiding killers such as heart disease and stroke in an area where those things are far too prevalent.

That’s what has been most disheartening about the Republican decision to use health care access as just another political tool to gain or regain power, the lives unnecessarily lost, the prolonged suffering of many that could have been curtailed. In one study, Medicaid expansion saved nearly 20,000 lives between 2014 and 2017 compared to 16,000 lives lost in states that did not accept the expansion, according to the Center on Budget and Policy Priorities.

What’s more, Republicans in North Carolina watched as rural hospitals were dying on the vine the past 13 years, with nine more at risk of closing even now. Medicaid expansion will help on that front, though the legislature will need to do even more to ensure rural residents will be able to easily access care.

We should rejoice that needy North Carolinians will soon get access to the care they need. We should weep that it took so long.

Issac Bailey is a McClatchy Opinion writer based in Myrtle Beach, SC., and is the James K. Batten Professor of Public Policy at Davidson College.