Despite state budget delay, Governor Roy Cooper lauds Medicaid expansion on trip to Hamlet
Matt Lamb, Richmond County Daily Journal, Rockingham, N.C.
9 min read
Aug. 16—HAMLET — Sarah Goodwin Sheperd was born and raised in Richmond County. A hard worker, mother, and wife; in 2018 an unexpected medical emergency befell her family.
Her husband was diagnosed with a frontal lobe brain tumor. Then, in 2021, Sarah, herself, was diagnosed with colon cancer.
Luckily, throughout the duration of Sarah and her husband's treatment, they had a family Medicaid plan to lean on and combat the exorbitant healthcare costs associated with cancer care.
On Monday, August, 14, 2023, Sarah received a devastating letter in the mail. Given her family's collective income, as of August 31, they will no longer be able to receive Medicaid coverage.
Sarah's story is the story of thousands of North Carolinians across the state.
Accordingly, Governor Roy Cooper has spent the week traversing North Carolina, traveling to counties with recent hospital closures, and discussing Medicaid expansion with local officials, business owners, healthcare providers, and law enforcement.
Convening at the historic Hamlet Depot Wednesday morning, Governor Cooper was flanked by: Chairman of the Richmond County Board of Commissioners, Jeff Smart, Hamlet council member, Abbie Covington, Hamlet Police Chief, Dennis Brown, owner of Busy Bees Academy and Learning Center, Aleacia Lambert, CEO of Sandhills Best Care, Dr. Tammie Gainey, North Carolina Department of Health and Human Services Secretary, Kody Kinsley, and cancer survivor, Sarah Goodwin Sheperd.
In March, with bipartisan support in both the House and Senate, Governor Cooper signed House Bill 76 — Access to Healthcare Options, into law. Unfortunately, implementation of the Medicaid expansion legislation is coupled with the passage of the North Carolina budget.
Despite majorities in both the House and Senate, North Carolina Republicans remain at an impasse regarding two different versions of the state budget. The budget was supposed to have been passed in July.
Nonetheless, Governor Cooper is optimistic for North Carolinians dealing with health insurance insecurity.
"The good thing is that we have a strong bipartisan commitment and vote from the General Assembly to expand Medicaid. We celebrated that in March, going to bring health insurance to more than 600,000 working North Carolinians, and we are grateful for that," Cooper said.
Cooper explained that North Carolina is losing big federal government dollars everyday that a budget is not passed.
"We've turned away about $2 billion in money from the federal government that could go to provide health insurance to our people, and in fact every month that goes by, we are turning down $521 million a month with our taxpayer money that we all pay to Washington, that could come back to North Carolina," Cooper said.
Cooper's round table discussion at the Depot was aimed at highlighting challenges in Richmond County that could be mitigated with state Medicaid expansion.
Dr. Tammie Gainey, CEO of Sandhills Best Care, illustrated the difficulty in providing comprehensive mental health care for patients who are uninsured.
"Over the past few months, we have seen a decline in some of our patients who receive care, and now they are going without care," Gainey said, as a result of the recent culling of Medicaid rosters.
Gainey said patients who need mental health care but are uninsured frequently forgo treatment, and by the time they seek care, they are already in crisis. Additionally, she said some patients are able to cover the costs for provider visits but are unable to afford the requisite medications.
Uninsured patients also limit the sustainability and longevity of clinics and hospitals, Gainey said.
"One of the barriers is uncompensated care for our clinics and our hospitals, right, and that can lead to them being shut down prematurely," Gainey said.
Hamlet Council member Abbie Covington echoed Dr. Gainey's concerns, where Richmond County citizens are going without treatment.
"I think the biggest issue, like Dr. Gainey said, is that people, there's a choice there, they can seek care knowing there's no compensation, or they can decide to postpone care, which to me, is worse than seeking care in an uncompensated manner. They just, you know, they [say] 'I don't have insurance, I can't afford the copay, I can't afford the medicine,'" Covington said.
Covington said many of her constituents and citizens throughout Richmond County suffer from diabetes and hypertension.
"We have a high rate of diabetes and hypertension, and people go unmedicated because, particularly the diabetes, the cost of insulin or insulin drugs is extremely expensive. The consequences then turn out to be much more expensive than treatment is. It's kind of a compound fracture at that point," she said.
Governor Cooper asked Aleacia Lambert, owner of Busy Bees, about the struggles she faces as a small business owner, and the struggles of her employees, many of whom fall inside the insurance gap, between open market insurance affordability and Medicaid.
"As a small business owner, again, we work to work, meaning that, you know, what we make goes back into our business most of the time, or goes back into our staff." Lambert continued, "Being a small business, sometimes we have to deal with staff being out of work because they have an issue, they can't go to the doctor, so they go home and self-medicate."
Lambert is excited for the prospect of Medicaid expansion. "Having the Medicaid expansion will be great for a small business owner, because it will fill that gap," she stated.
Chairman of the Richmond County Board of Commissioners Jeff Smart has a unique perspective; He is an elected official and small business owner at Mabry's Drug and Home Care in Hamlet.
"From the chairman side of Richmond County, that portion, this is not political to me, it's something that our county needs, we have, we are at 45% currently of people in Richmond County on North Carolina Medicaid, so that tells you where we are from a rural standpoint," Smart said.
Smart also witnessed the ramifications of an increase in prescription copays at his pharmacy, where patrons were unable to afford the difference, and some had to fill their medications less frequently.
Following Chairman Smart's insight, Governor Cooper explained his perspective on insuring Americans.
"I believe that we live in the richest country in the world, we ought to find some way to make sure that people have health insurance," Cooper said.
Hamlet Chief of Police Dennis Brown conveyed the seemingly insurmountable feat law enforcement officers have navigating addiction and mental illness in Richmond County.
"We don't have the resources here, we have to rely solely on hospital care treatment when it comes to our mental folks, mental health folks, and same thing Dr. Gainey and Ms. Lambert has already said, what we are finding are our folks that are going through mental health crisis are self-medicating. They know they need help. The hospital has become a negative place for them. They don't want to go to the hospital anymore, so they are treating themselves with illegal narcotics or substances that you can find on the streets," Brown explained.
Brown feels like the crisis is at its apogee in Richmond County.
"They'll go to the hospital for an evaluation. Medicare will only cover a certain percentage of treatment. If there's not a facility available that will take them — usually isn't, because they don't have health insurance, they are released back on the street — no follow up assistance," he said.
Brown continued, "We've had officers assaulted that are dealing with mental health issues now. We've had to place folks that do not need to be incarcerated in jail because they have turned violent. We've reached out to adult protective service, they won't help, we've reached out to their care provider — whoever that is, they won't help, what do we do, where do we go," Brown said.
Governor Cooper asked Brown what percentage of time Hamlet officers are spending with people who have mental health or addiction issues.
"I think the better question is what time do we not spend on those issues," Brown said. Brown looks forward to Medicaid expansion, where citizens that need treatment, not incarceration, are able to receive services.
Secretary of the North Carolina Department of Health and Human Services Kody Kinsley described the logistics of the plan's rollout to the panel.
"Because of some amazing work of our team, on day one that we go live, we'll be able to put 300,000 people that are currently in a family planning benefit, which I'm sure you're familiar with — it's a much less benefit, we'll be able to put them into full coverage on day one. So that means folks that you are seeing currently, that are having to pay out of pocket, are going to be able to all of a sudden have the coverage that they need," Kinsley said.
Kinsley illustrated why Richmond County will benefit tremendously from expansion. He said that rural communities are three to four times more likely to be uninsured than their urban counterparts. Additionally, 80% percent of the recipients of insurance through Medicaid expansion are working families, like most of Richmond County.
"I have long believed that the lack of Medicaid expansion has been an unfunded mandate on our local communities and county governments, and we have got to turn the tide here," Kinsley said.
Long time Rockingham Mayor, state senator, and now chairman of the Economic Development Partnership of North Carolina Gene McLaurin thanked Governor Cooper for traveling to Richmond County, and spoke on the ancillary benefits to Medicaid expansion.
"Another benefit to expanded Medicaid is the number of jobs that will be created, particularly in the health care field, you know, we'll be able to provide more people more opportunities for employment all across the state. The last estimate I saw was over 30,000 jobs across the state could be created if we would go ahead and make that decision, and when I say we, I mean the legislature, it's in their hands," McLaurin said.
McLaurin closed, imploring those in attendance to reach out to their legislators and impart to them the importance of getting a budget passed, and freeing up the Medicaid expansion bill to be implemented across North Carolina.
