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WPTF Staff
Medicaid expansion was recently passed by the North Carolina State Legislature. Beginning on December 1, 2023 adults from age 19 through 64 who earn 138 percent of the federal poverty income guidelines may now be eligible for Medicaid.
According to the North Carolina Healthcare Association, 600,000 people are now eligible to receive benefits but just over half of that number, 346,408 people, have enrolled. Since expansion began, the program has covered more than 265,000 prescriptions for new enrollees for things like heart health, diabetes, and other illnesses and paid more than $4.8 million in claims for dental services.
Brian Floyd, the Chief Operating Officer of ECU Health, joined WPTF and the North Carolina News Network to talk about what Medicaid expansion means for North Carolina. You can listen to the full conversation here.
ECU Health provides care in 29 counties throughout Eastern North Carolina. In addition to outpatient facilities, home health care, hospice services, and about 120 clinics and wellness centers, ECU Health has its flagship academic medical center in Greenville as well as eight community hospitals.
Brian says that Medicaid expansion is critical, especially in North Carolina, where there are a lot of rural communities. In a state like North Carolina, where two-thirds of the population lives in rural communities – particularly in the eastern portion of the state – Brian says, “Medicaid expansion is critical to help folks who don’t have access to insurance, and who don’t believe that they have access to coverage, seek medical care.” He adds that “People in rural communities tend to have a lot of chronic diseases…so this helps them get preventative care and save money in the long run.” One of the misconceptions is that people who work cannot get Medicaid. That is no longer the case.
Having access to medical care also helps communities financially. Brian says, “…we really know having access in the long term helps them both financially as well as in the quality of life.”
Medicaid coverage also includes dental care, which, Brian says, is so important for overall good health. “Unmanaged dental care leads directly to endocarditis and bacterial infection in the valves of the heart, even, that lead to open heart surgeries to correct that.
As of this writing in March 2024, a total of 41 states, including the District of Columbia, have passed Medicaid expansion. Most of the governing bodies of those states have considered the long-term costs of healthcare in the state when deciding to expand Medicaid services. Floyd believes that the long-term savings make the short-term costs worthwhile. “In the long term over one’s life, it is so beneficial that you have preventative care early, maintenance of chronic diseases, you see your doctors regularly, and manage your health over a lifetime. And that’s why it’s so important to North Carolina, because the long-term costs…we’re all paying for each other.”
He adds, that “if you want to know how healthy people are, and what their cost of care is going to be, you can look at social determinants and the socioeconomics of the community.” Rural communities look different from urban communities. Fewer resources and a lower density of people are among the items that require more support for rural communities.
North Carolina, he says, has the second-largest rural population in the United States. It requires, therefore, the kind of attention that requires ECU Health to set, as its mission, “We’ve set our target to be the national model for rural healthcare delivery.” The community they serve is as large as the state of Maryland.
When Medicaid Expansion passed, it included the Healthcare Access and Stabilization Program (HASP). HASP is a separate program from Medicaid expansion, but HASP payments allow hospitals to help cover the hospitals’ portion of what is required for Medicaid expansion. The program will help boost Medicaid reimbursement for hospitals at a rate closer to the cost of care. Hospitals typically receive only 72 cents for every dollar spent on providing care to Medicaid beneficiaries and uninsured individuals. This leads to an annual reimbursement gap of $2.3 billion.
Brian says that many hospitals around the country – particularly those in rural areas – operate in a state of financial insecurity. HASP funding helps strengthen those hospitals so that they can operate in a more fiscally sound way.
For more information on Medicaid expansion, or to determine eligibility, visit Medicaid.nc.gov or call the North Carolina Medicaid Center at (888) 245-0179.
This interview was sponsored by the North Carolina Healthcare Association (NCHA) and facilitated through a partnership between the North Carolina News Network, WPTF, and NCHA. Brian Floyd, R.N. M.B.A., is the Chief Operating Officer of ECU Health and a member of the board of the North Carolina Healthcare Association. Kristine Bellino is the Vice President of News and Information Programming for Curtis Media Group. Stephanie Strickland of the North Carolina Healthcare Association also contributed to this article.
You can listen to the full conversation here.