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Charlotte NC

Sick of the never-ending health insurance debate? So are neighbors Constituents want safety net strengthened

September 27, 2017

Jean Busby had no idea dehydration could be so expensive.


After feeling dizzy and thirsty during a rally at the state capitol, the Charlotte resident was rushed to a Raleigh hospital, where she learned the hard truth about health insurance.

"I'm not old enough for Medicare right now, but I do have a pre-existing health condition," said Busby, a diabetic who was tagged with a four-digit medical bill for an emergency room visit and overnight treatment. "I got dehydrated and had to go to the hospital and the bill is $4,000. They're calling me constantly, saying ‘can you pay $500 a month,' ‘can you pay $200 a month?' No, I can't pay that kind of money because I've got to pay my other bills. Emergency room, one night, $4,000. That's ridiculous."

Busby, who recounted the episode last month at a Charlotte rally marking the 52nd anniversary of Medicare, the federal health insurance program for seniors, isn't alone.

American health insurance is a battlefield, where skirmishes over costs and access have raged since the Patient Protection and Affordable Care Act became law in 2010. Medicine accounts for one-sixth of the nation's economy and Americans are paying more for private coverage, or in the case of Medicare, taking on a heavy tax burden.

"Health care should be for everyone," said Mary King of Charlotte, who has been treated for a pair of back injuries, including surgery after a head-on auto collision. "It should not just be for the rich."

The most recent skirmish took place July 28 in the U.S. Senate, where the Republican majority failed to pass a so-called "skinny repeal" of the Affordable Care Act. According to the non-partisan Congressional Budget Office, the bill's rollback of individual and employer mandates and removal of $880 billion from Medicare funding would cut 17 million Americans – 1 million in North Carolina – from insurance rolls immediately. The bill would have defunded Planned Parenthood, as well as hospice and senior care centers. The vote was 51-49 against with North Carolina's senators, Republicans Thom Tillis and Richard Burr, favoring repeal.

"Senators Thom Tillis and Richard Burr have made a lot of noise about being independent legislators who care about their constituents, but their support for the so-called ‘Skinny Repeal' version of Trumpcare shows that their high-minded words are nothing but hot air," said Gerrick Brenner, executive director of Progress NC Action. "Late-night votes on bills crafted in secret and released minutes before the vote might be commonplace in North Carolina, but the American people deserve better. Senators Tillis and Burr should be ashamed of themselves for supporting Donald Trump and Mitch McConnell's failed attempt to demolish the American health care system, especially after Tillis and Burr refused to hold a single town hall meeting with their constituents."

The stakes for North Carolina

North Carolina is in the bottom half of states in terms of health care. The personal finance website WalletHub found the Tar Heel State is 47th in average monthly insurance premiums, 38th in the number of insured adults age 18-64 and 31st in insured children up to age 17. An ACA rollback would result in 164,000 N.C. children losing insurance coverage, tripling the percentage of uninsured kids in the state according to the CBO's estimate.


"Healthcare is not a partisan issue," said U.S. Rep. Alma Adams, a Charlotte Democrat. "As elected representatives, we have a sacred responsibility to ensure that every American has access to quality and affordable healthcare. Instead of honoring this commitment, Republicans have held Congress hostage for months with attempt after attempt to strip millions of Americans, from 22 million to 32 million, of healthcare. This is unacceptable and enough is enough."


While the repeal drive has temporarily receded in Congress, it hasn't gone away as President Donald Trump and GOP leaders look to cobble new legislation.
"The majority of members of Congress made a promise to the American people to repeal and replace Obamacare with solutions that will help control the cost of premiums and provide more choices and flexibility for families and individuals," Tillis said after the "skinny repeal" failed. "While [the] vote was unsuccessful, we cannot accept the status quo as Obamacare continues down an unsustainable path, and Congress has an obligation to keep pursuing solutions to fix our nation's broken health care system."


Said Burr: "I am disappointed that the Senate could not pass legislation to address the health care crisis facing our country. Though we were unable to come to a resolution, our health care system is still broken, costs continue to rise, and Americans have fewer options for health care coverage. I will continue to keep my promise to North Carolinians by working to provide relief to families burdened by the unbearable weight of Obamacare."


The Trump administration has moved to dismantling some ACA tools, including cutting the ACA enrollment period from 90 days to 45, refusing to guarantee subsidies to keep premiums down, and using taxpayer money intended for advertising the exchanges to attack the ACA instead. ACA supporters accuse the president of sabotaging the law and destabilizing insurance markets.


"The Trumpcare debacle shows that Republicans have no workable solutions for improving the American health care system, and they should get out of the way instead of continuing to make things worse," Brenner said.


The insurance battle is also being waged in North Carolina, which is down to a single carrier – Blue Cross Blue Shield – on the federal exchange after Aetna dropped out the marketplace last year. Gov. Roy Cooper tried to extend Medicare access to low-income residents, only to have the Republican-controlled General Assembly challenge his authority in court.


Progressive activists are becoming increasingly enamored with a single-payer model – usually referred to as Medicare for All – in which one agency, such as the federal government, organizes funding. Advocates say it would insure more people and provide stable funding for North Carolina's health care providers. Without ACA insurance, increased indigent care costs in the state would rise by an estimated $2.8 billion by 2019 and 76,000 jobs would disappear. Rural areas would be hit particularly hard, as well as lower-income communities.


"I'm really behind Medicare for All," Busby said. "With health care, people can take care of themselves much better instead of when they get really, really sick and they have to go to the hospital."