By Heather Burkhardt, Executive Director, NC Coalition on Aging
Medicaid expansion will help an estimated 34,000 middle-aged, low-income North Carolina workers to remain healthy and productive while improving their finances for retirement.
Most of them are childcare, healthcare, and retail workers as well as farmers and others in physically demanding jobs. By middle age, chronic conditions such as diabetes, heart disease, arthritis, chronic obstructive pulmonary disease (COPD), and cancer are starting to take their toll. In fact, seven out of 10 of these workers have at least one chronic condition; 37 percent have two conditions and 14 percent have three.
Being aged 55-64, they are too young for Medicare. Unfortunately, they are among the 600,000 North Carolinians who fall in the ‘coverage gap.” Their income is under the threshold for regular to qualify for a premium subsidy for private insurance under the Affordable Care Act and they are too young for Medicare.
Closing the coverage gap would put a new “Medicaid card” in their wallets. Allowing many to afford to find a regular doctor, get help filling prescriptions, and obtain treatment for such serious issues as addictions, mental illness, diabetes, COPD and heart disease. More than 400 studies document how expansion increases access to care, improves health outcomes, saves lives and enables more persons to get and keep jobs. In expansion states, persons with disabilities are significantly more likely to be employed.
Considering lives saved in expansion states and a higher death rate in non-expansion states, one study estimated that North Carolina lost an extra 1,400 lives in persons aged 55-64 over four years.
The affordable care also increases food, housing and financial security in this low-income group. A 2020 study found that persons aged 50-64 saved between $496 and $648 per year on out-of-pocket medical costs under expansion. They can make regular rent and mortgage payments and avoid medical debt. In expansion states, a higher share of the workforce has jobs.
As for the “big picture,” expansion is an engine for economic growth. It injects $5 billion into North Carolina’s economy and has multiple “ripple effects” in creating jobs. It will stimulate another $200 million per year in state revenue and $43 million for localities.
With the state needing to fill over 182,000 direct care openings over 10 years, the new revenue would create an estimated 21,000 new jobs in that sector. After the ACA began, expansion states saw job growth significantly above on-expansion states (2.4 percent versus1.8 percent).
In summary, Medicaid expansion is a great investment to strengthen and enrich the lives of North Carolinians entering the Third Age. Info: www.nccoalitiononaging.org.