By Peg O’Connell, Chair, Care4Carolina
Days before Sam, a young woman of Eastern North Carolina, was scheduled to serve, the U.S. military refused to enlist Sam due to a few hundred dollars due to medical providers. Unaware of her medical debt, Sam suddenly had no job or place to live – all because she was in North Carolina’s health insurance coverage gap.
This is how I came to learn of Sam’s situation and was lucky to get to know her. It was her dream to serve in the armed services. She had a difficult childhood and cared for her younger sister. As her sister’s high school graduation drew near, Sam knew it would soon be her time to enlist. She kept herself in good physical shape, studied hard and took the tests. She scored well. She was working with her recruiter all along.
As the day approached to depart for basic training, Sam quit her civilian job, gave up the lease on her apartment and said goodbye to friends and family. But the military, having just learned of Sam’s medical debt, turned her away. The promising young woman’s dreams were shattered.
The issue of medical debt is usually a story of numbers and all of these numbers are important, but as you can see from Sam’s situation, the issue of medical debt is also a personal one and impacts thousands of people in North Carolina.
According to a study by Georgetown University, North Carolina has one of the highest levels of medical debt in the country. Three of the top five counties for medical debt are here—Greene, Lenoir and Anson counties.
One of the reasons that North Carolina finds itself in this dubious leadership position is our failure to expand Medicaid. Seventy-nine of the 100 counties with the highest level of medical debt are in states that have not expanded their Medicaid programs.
Every year in the United States, an estimated 530,000 families turn to bankruptcy because of lost work from medical issues and the associated bills. Many of these families are here in North Carolina.
According to the National Bureau of Economic Research, Medicaid expansion “significantly reduced the number of unpaid non-medical bills and the amount of non-medical debt sent to third-party collection agencies.” Expanding health coverage for people caught in the gap not only provides access to health care without the risk of bankruptcy, but it also helps people keep up with all their other expenses like housing and buying food.
The story of Sam is shocking and heartbreaking, but it is not just the story of one young woman. This is the story of 600,000 North Carolinians. Unplanned medical expenses or an emergency room visit can ruin people’s lives. Unpaid medical expenses go on credit reports and prevent people from getting jobs, decent housing and transportation. For our state, this is a shame. We know how to fix this problem, and now we simply have to find the will to do it.
As for Sam, she may yet get to join the military and achieve her dream. With the help of some friends, she has been able to pay off her medical debts and is studying to take the military entrance exams again. She has a shot at a bright future. But what about the 600,000 other North Carolinians. We now must expand Medicaid for them.