by Sara Pequeño
More than 1 in 10 people in North Carolina are living without health insurance. They’re working in construction, retail or manufacturing. They’re cooks and nursing assistants, janitors and truck drivers. From the Nantahala Forest to the Outer Banks, the uninsured are our neighbors and community members.
North Carolina has been talking about Medicaid expansion for more than a decade, but Democratic initiatives to get more people insured have been repeatedly blocked in the Republican-led House and Senate.
Even though it looks like the state budget could possibly include expansion this year, N.C. House Speaker Tim Moore said last week that Republicans will not approve the state budget if it includes Medicaid expansion.
But not all Republican officials agree with Moore.
While 11.3% of North Carolinians are uninsured, the rate hovers closer to one in four uninsured people in parts of the state. Dale Wiggins, a Graham County commissioner, says he sees it every day. Twenty-six percent of working-age Graham County residents lack health insurance, according to a Georgetown analysis.
“I think it’s really easy, sometimes, for people that have the health insurance to think that everybody does,” Wiggins says. “It just comes down to what you’re exposed to.”
For Wiggins, it also comes down to his personal experiences and morals. Wiggins, a Republican, is a cancer survivor. Because of this, he says he can’t fathom how someone could ignore Medicaid expansion as a fundamental need. He is also a devout Christian; he recited John 13:34 from memory on a call, a verse where Jesus calls on folks to love each other “as (he) has loved you.”
Moore is also a Christian, according to his website. In spite of these beliefs, he has vocalized his opposition to Medicaid expansion for years. In 2019, he told WRAL: “The best thing that folks can do is to get a job.”
This, of course, was pre-pandemic, before an estimated 257,000 people lost their employee-sponsored insurance. Wiggins also notes that some people with jobs still don’t have health insurance.
“All these people that are out here working in construction, we need them to be healthy,” he says. “They need to be healthy. They have families, just like I do. When you take away all the rhetoric, and you get it down to the men, women and children: How can you say no?”
Five other red counties in western North Carolina have passed resolutions supporting Medicaid expansion, as have some municipalities. Kevin Corbin, a Republican and the state senator for almost all of these counties, has also tried to lead the way on Medicaid expansion.
As the state weighs the coming budget, the federal government is doing the same. President Biden’s Build Back Better Act has a provision that would temporarily extend Medicaid tax credits to uninsured folks in the 12 states that haven’t implemented an expansion. Wiggins doesn’t see this as the best solution.
“It’s a one size fits all when it comes to the federal government,” he says. “Everybody has to play the same way. We have an opportunity right now to do it in a way that will be best for the people of this state.”
If the state fails to pass Medicaid expansion but the federal government succeeds, it would be easy for Republicans to condemn the overreach of the federal government for doing something they could have taken control of. In the end, the people who will still lose are the uninsured in Graham County, Moore’s Cleveland County, and other rural areas in the state.
As we sit on a budget surplus, as we receive federal incentives to do so and as we see a pandemic take more than 18,000 lives in our state, we see the necessity of Medicaid expansion and the financial ease with which it could be implemented. Republican leaders need to listen to the people in their party who spend their day-to-day lives around the uninsured, and ask themselves who they’re serving.
Sara Pequeño is a Raleigh-based opinion writer for McClatchy’s North Carolina Opinion Team and member of the Editorial Board.
