Veterans need action from state legislators

The “coverage gap” refers to people who earn too much to qualify for Medicaid but not enough to get help in the private insurance marketplace. Prior to the pandemic, approximately 400,000 North Carolinians lacked access to affordable health insurance. Now, The Kaiser Family Foundation estimates the number of North Carolinians who would benefit from closing the coverage gap has grown by more than 200,000.

These are small business owners, child care providers, service workers and many pastors. They are parents raising small children. They are our farmers and frontline workers. They include our veterans, and they also include an additional 23,000 uninsured military spouses and children in North Carolina. Incredibly, one in four veterans who served in Iraq and Afghanistan lacks health insurance.

The U.S. Department of Veterans Affairs does a lot to support our veterans, but it is far from a cure-all. Only an estimated 40 percent of all veterans are enrolled in the VA system. Eligibility for VA care is dependent on service duration, discharge, and disability, leaving many veterans uninsured and unable to get the care they need, even after fulfilling their military commitment.

States that have closed their health care coverage gap under the Affordable Care Act have lower rates of uninsured veterans than states that did not close the gap.

Many military veterans, especially those in our rural counties, face significant barriers to accessing health care services. For veterans enrolled in the VA, long drive times to the nearest VA clinic present a substantial burden. Veterans residing in rural areas tend to be older and have more complicated health needs; traveling long distances to receive care is simply unfeasible for this population.

In a statewide poll, 81% of all respondents – Republican, Democrat or otherwise – favored expanding Medicaid in order to provide insurance for those who served our country in the armed forces and who now fall into N.C.’s coverage gap. This is not surprising, especially given North Carolina’s long and proud record of supporting our armed forces. But it is surprising that we’re in such a tragic bind, now.

Thirty-eight states already have expanded Medicaid, many showing the kind of innovative thinking for which N.C. is known. Montana, for example, links insurance benefits with a successful voluntary workforce training program. Legislators can take the best ideas from these 38 states and make a plan that works for North Carolina.

In 2021, the General Assembly extended Medicaid coverage for many new mothers and other parents. This month, the N.C. Senate overwhelmingly supported a broader move to close the gap. As the action now heads to the House, we can and should collaborate on a North Carolina-tailored plan that helps others in the gap, including our veterans. It would be wrong to leave them behind.