Soldiers know that the success of a military operation hinges on its execution. A simple political decision is not enough. The same is true with North Carolina’s expansion of Medicaid.
Veterans around the state cheered earlier this year, both when the NC General Assembly overwhelmingly approved expanding Medicaid and when Governor Cooper signed the bill into law. Our policymakers made a wise and strategic decision to close the health insurance coverage gap. But now, with lives in the balance, we must avoid delay. We must draw up a smart and speedy operational plan, and then we must execute it.
The “coverage gap” describes the dire predicament of people who earn too much to qualify for Medicaid, but who do not earn enough to get help in the private insurance marketplace. This includes an estimated 16,000 veterans and an additional 23,000 uninsured military spouses and children in North Carolina. Incredibly, one in four veterans who served in Iraq and Afghanistan lack health insurance.
Tens of thousands more North Carolinians go to work every day, but they either do not receive employer benefits or do not make enough to afford private insurance. All told, around 600,000 of our fellow Tar Heels are in the coverage gap.
By expanding Medicaid, our policymakers made the admirable decision to help protect the lives of these friends, family members, and neighbors. By having health insurance, these fathers, mothers, sons, and daughters — who protected our freedom — can seek treatment for illnesses and can receive help to prevent costly illness in the future. It will also mean that they do not crowd into emergency rooms late in the game, straining limited hospital resources, especially those in rural areas.
This is good news to many beleaguered veterans. The U.S. Department of Veterans Affairs does great good, but VA is not a cure-all. Only an estimated 40% 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 care after they have fulfilled their military commitment.
In rural areas, many veterans face long drive times to the nearest VA clinic, which presents its own challenges. Veterans living in rural areas tend to be older, and they tend to have more complicated health needs; traveling long distances to receive care is simply not feasible.
States that have closed their health care coverage gap have lower rates of uninsured veterans than those states that did not close the gap. But closing the gap in North Carolina won’t happen until our elected leaders agree on a budget. Already there are signs of possible flashpoints in that process.
With Memorial Day fresh in our hearts, I hope our able policymakers will keep in mind the words of an outstanding military leader — President Dwight Eisenhower, a hero of World War II — who observed, “I believe when you are in any contest you should work like there is always to the very last minute a chance to lose it. This is battle, this is politics, this is anything. So I just see no excuse if you believe anything enough for not putting your whole heart into it.”
Putting your whole heart into helping our state’s veterans means working through any final details on Medicaid expansion quickly and efficiently, so that we can finally declare victory over the coverage gap.
Jim Hoffman is founder and president of American Heroes for North Carolina, a Guilford County-based organization that seeks to promotes the interests of veterans and to make the Triad area a welcoming place for veterans by educating the community about the importance of supporting our veterans and by educating veterans about their post-military opportunities. Hoffman served in the Army during the 1980s and was honorably discharged as a major.
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