Cherokee Indian Hospital CEO Casey Cooper pitched the need for North Carolina to adopt the expansion of Medicaid before the Swain County Board of Commissioners last Thursday, July 9. All but one of the commissioners were convinced and supported drafting a resolution.
Closing the coverage gap is the Eastern Band of Cherokee Indians’ top legislative priority at the state level, Cooper said. He went onto explain how expanding the federal program that helps insure folks who can’t afford insurance otherwise or are not offered it through an employer program would benefit the local economy and public health.
An estimated 23% of working adults in Swain County are uninsured. If North Carolina were to expand Medicaid, an estimated 1,100 people would gain access to affordable health insurance, according to information provided by Care4Carolina. This would equate to an estimated 32 new jobs and $3.9 million in new business activity.
“For me, that’s a little startling,” Cooper said. “It’s kind of hard to get your mind around that—to think 23% of us are working adults who don’t have coverage and are one catastrophic illness away from bankruptcy, to be quite honest.”
The majority of the uninsured are working adults and are white women, also, studies show.
Small hospitals like the ones in Western North Carolina are more financially vulnerable because of their thin profit margin. Often, a larger portion of patients are either on Medicare and/or Medicaid or are uninsured. Cooper said six rural hospitals have closed in North Carolina along since 2010.
As far as the Cherokee Hospital, Cooper said the facility relies on $7 million from the tribe to make up its deficit.
Financial benefit
The federal government wanted states to expand Medicaid with the adoption of the Affordable Care Act, but North Carolina has remained one of the few states that did not expand. Even with a 90% match from the federal government, the argument persists that the cost would still be too high for the state.
There’s never been a better time though, Cooper said, noting hospital systems have recently agreed to step up and help cover the states’ cost through assessments. Additionally, the most recent federal stimulus package adds and additional $1.7 billion in 2 years for states to expand.
“It’s proven, closing the coverage gap works; the economic argument is over,” Cooper said.
To the argument the federal government will change its mind in the future, Cooper said, it’s not likely, as that would require them to change the Social Security Act.
He also countered the fear that the health systems would be overwhelmed with patients if Medicaid was to expand. That hasn’t happened in states where Medicaid has expanded he said because you have more paying customers, more are able to provide services.
Another big selling point is Cherokee Hospital’s potential to expand services to non-native patients, which he said would only be possible with more insured patients. Those services could include access to the recently completed behavioral health crisis stabilization unit and an opioid treatment program.
With the state legislature set to be in session for just another month or so, the board decided to move forward with approving a draft of the resolution. Commissioner Kenneth Parton voted against, saying he just wasn’t prepared to vote on the issue without giving it more thought.
In other actions Thursday, the board approved the tax collector’s report and minutes.
Recovery Act funds, erosion control
The board also spent some time discussing how it might allocate American Recovery Act funds. The board already spent $250,000 back in March through a premium payment to county employees who were frontline workers during the pandemic. County Manager Kevin King confirmed the county has received its first payment of $1.6 million with the second half of that set to be sent in a year from now.
Parton questioned the county even accepting the funds that are directed at recovery from the pandemic. With tourism having increased tremendously last year, the county doesn’t have a need for recovery he pointed out.
King said the ARA is also designated to be invested in infrastructure, a need that does exist locally.
The board also spent some time talking about development. Specifically, they asked the erosion committee go ahead and present the erosion control ordinance it reviewed. On delays for septic permits, King said the county now has a contract worker helping with the backlog by working 30 hours a week.
The commissioners will have a work session on Thursday, July 22 at 6 p.m. at the Swain Administration Building (50 Main Street), third floor auditorium.