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40TH STATE TO EXPAND MEDICAID

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UNDER THE AFFORDABLE CARE ACT.

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THE BIPARTISAN EXPANSION, SIGNED

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INTO LAW LAST MONTH, COMES AFTER

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A DECADE OF REPUBLICAN

6
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RESISTANCE IN THE STATE.

7
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AS JOHN YANG REPORTS, IT WILL BE

8
00:00:19,233 --> 00:00:20,166
LIFE CHANGING FOR SOME UNINSURED

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NORTH CAROLINIANS AND THEIR

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PROVIDERS, BUT NOT ALL.

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JOHN: TUCKED AWAY IN A SHOPPING

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CENTER ON WINSTON-SALEM'S

13
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SOUTHWEST SIDE, NONPROFIT UNITED

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HEALTH CENTERS IS A LIFELINE FOR

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ITS PATIENTS.

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>> SO WE HAVE ABOUT 10 EXAM

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ROOMS.

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JOHN: PEDIATRICIAN VERONICA

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WILTSHIRE, THE CENTER'S CHIEF

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MEDICAL OFFICER, SAYS ACROSS

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THREE LOCATIONS IT SERVES 6000

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PATIENTS.

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MOST ARE BLACK, HISPANIC, OR

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LATINO.

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THE NEARLY 80% OF PATIENTS WHO

26
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DON'T HAVE INSURANCE PAY ON A

27
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SLIDING SCALE.

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IN ONE PLACE, PATIENTS CAN SEE A

29
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DOCTOR, GET PRESCRIPTIONS

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FILLED, AND RECEIVE DENTAL CARE.

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THEY CAN EVEN ENROLL IN

32
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MEDICAID, THE FEDERAL AND STATE

33
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HEALTH INSURANCE PROGRAM FOR

34
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THOSE WITH LOW INCOMES.

35
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>> OUR PATIENT POPULATION, IT'S

36
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ALL ABOUT EASY ACCESS.

37
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SO IF WE CAN PREVENT THEM FROM

38
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GOING ONE OTHER PLACE, BECAUSE A

39
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LOT OF THEM HAVE TO TAKE A BUS.

40
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JOHN: ACCESS TO HEALTH CARE HAS

41
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BEEN A CHALLENGE FOR LOW-INCOME

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RESIDENTS OF NORTH CAROLINA, ONE

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OF 11 STATES THAT HADN'T

44
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EXPANDED MEDICAID COVERAGE UNDER

45
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THE AFFORDABLE CARE ACT, UNTIL

46
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NOW.

47
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LAST MONTH, GOVERNOR ROY COOPER,

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A DEMOCRAT, SIGNED A BILL PASSED

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BY THE REPUBLICAN-ONTROLLED

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LEGISLATURE EXPANDING MEDICAID

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ACCESS IN THE STATE.

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>> WE HAVE A MEDICAID EXPANSION

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BILL.

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JOHN: WHEN IT'S IMPLEMENTED, THE

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PROGRAM WILL BE OPEN TO FAMILIES

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AND INDIVIDUALS WHOSE INCOMES

57
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ARE LOWER THAN 138% OF THE

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FEDERAL POVERTY LINE, ABOUT

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$20,000 FOR AN INDIVIDUAL.

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BEFORE EXPANSION, MOST ADULTS

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WITHOUT CHILDREN OR A DISABILITY

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WEREN'T ELIGIBLE AT ALL, NO

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MATTER HOW LOW THEIR INCOME.

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>> PATIENTS ARE GOING TO BE ABLE

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TO COME TO SEE THEIR DOCTORS

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WITHOUT HAVING TO WORRY ABOUT

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HEALTH CARE COSTS.

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A LOT OF TIMES IN THE POPULATION

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OF PATIENTS WE SERVE, IT'S

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EITHER, SHOULD I BUY FOOD FOR MY

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FAMILY, SHOULD I PAY MY RENT, OR

72
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SHOULD I BUY THE MEDICATION?

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JOHN: IT'S A DILEMMA UHC PATIENT

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TWAKEENA SIMMONS, A NURSING

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ASSISTANT, KNOWS ALL TOO WELL.

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HER EMPLOYER-PROVIDED HEALTH

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INSURANCE IS INADEQUATE, BUT

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SHE'LL QUALIFY FOR MEDICAID

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UNDER THE EXPANSION.

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>> THE DENTIST, YOU KNOW,

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THEY'RE KINDA PRICEY, AND THEN

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THE DOCTOR, PRICEY.

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MEDICINE, DEFINITELY PRICEY.

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JOHN: AND CLINICS LIKE UHC WILL

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BENEFIT, TOO.

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IN ALL, THE EXPANSION, AND A

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ONE-TIME FEDERAL BONUS, IS

88
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EXPECTED TO BRING IN $8 BILLION

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A YEAR FOR THE STATE'S HEALTH

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CARE PROVIDERS.

91
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THE STATE GOVERNMENT'S

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CONTRIBUTION TO THE COST OF

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EXPANDED COVERAGE WILL COME FROM

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HOSPITALS, NOT TAXPAYERS.

95
00:02:52,566 --> 00:02:54,733
>> HELLO, HELLO, HELLO.

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JOHN: JUST DAYS AFTER THE BILL

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WAS SIGNED, DOCTOR WILTSHIRE WAS

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PART OF AN ADVOCACY DAY AT THE

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STATE'S CAPITOL.

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>> CAN I PLEASE GIVE YOU A HUG?

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>> SURE.

102
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I LOVE HUGS.

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JOHN: THE KEY MESSAGE TO

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LAWMAKERS?

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THANK YOU.

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>> I KNOW YOU'VE BEEN WORKING ON

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THIS FOR MANY, MANY, MANY YEARS.

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JOHN: STATE REPRESENTATIVE DONNY

109
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LAMBETH IS A FORMER HOSPITAL

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EXECUTIVE.

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SINCE 2017, HE'D BEEN TRYING TO

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GET HIS FELLOW REPUBLICANS, WHO

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CONTROLLED BOTH LEGISLATIVE

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CHAMBERS ALL THOSE YEARS, TO

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PASS EXPANSION.

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>> EARLY ON PEOPLE JUST DID NOT

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UNDERSTAND IT.

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WE ALSO HAD CHANGES IN ATTITUDE

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TOWARDS OBAMACARE AND MEDICAL

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EXPANSION.

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JOHN: SO IT WAS AN EDUCATION

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PROCESS TO GET YOUR FROM THE

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REPUBLICANS ON YOUR SIDE?

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>> EXACTLY.

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WHEN YOU FIRST TALK ABOUT

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EXPANSION IT IS LIKE -- AND THIS

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IS WHAT THEY SAID TO ME -- OH

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NO, WE'RE EXPANDING ANOTHER

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GOVERNMENT ENTITLE PROGRAM.

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BUT THIS DOES NOT COST THE STATE

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ANY MONEY.

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JOHN: AND SOME REPUBLICAN

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LAWMAKERS SAY THEY WERE WERE

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PERSUADED TO VOTE FOR EXPANSION

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BECAUSE MOST OF THOSE WHO WILL

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GAIN COVERAGE ARE EMPLOYED.

137
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LIKE EVITA BASS, WHO WORKS IN

138
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CHILD CARE IN HILLSBOROUGH AND

139
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DIDN'T QUALIFY FOR MEDICAID

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UNDER THE OLD RULES.

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YOU'RE AN ASSISTANT DIRECTOR

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HERE?

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>> I AM.

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JOHN: WORK FULL TIME?

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>> I DO.

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JOHN: BUT NO HEALTH INSURANCE.

147
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>> NO HEALTH INSURANCE.

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JOHN: ARE YOU CONSTANTLY WORRIED

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ABOUT, WHAT HAPPENS IF I GET

150
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SICK?

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WHAT HAPPENS IF I HAVE AN

152
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ACCIDENT?

153
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>> YES, IT IS A CONSTANT WORRY.

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LIFE FOR ME, WHEN I WAS GROWING

155
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UP, MY MOM ALWAYS PREACHED ABOUT

156
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GOING TO YOUR ANNUAL VISITS,

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MAKING SURE THAT YOU GET CHECKED

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OUT.

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AND WORKING IN DAYCARE, YOU CAN

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PROBABLY IMAGINE WE COME ACROSS

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A LOT OF GERMS, SO IT'S VERY

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HARD TO KEEP YOURSELF UP THERE.

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BUT I DO WHAT I HAVE TO DO SO I

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DON'T HAVE THAT DOCTOR BILL.

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JOHN: LAST YEAR, BASS, WHO IS

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30, HAD EMERGENCY SURGERY THAT

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00:04:38,600 --> 00:04:40,866
LEFT HER OUT OF WORK FOR A

168
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MONTH, AND STUCK WITH MORE THAN

169
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$36,000 IN DEBT, AN EXPENSE

170
00:04:49,133 --> 00:04:50,066
MEDICAID WOULD HAVE HELPED PAY.

171
00:04:50,066 --> 00:04:51,000
>> ONE THING I'VE ALWAYS LIVE

172
00:04:51,000 --> 00:04:51,933
BY, BETTER LATE THAN NEVER.

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YOU KIND OF JUST GOTTA ROLL WITH

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00:04:52,600 --> 00:04:55,700
THE PUNCHES.

175
00:04:55,700 --> 00:04:56,633
GRANTED, I WISH IT WOULD HAVE

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CAME A LITTLE BIT EARLIER.

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JOHN: IF BASS QUALIFIES UNDER

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MEDICAID'S NEW INCOME

179
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REQUIREMENTS, AS SHE BELIEVES

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SHE WILL, SHE SAYS SHE'LL ENROLL

181
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AS SOON AS POSSIBLE.

182
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AND THEN HOW QUICKLY ARE YOU

183
00:05:05,533 --> 00:05:07,500
GOING TO MAKE THAT APPOINTMENT

184
00:05:07,500 --> 00:05:08,433
FOR A CHECKUP?

185
00:05:08,433 --> 00:05:10,900
>> AS SOON AS THEY APPROVE ME.

186
00:05:10,900 --> 00:05:11,833
I ALREADY HAVE MY PRIMARY CARE

187
00:05:11,833 --> 00:05:12,366
DOCTOR THAT I WANT TO GO BACK

188
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TO.

189
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AND I'M EXCITED.

190
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JOHN: WHEN NORTH CAROLINA'S

191
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MEDICAID EXPANSION IS FULLY

192
00:05:22,233 --> 00:05:23,166
IMPLEMENTED, AN ESTIMATED

193
00:05:23,166 --> 00:05:24,733
600,000 WILL GAIN ACCESS TO

194
00:05:24,733 --> 00:05:25,666
HEALTH COVERAGE.

195
00:05:25,666 --> 00:05:26,600
BUT THAT DOESN'T MEAN THERE

196
00:05:26,600 --> 00:05:28,733
WON'T STILL BE PEOPLE IN NORTH

197
00:05:28,733 --> 00:05:29,766
CAROLINA WITHOUT INSURANCE.

198
00:05:29,766 --> 00:05:31,600
>> THERE'S STILL GOING TO BE A

199
00:05:31,600 --> 00:05:32,733
HUGE NEED FOR SAFETY NET

200
00:05:32,733 --> 00:05:34,033
ORGANIZATIONS.

201
00:05:34,033 --> 00:05:35,800
JOHN: KRISTA WOOLLY RUNS THE

202
00:05:35,800 --> 00:05:37,266
COMMUNITY CARE CLINIC OF ROWAN

203
00:05:37,266 --> 00:05:38,900
COUNTY IN THE PIEDMONT REGION OF

204
00:05:38,900 --> 00:05:39,833
CENTRAL NORTH CAROLINA.

205
00:05:39,833 --> 00:05:41,533
>> A LOT OF OUR PATIENTS WILL

206
00:05:41,533 --> 00:05:43,633
COME IN HERE AND GO TO THE

207
00:05:43,633 --> 00:05:44,766
DENTIST, THEY'LL GO TO THE

208
00:05:44,766 --> 00:05:45,566
DOCTOR, AND THEY'LL PICK UP

209
00:05:45,566 --> 00:05:46,700
THEIR PRESCRIPTIONS.

210
00:05:46,700 --> 00:05:48,333
JOHN: IT'S A TOTALLY FREE CLINIC

211
00:05:48,333 --> 00:05:49,266
FOR COUNTY RESIDENTS WHO DON'T

212
00:05:49,266 --> 00:05:50,200
HAVE INSURANCE AND MAKE LESS

213
00:05:50,200 --> 00:05:51,033
THAN THREE TIMES THE FEDERAL

214
00:05:51,033 --> 00:05:53,100
POVERTY LINE.

215
00:05:53,100 --> 00:05:58,100
>> WE HAVE 1.1 MILLION UNINSURED

216
00:05:58,833 --> 00:05:59,766
FOLKS IN NORTH CAROLINA.

217
00:05:59,766 --> 00:06:00,766
WHAT WE HEAR IS THAT MEDICAID

218
00:06:00,766 --> 00:06:01,300
EXPANSION WILL COVER ABOUT HALF

219
00:06:01,300 --> 00:06:04,766
OF THAT.

220
00:06:04,766 --> 00:06:05,700
SO WE'LL STILL HAVE 600,000,

221
00:06:05,700 --> 00:06:06,633
700,000 PEOPLE WITHOUT INSURANCE

222
00:06:06,633 --> 00:06:08,766
AND WITHOUT THE ABILITY TO

223
00:06:08,766 --> 00:06:09,700
AFFORD ACA.

224
00:06:09,700 --> 00:06:10,666
JOHN: KENNETH SMALL IS ONE OF

225
00:06:10,666 --> 00:06:12,033
THEM.

226
00:06:12,033 --> 00:06:15,633
HE IS THE ENTIRE STAFF OF THE

227
00:06:15,633 --> 00:06:16,566
SALISBURY, NORTH CAROLINA

228
00:06:16,566 --> 00:06:17,766
LANDSCAPING BUSINESS HE OWNS.

229
00:06:17,766 --> 00:06:18,800
>> I HAVE BEEN TO ACTUAL

230
00:06:18,800 --> 00:06:20,033
INSURANCE GROUPS THAT

231
00:06:20,033 --> 00:06:25,033
TRY TO FIND YOU THE BEST DEAL

232
00:06:25,933 --> 00:06:26,866
THAT THEY CAN.

233
00:06:26,866 --> 00:06:27,666
YOU CAN'T AFFORD TO PAY THE

234
00:06:27,666 --> 00:06:28,600
PREMIUMS THAT THEY WANT.

235
00:06:28,600 --> 00:06:29,533
JOHN: SO HE RELIES ON THE CLINIC

236
00:06:29,533 --> 00:06:32,766
FOR HEALTH CARE AND FOR MOST OF

237
00:06:32,766 --> 00:06:33,700
HIS PRESCRIPTIONS, INCLUDING

238
00:06:33,700 --> 00:06:36,733
INSULIN FOR HIS DIABETES, AND

239
00:06:36,733 --> 00:06:37,900
FIVE CHOLESTEROL MEDICATIONS.

240
00:06:37,900 --> 00:06:41,166
AFTER QUADRUPLE HEART BYPASS

241
00:06:41,166 --> 00:06:43,600
SURGERY IN 2017, THE CLINIC ALSO

242
00:06:43,600 --> 00:06:48,400
HELPED HIM LOWER A NEARLY

243
00:06:48,400 --> 00:06:49,333
$70,000 HOSPITAL BILL TO $6000.

244
00:06:49,333 --> 00:06:50,633
>> I'VE NEVER PAID OUT OF POCKET

245
00:06:50,633 --> 00:06:52,133
TO COME HERE.

246
00:06:52,133 --> 00:06:54,366
ANYTHING.

247
00:06:54,366 --> 00:06:58,000
SO THEY THEY'RE FILLING A LARGE

248
00:06:58,000 --> 00:06:58,933
GAP BETWEEN PEOPLE WHO ARE

249
00:06:58,933 --> 00:07:00,200
MAKING TOO MUCH MONEY TO QUALIFY

250
00:07:00,200 --> 00:07:02,900
FOR MEDICAID AND CAN'T AFFORD

251
00:07:02,900 --> 00:07:04,066
INSURANCE.

252
00:07:04,066 --> 00:07:07,766
AND THAT'S WHERE I FALL IN.

253
00:07:07,766 --> 00:07:08,700
JOHN: BECAUSE EVERYONE THINKS

254
00:07:08,700 --> 00:07:09,633
THAT, WELL, WITH OBAMACARE AND

255
00:07:09,633 --> 00:07:10,866
WITH EXPANDED MEDICAID, WE'VE

256
00:07:10,866 --> 00:07:14,233
PROBLEM.RE OF THE UNINSURED

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>> YEAH, NO.

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THERE'S STILL A BUNCH OF

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UNINSURED OUT.

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>> WE SENT YOU FOR THE STRESS

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TEST TO GET A BETTER IDEA OF

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YOUR HEART.

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JOHN: DR. AMY WILSON IS THE

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CLINIC'S MEDICAL DIRECTOR.

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WITH THE EXPANSION OF MEDICAID,

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YOU MAY LOSE SOME PATIENTS.

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>> YES.

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AND THAT'S GREAT.

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I WOULD LOVE FOR THERE TO NOT BE

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A NEED FOR ME STILL, BUT

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UNFORTUNATELY, I THINK THERE IS

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STILL GOING TO BE.

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JOHN: BACK AT UHC IN WINSTON

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SALEM, DR. VERONICA WILTSHIRE

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ALSO KNOWS THAT NOT ALL THE

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CLINIC'S PATIENTS WILL QUALIFY

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FOR EXPANDED MEDICAID.

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>> DID SHE START SCHOOL ALREADY?

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JOHN: BUT SHE SAYS THE INCREASED

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REVENUE FROM MEDICAID WILL HELP

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ALL THE CLINIC'S PATIENTS.

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>> JUST TO BUILD UP A MENTAL

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HEALTH DEPARTMENT OR HIRE MORE

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DENTISTS IN OUR CLINIC.

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WE CAN HIRE A PATIENT NAVIGATOR

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WHO WILL BE ABLE TO HELP OUR

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PATIENTS FILL OUT THEIR FORMS,

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YOU KNOW, EDUCATE OUR PATIENTS.

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IN HEALTH CENTERS, ALL THE

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REVENUE THAT WE RECEIVE GOES

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BACK INTO THE HEALTH CENTER.

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JOHN: NORTH CAROLINA COULD START

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ENROLLING NEW PATIENTS LATER

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THIS YEAR, A STEP, SUPPORTERS

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SAY, TOWARD IMPROVING THE HEALTH

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AND WELL-BEING OF HUNDREDS OF

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THOUSANDS OF RESIDENTS.

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FOR THE "PBS NEWSHOUR," I'M JOHN

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YANG IN WINSTON-SALEM, NORTH

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CAROLINA.

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♪