WS Chronicle

By TEVIN STINSON 

The Chronicle  

In 2023 North Carolina became the 40th state to expand Medicaid. Under expansion, people ages 19 to 64 are covered. To date, nearly 650,000 North Carolinians have enrolled. Although enrollment numbers have exceeded expectations, there are thousands of people in Forsyth County who are eligible and haven’t taken advantage of this opportunity to get affordable healthcare coverage.  

What We Know 

Approved by the N.C. House of Representatives by a vote of 92-22, House Bill 76 established a program called NC Health Works to expand Medicaid to people earning up to 133% of the federal poverty level.  

Before the bill, which is titled “Access to Healthcare Options,” passed, in North Carolina only people with disabilities, over the age of 65, pregnant, and who met the income eligibility limits, were eligible for Medicaid, meaning many adults fell into the coverage gap.  

Former Governor Roy Cooper said the bill was an investment and a step toward a healthier North Carolina. “Medicaid expansion is a once-in-a-generation investment that will strengthen our mental health system, boost our rural hospitals, supporting working families, and so much more,” wrote Cooper in a press release after signing the bill into law.  

While it was Democrats who pushed for Medicaid expansion for nearly a decade, it was Republican Sen. Donny Lambeth who introduced H.B. 76. Lambeth (Winston-Salem), who is a retired hospital administrator, has pushed for Medicaid expansion since he took office in 2017.  

When talking to his colleagues about the bill in 2023, Lambeth said it was the single most important thing they could do to improve the quality of life of North Carolinians.     

“Health insurance is very expensive, and I think this is one thing we can do that will truly make a difference,” Lambeth said. “I’ve continued to push this notion that we can make North Carolina a better state if we move forward in improving access to care.” 

In addition to expanding Medicaid, H.B. 76 also develops a workforce development program to provide job training opportunities and other career readiness resources for those in need and allocates $4 million to county-level departments of social services to support implementation. Amendments to the bill also allocate $50 million for counties to certify Medicaid eligibility and pay for medical care for those who are incarcerated, and another creates a pilot program to attract medical providers to rural counties across the state by offering a special loan and loan forgiveness program.  

You May Qualify for Coverage 

In Forsyth County there are 116,562 people enrolled in Medicaid and more than 25,000 of those are new enrollees. But according to Jonelle Berky, Forsyth County Medicaid Services division director, there is still work to be done. There are more than 17,000 people in Forsyth County who are eligible and haven’t enrolled.  

Berky said access to Medicaid will help those in underserved communities move away from “reactive care” and to preventative care. “We know when folks receive reactive care there is already sickness there and when you’re looking at chronic sickness, you’re looking at possible deaths,” said Berky during an interview with The Chronicle.  

“Seven out of 10 die from chronic illness because oftentimes that chronic illness was treated reactively. We want to get the Medicaid out there so our communities can be proactive.” 

You can be covered under H.B. 76 if you are a citizen ages 19 through 64 earning up to 138% of the federal poverty line (For example: Singles earning about $1,730/month or families of three earning about $2,970/month). The coverage includes services like primary care, hospital stays, maternity care, vision and hearing, dental/oral health care and more. Medicaid also pays for doctor visits, yearly check-ups, emergency care, and mental health. 

Recent Winston-Salem State University (WSSU) graduate and former member of the men’s basketball team, Charles Terry, is in the age range of those now covered under H.B. 76. Terry, who now works as an eligibility specialist with the county, said he’s on a mission to educate his peers.  

“A lot of people, especially my age, don’t know a lot about Medicaid and we’re not taking advantage of the resources that we have,” Terry said.  

Get It While You Can 

While nearly 650,000 have benefited from Medicaid expansion, it may soon be a thing of the past. House Republicans are looking to cut Medicaid funding.  

In February, the Energy and Commerce Committee, which oversees Medicaid, was directed to cut spending by $880 billion over the next decade.  

North Carolina isn’t the only state looking to reverse Medicaid expansion. Eight other states are also looking to make changes to try to offset the cost of President Donald Trump’s federal spending cuts. According to NC Health News, the government pays for about 90% of the cost for patients covered under expansion and hospitals cover the remaining 10% through a special tax assessment.  

Nearly 40% of the program’s beneficiaries in North Carolina live in rural counties and these are the areas that will be impacted the most if expansion is reversed. In many cases it could lead to hospitals closing.  

When asked if she is worried about Medicaid expansion being reversed and the impact it could have on citizens across the state, Berky said, “I’m worried about the here and now. I’m worried about folks that are in this community that are possibly eligible that have not applied, that’s my concern. 

“Am I concerned with federal cuts and how it’s going to affect this community? Absolutely … but what we’re saying is our main focus is, we have the access now and we want folks to come in and take advantage of it.”  

How To Apply  

You can apply for Medicaid online or in person at the Forsyth County Department of Social Services.  

To apply online visit https://epass.nc.gov/. Applicants will need to create an NCID, which is a secure online user ID and password to access various government programs.  

The Forsyth County Department of Social Services is located at 741 N. Highland Ave. Applications are taken daily Monday through Friday from 8 a.m. to 5 p.m. No appointment is needed.  

If you have any questions, call 336-703-3800 or the N.C. Medicaid Contact Center at 888-245-0179. 

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