Stephanie sy in Alabama.
Geoff: This week, North Carolina
became the latest in a growing
number of states to expand
medicaid under the affordable
care act.
Governor Roy cooper signed the
bill into law, marking a major
victory for Democrats in their
efforts to expand federally
assisted health care coverage to
low income Americans.
>> The strength of our
communities depends on the
health of our people and today
is a historic step for a
healthier North Carolina.
When this law takes effect,
it'll make healthcare more
accessible for more than 600,000
north carolinians.
Geoff: Expanding health care
access has gained support among
voters.
The latest pbs "Newshour" marist
poll shows 63% of Americans
believe it's the government's
responsibility to ensure health
care coverage to Americans.
For more on this latest
investment in medicaid access,
we're joined by North Carolina's
secretary of health and human
services, Kody Kinsley.
Welcome to the "Newshour."
>> Great to be here.
Geoff: North Carolina is
expanding medicaid to adults who
make 138% of the federal poverty
level, that would be $41,000 for
a family of four.
You have been traveling the
state and talking to people who
would benefit from this expanded
access.
Secretary Kinsley: People are
really excited.
I want to thank the governor for
the broad coalition of people
who have worked so hard to get
us to where we are today.
In the last few years, some
things have changed.
First and foremost, additional
payments from the Biden
administration to incentivize
states to join medicaid changed
the conversation.
Also, seeing people experience
the mental health crisis that we
are in in this country today has
made people realize we need to
have every tool at our disposal.
There is no tool that can change
the game for mental health in
North Carolina more than
medicaid expansion.
Geoff: To your point about that,
across the country, mental
health care centers have closed
and it is jails but end up
becoming mental health care
facilities.
Tell me more about your plan to
invest in health care.
Secretary Kinsley: We want to
invest using those signing bonus
dollars for medicaid expansion,
$1 billion to try to rebuild
capacity in the mental health
system we know has languished
for far too long.
We need to take the resources to
where they are needed.
60% of people in incarcerated
settings have a substance abuse
disorder.
Many of mental health illness.
If people had those rates of
diabetes or any other disease,
we would do other is a problem
with the system.
We want to invest in prearrest
diversion, jail based programs,
reentry programs that break the
costly cycle that we know -- we
need health care and. Handcuffs.
That is something we have heard
first-hand from sheriff's across
North Carolina.
We have been battling the opioid
epidemic.
We will not arrest ourselves out
of these issues.
If we diverge people to
treatment, give them a path to
recovery, we get to support them
in healing their families and
their communities.
This is the right path forward
and a smart investment.
Geoff: When you say the
conversation around expanding
medicaid has changed, I spoke
with the North Carolina
Republican senate leader on this
program weeks ago.
He initially objected to
medicaid expansion in north
Carolina.
He had a change of heart and
said it makes perfect sense.
There are still some folks who
have questions about the cost,
to include Donald Bryson.
He runs a foundation.
He had some issues with the
overall price tag.
>> How much will this cost us in
the long term?
What is the effective medicaid
expansion in North Carolina?
How much will this cost
taxpayers in North Carolina?
These are all questions are
unanswered but it seems like we
are betting everything on
funding.
Geoff: What about the cost and
what is the plan to prevent cost
overrides?
Secretary Kinsley: I would have
love for us to expand medicaid a
long time ago but the advantage
of going this far down the path
is we have other proof from
other states.
Medicaid expansion controls
costs for health care and help
save rural hospitals.
We know the federal government
is committed to maintaining the
90-10 plan we have worked out to
have hospitals pay for the 10%
match, this is cost contained.
This is a smart investment.
Right now, we pay for this care
for people no matter what when
you end up in the emergency
department with a stroke or
major cardiovascular event.
Reaching them at a point of
prevention and getting them on
preventative care is a lot
cheaper.
This is not only a smart
investment for resources, it
will make a large difference
over time.
Geoff: It has been more than a
decade that the supreme court
ruled states did not have to
accept medicaid expansion under
the affordable care act.
Nearly half of the states opted
out.
What has that meant for
working-class north carolinians,
seniors, folks who live in rural
areas who have not had expanded
access to health care for more
than a decade?
Sec. Kinsley: I grew up in north
Carolina and without health
insurance.
I know firsthand what it is like
to have family members try to
decide whether they are going to
buy food or see the doctor.
Parents praying their arm is
just hurt or sprained not
broken.
My story, like these other
600,000 stories in north
Carolina that will benefit from
expansion, have been
heartbreaking day by day.
This last decade of waiting has
met some people who started on
this journey with us are no
longer here because they have
lost their lives.
This is the right thing to do
and I'm glad we are doing it now
and I hope we can continue to
invest in people because they
are our greatest strength.
Geoff: Kody Kinsley is the
secretary of health and human
services for the state of north
Carolina.
Thank you for being with us.
Secretary Kinsley: Thank you.