Cory Vaillancourt, Smoky Mountain News

As the greatest public health crisis in more than a hundred years continues to ravage both the physical and fiscal health of the world, the nation and the state of North Carolina, a group of 15 Democratic candidates is calling for the immediate expansion of Medicaid.

“It’s been critical for some time, and we have a General Assembly that basically just has refused to act on the issue,” said Brian Caskey, a Mills River Democrat currently running against incumbent Republican Sen. Chuck Edwards in the 48th Senate District. “Medicaid expansion for years has been the decent and moral thing to do, but right now it’s the necessary thing to do.”

North Carolina is one of just 14 states that haven’t taken advantage of the opportunity to expand Medicaid coverage, which was made available via the Patient Protection and Affordable Care Act passed in 2010.

Beginning in 2014, states could choose to include people in Medicaid who earn up to 133 percent of the poverty level, with the federal government picking up 100 percent of the cost of the expansion population from 2014 through 2016, 95 percent of the cost in 2017, 94 percent in 2018, 93 percent in 2019 and 90 percent in perpetuity thereafter.

North Carolina, like most of the South, declined to participate, citing the potential cost to states if the federal government ever decided to decrease or do away with the 90 percent funding level.

North Carolina’s Democratic Gov. Roy Cooper has also called for Medicaid expansion — something vehemently opposed by the Republican-controlled General Assembly; in fact, Cooper vetoed the state’s budget last summer over the failure to include Medicaid expansion, and nine months after the law requires a budget to be passed (July 1) Republicans still haven’t been able to override Cooper’s veto.

A press release issued by the Caskey campaign on March 30 cites the global Coronavirus Pandemic and the “unimaginable stresses” it will place on North Carolina’s health care system as big reasons for the collective call for Medicaid expansion.

Caskey is joined by a host of Western North Carolina Democrats, including Ed Hallyburton of Rutherford County (District 112).

“No matter what we look like, where we live or what’s in our wallets, getting sick reminds us that at our core we’re all just human,” Hallyburton said. “For too long, we’ve allowed a powerful few to profit by making life and health a product for sale. We must ensure that everyone can access the care that is needed, without fearing bankruptcy. This is a moment that we must stand with, and for, each other — across our differences and against anything and anyone who seeks to divide us.”

David Wheeler, Democratic nominee for the Senate seat in Polk, Rutherford, McDowell, Mitchell, Yancey and Madison counties (District 47) said that the lack of access to quality health care is “not acceptable in the most powerful country in the world and one of the most prosperous states in the country.”

In addition to Caskey, Hallyburton and Wheeler, N.C. Senate candidates Edward Phifer (Morganton), Julie Mayfield (Asheville) and Victoria Fox (Canton) also signed on to the release.

N.C. House candidates supporting the effort include Ted Remington (Marion) Cecelia Surratt (Morganton), Sam Edney (Brevard), Susan Raye Landis (Murphy), Alan Jones (Canton), Rep. Susan Fisher (Asheville), Rep. John Ager (Asheville) and Rep. Joe Sam Queen of Waynesville, who’s been campaigning on Medicaid expansion for some time now.

“Medicaid expansion is for low-wage workers in North Carolina, and our low wage worker community is taking the biggest hit,” said Queen. “They need health care. Can you imagine being without both a job and health care? We’ve already paid for it and the legislature is just wasting it. It’s way past time, and now the crisis is upon us.”

Moe Davis, the Democratic nominee to replace Congressman Mark Meadows, R-Asheville, has also indicated support for the demand, even though elected officials on the federal level have no say in the decision.

“Expanding Medicaid in North Carolina is not the solution to our broken health care coverage system, but it would toss a lifeline to thousands of people in this district who were already struggling to tread water before COVID19 broke open the dam,” said Davis. “If we really had ‘the greatest economy ever in the history of the United States’ as [President Donald] Trump said a month ago when he was in India, we should have been paying down our debt then so we had the capacity to incur debt now when we’re in a crisis. The poor and those who now suddenly find themselves out of work should not have to bear the burden for the revenue problem that began with a massive giveaway to big corporations and the wealthiest Americans.”

Expanding Medicaid would cover more than 400,000 North Carolinians who currently lack access to health care coverage, according to Caskey’s release.

In Western North Carolina, expansion would cover between 600 and 900 people in each of the region’s smallest counties like Clay, Graham and Mitchell.

In mid-sized counties like Avery, Cherokee, Macon, Madison, Polk, Transylvania, Swain and Yancey, that number is between 1,000 and 2,000 in each county.

In larger counties like Burke, Haywood, Henderson, Jackson and Rutherford, between 3,300 and 6,900 people would be covered in each county. In Buncombe County, WNC’s largest county, the number of people who would benefit is estimated to be nearly 17,000.

All in all, that’s almost 56,000 people throughout WNC. The economic growth associated with expansion is estimated by Caskey to be more than half a billion dollars.

“As of [March 30], 44 percent of the COVID19 cases reported are among the working poor, people aged between 25 and 49,” Caskey said. “These are the people who can’t afford to take off work. These are the very people most likely without health insurance and are the very ones bagging your groceries or handling your food in the drive-thru.”

Queen’s November opponent, Bryson City Republican and former Rep. Mike Clampitt, said that in light of the recent federal stimulus package — the largest in American history — as well as uncertainty over the financial impact of the pandemic on tax revenues, he was leery of winding up on the hook for the costs of Medicaid expansion.

“I think it would be a knee-jerk reaction, and with the cost to taxpayers especially in light of the loss of jobs and the tax revenue, we need to be good stewards of what money we do have at the moment and be very thoughtful as we go forward,” Clampitt said. “I’m for health care, but we need to take a step back, be rational, and look at the affordability.”

Davis’ opponent in the N.C. District 11 congressional race has yet to be determined — the runoff between Republicans Lynda Bennett, of Maggie Valley, and Madison Cawthorn, of Hendersonville, was recently moved from May 12 to June 23 as a result of the pandemic.

Bennett didn’t respond to a request for comment on this story, but Cawthorn doesn’t see Medicaid expansion as the right move.

“I don’t think it is,” Cawthorn said. “I don’t think the government does anything efficiently. What they should be doing is introducing more competition and deregulating a lot of the health care industry.”

Caskey’s opponent, Sen. Edwards, did not immediately respond to a request for comment, but both Caskey and a quick Google search say that Edwards has been one of the greatest opponents of Medicaid expansion in the General Assembly.

“This is 100 percent of the reason why he’s wrong for North Carolina,” Caskey said. “I’ve been telling people at all my events that Chuck Edwards is simply a Raleigh yes man. He’s simply there to vote for the majority party in Raleigh. November is going to offer voters a choice.”