UNC Health workers to CEO: Medicaid expansion deserves priority

UNC Health professional students, faculty/staff and alumni are urging the Chapel Hill, N.C.-based health system to help ensure North Carolina expands Medicaid, even if it means leaving the state's hospital association as leverage to gain it, according to a letter to the organization's CEO.

In the Sept. 11 letter, the group asks Wesley Burks, MD, to consider leaving the North Carolina Healthcare Association if the association continues its stance on Medicaid expansion. North Carolina's House of Representatives and Senate previously passed separate legislation to move the state closer to Medicaid expansion, although lawmakers were unable to negotiate differences and reach a final deal.

"North Carolina is thus on the cusp of a historic milestone of advancing health equity and health outcomes, yet the N.C. Healthcare Association, whose largest member is UNC Health, is blocking that progress to protect a business model predicated on the strictest certificate of need laws," the letter to Dr. Burks states.

The letter also added that "NCHA's refusal to negotiate on CON laws effectively mounts opposition to Medicaid expansion," and that "UNC Health can wield its influence to work alongside NCHA and ensure protections for rural and at-risk hospital systems."

UNC Health professional students, faculty/staff and alumni then asked that UNC Health consider leaving the association "if you cannot move NCHA to prioritize Medicaid expansion over financial interests."

In a statement shared with Becker's, UNC Health said it "has been actively involved in working with legislative leadership and the governor to assist in moving forward with a compromise solution for Medicaid expansion. We have met multiple times with the governor, president pro-tem and the speaker — not only this year, but over the past several years — to advocate for and offer solutions to expand this critical health insurance coverage for many of our fellow citizens."

UNC Health also said it "communicate[s] directly with leadership on important policy issues," which is sometimes "done contrary to what NCHA may be advocating for." 

"UNC Health is encouraged by the tangible steps forward regarding Medicaid expansion in North Carolina. Our mission is to improve the health and well-being of North Carolinians, and we believe that closing the healthcare coverage gap is paramount in helping us meet that mission," the health system said.

"We applaud the students and their efforts to advocate for this most important health policy issue."

In a statement shared with Becker's, the association said it is "open to discussing changes or reforms to CON law, however, we have also emphasized to lawmakers that any changes should be done very carefully and deliberately to not harm rural hospitals and the healthcare safety net, especially given the current economic environment health systems and hospitals are facing with issues like persistent inflation, skyrocketing expenses for labor and caring for sicker patients who need longer lengths of stay and more complex care."

The association also said North Carolina healthcare organzations have offered to pay for nearly all of the state's share of Medicaid expansion, if lawmakers "will also pass legislation that includes the ability for the state to apply for a directed payment program available from CMS which we are referring to here in our state as the Healthcare Access and Stabilization Program."

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