Dr. Dave Tayloe has one simple message for Gov. Roy Cooper’s efforts expand access to Medicaid.
“Hang in there. You are on the side of the angels,” he said. “This is the right thing to do, and it’s taken a long time for reasons that I understand. Politics is a fickle way to do health care, but we are making progress.
“I have had conversations with people in the legislature who understand that it is time to do this.”
With the sounds and activities of Tayloe’s busy Goldsboro Pediatrics in the background Tuesday afternoon, Cooper met with representatives of local health care and social service agencies, as well as Mayor Chuck Allen and Wayne County Sheriff Larry Pierce, for a roundtable discussion on the need to expand Medicaid.
Attorney Phil Baddour said part of his practice includes representing people who apply for Social Security disability.
“Many of those people do not have adequate health care,” Baddour said. “It is a very big struggle for them. And just as a citizen, Governor, and I think you know this, Wayne Memorial Hospital is very important to this community. You know the struggles that rural hospitals have had.
“I don’t think anything would make our hospital more viable and ensure its well-being than if we expanded Medicaid for our population.”
Expansion is also good for doctors, said Tayloe, who founded the practice in 1977.
“If you are going pay doctors to take care of patients who don’t have insurance and don’t have the cash to pay, doctors are going to feel better about going to work,” he said. “You always feel terrible if somebody can’t access a service because of finance.
“We have been so lucky here that ever since I started, we have seen everybody who has walked through the door.”
Cooper asked Pierce about the amount of time his deputies spend dealing with people with mental health and substance abuse issues who should be receiving treatment instead of being in jail.
Pierce agreed that it is a drain on the office.
Bills to expand the coverage were filed last week in the state House and Senate.
Cooper said he thinks that more balance of power in the General Assembly is good and that the people spoke very loudly in November that they wanted more balance in their state legislature.
“There is no question there are Republicans and Democrats who see the need to expand access to health care of families in North Carolina,” he said. “They see it is important because No. 1, we can insure 500,000 or 600,000 more North Carolinians. No. 2, this is federal tax money that we are already paying to Washington that will bring us about $4 billion a year.
“No. 3, it helps private insurance plans because we are reducing the number of indigent people and helps control health care cost. No. 4, it is going to create 30,000 to 40,000 new good-paying jobs — many of those jobs in rural North Carolina. No. 5, it is going to help save rural hospitals. No. 6, we have 30,000 veterans who are uninsured in North Carolina. Medicaid expansion will insure 23,000 of those veterans.”
Cooper said supporters believe they can convince hospitals and health care providers to provide the money for the state’s 10-percent match.
“So here we are without having to expend many state tax dollars,” he said. “We can draw down $4 billion per year, insure more people and improve our economy. It is a win-win-win. I believe we have enough Republicans and Democrats so we can come up with a North Carolina solution.”
The state can follow the 37 states that already have expanded Medicaid and the others that are doing so, he said.
North Carolina needs to be one of them, he said.
Cooper was asked why the issue has turned so urgent.
“People are dying every day of opioid overdoses,” he said. “People are having to deal with mental health issues and not getting treatment. Rural hospitals are on the brink of closing. We need to make sure we provide that infusion to help deal with all of those very immediate problems.”
There is something wrong when a person serves the country, returns home and does not have health insurance, Cooper said.
Cooper said a lot of what he has learned about the issue was confirmed by those participating in the roundtable.
One thing is to ensure that medical providers receive the information they need, as the state switches to managed care Medicaid, he said.
“Hearing about the sheriff (Larry Pierce) talk about all of the time law enforcement officers spent with people with substance abuse disorders and with mental health issues,” Cooper said. “That stands out as I talk with law enforcement across the state.
“This is a way to help them out. This is a way to take a lot of those patients who need to be getting treatment off their plate and out of our jails because they really don’t need to be there.”
Medicaid expansion is exciting for Goldsboro Pediatrics because it is probably the largest pediatric practice in North Carolina and has been closely integrated in the community and the hospital, the health department, public schools and other agencies, Tayloe said.
“We also work closely with the administration of Governor Cooper in Raleigh and with the Community Care of North Carolina staff and infrastructure folks to put together what we think is the best Medicaid plan in the county.”
Tayloe said that in his travels to other states, others could not believe how good the Medicaid program is in North Carolina.
That is before the legislature made the move to commercial managed care, he said.
“So it is going to be a huge challenge to keep what we have going, but I think we can do it. But Medicaid expansion is such a vital part of that so that the parents of our patients have insurance. Those parents are healthier.
“The ones who need mental health, substance abuse treatment can get it, and we can hopefully improve a lot of the outcomes in our rural county.”
The lack of Medicaid expansion is a “chink” in the health care infrastructure, since the Affordable Care Act made it so very smart to expand Medicaid, Tayloe said.
“What you do if you don’t expand Medicaid is you really disadvantage those people under 100 percent of poverty who can’t get the subsidies to get private insurance and they don’t qualify for Medicaid. So they are basically uninsured unless they pay cash.”