Hundreds of UNC Health professionals, med students and faculty push for compromise on Medicaid expansion

Published September 15, 2022

By Joe Killian

Hundreds of UNC medical and nursing students, health professionals, faculty and alumni are asking the head of UNC Health to push the N.C. Health Association to compromise in the current debate over Medicaid expansion in North Carolina.

In a letter delivered Wednesday morning, the group asks Dr. Wesley Burks, CEO of UNC Health, to consider leaving the N.C. Healthcare Association if it will not soften its position on loosening Certificate of Need (CON) laws. The N.C. General Assembly’s GOP majority insist on changes to those laws before passing legislation to expand Medicaid. Loosening them could provide more competition for hospitals, changes for telemedicine and more independence for advanced practice nurses. While the association has supported medicaid expansion for years, it has stopped short of negotiating on CON laws to achieve it.

UNC Health professionals, medical students, faculty and alumni are pushing for negotiating on laws that could increase hospital competition in order to achieve Medicaid expansion.

“Our current political reality is that the only Medicaid expansion bill that can pass the NC legislature has to include CON reform,” the letter to Burks reads. “NCHA’s refusal to negotiate on CON laws effectively mounts opposition to Medicaid expansion in North Carolina, despite the fact that the current CON provisions have done demonstrably little to reduce costs, increase access to care, or advance health equity. Ample evidence shows that Medicaid expansion achieves all three of these goals, and thus should be prioritized.”

Gov. Roy Cooper, a Democrat, has also called for compromising on certificate of need laws in order to achieve Medicaid expansion, saying it has taken too long for Republicans to agree on the need for expansion and industry lobbies shouldn’t stand in the way now that it is in reach.

“Now I wish we could have that fight later and get Medicaid expansion done today,” Cooper wrote in an editorial last month. “But the Senate leadership is insisting that government restraints on hospital competition should be reduced before Medicaid expansion takes place. Hospital leaders know that no vote will come on Medicaid expansion this year unless they compromise on competition, but the powerful hospital lobby hasn’t yielded out of fear for their profits. Our state has some of the most restrictive laws on hospital competition, so there is room to move.”

“North Carolina needs our hospital leaders to step up now and do what’s right for their patients and the health of our state,” Cooper wrote. “A negotiated deal by hospitals with the legislature in the next few weeks means we can expand Medicaid, save lives and draw down that desperately needed federal money. Our hospitals have stepped up before when we needed them, and it’s time for them to step up now. Immediately and urgently. It’s time for our hospitals and the legislature to get this done for all of us.”

In Wednesday’s letter, hundreds from the UNC Health community asked Burks to take a serious step to pressure the association into negotiating.

“We are respectfully asking Dr. Burks and UNC Health to consider leaving the N.C. Healthcare Association if they cannot move NCHA to prioritize Medicaid expansion over financial interests,” said Meera Nagaraj, second-year medical student at UNC-Chapel Hill. “As UNC health professional students, faculty and providers, we regularly witness the harm to our patients caused by the Medicaid coverage gap. UNC Health must act decisively to address these injustices in this historic opportunity to expand Medicaid.”

More than 500 students, faculty, staff, alumni and health providers have signed the letter.

“As UNC health professional students and faculty, we regularly bear witness to the missed appointments, skipped medications, preventable diseases, and premature deaths caused by a lack of comprehensive Medicaid coverage in this state,” the letter reads. “We have never been closer to expanding Medicaid and addressing these injustices. By acting now you can stop unnecessary suffering and pain. ”

“We have never been closer to expanding Medicaid and addressing these injustices,” the letter reads. “By acting now you can stop unnecessary suffering and pain. We simply do not know when this opportunity will present itself again and we must not let it go to waste.”