Reaffirmation of Support for Universal Health Care Policy
A Policy Statement of the North Carolina Council of Churches,
September 2021
SUMMARY
In 1993 and again in 1997, the North Carolina Council of Churches issued a policy statement on health care that expressed concern about the large number of North Carolinians without adequate health insurance and about the high and increasing cost of health care. At that time, we called for a national health plan that would guarantee universal coverage for health care, coupled with effective cost control, broad-based and equitable financing, and assured quality of services.
In the years since, little has changed for the better, while costs and the number of uninsured and underinsured continue to rise. The passage of the Affordable Care Act (ACA) in 2010 was a landmark bill that included significant policy changes, such as allowing dependents to remain on their parents health plan until they are 26, eliminating insurance companies abilities to charge more or deny coverage for people with pre-existing conditions, banned lifetime benefit limits, expanded preventive care in all qualified insurance plans, made Federal subsidies available to qualifying individuals have made health insurance accessible to many people and Medicaid expansion has greatly increased the number of Americans eligible for Medicaid in those states that chose to expand their Medicaid program (38 US states as of 2021).
Even with these positive changes, every person does not yet have access to truly affordable healthcare. High premiums keep people from choosing a healthcare plan and high deductibles keep many insured people from using their healthcare plan.
The COVID-19 pandemic clearly illustrated that our country is in a healthcare crisis. Estimates of greater than 240,000 North Carolinians lost health insurance coverage in the first six months of the pandemic alone. This is just one extreme example of why healthcare coverage should never be tied to employment.
THE CURRENT STATUS
- North Carolina is fifth in the nation in lost health insurance coverage due to the Covid-19 recession.
- In North Carolina one-in-five adults under the age of 65 are uninsured. This is a 24% increase since 2018.
- An additional 1.1 million are considered to be underinsured. When deductibles add up to five percent or more of a family’s income, those families are considered underinsured. In North Carolina, average deductibles are $3,325, or 5.7 percent of median income.
- Many families fall into the ‘family coverage glitch.’ For single-person policies, employees qualify for marketplace subsidies if they spend more than 9.86 percent of their income on premiums. But that doesn’t work for family plans: in NC, families spend an average of 10.25 percent of their income on premiums, but don’t get the subsidies.
- Employers with fewer than 50 employees use insurer-offered plans that meet ACA mandates. The federal out of pocket limits for family plans rose to $16,400 in 2020 versus $12,600 in 2014.
- The average premium in North Carolina for an employee-sponsored family plan was $18,211 in 2018.
- Black, Indigenous, Latinx, Asian Americans, and people of color, as well as people living in rural communities, have not only been hit the hardest by COVID-19 but also face disproportionate barriers in being able to access the health care they need. 54% of North Carolina’s uninsured are people of color.
Recommendations
Continue to call for and provide unwavering support for a universal single-payer Medicare-for-All healthcare system, available to all residents, and free at the point of service. Until this long-term goal is reached, we support the following interim measures:
- Support the proposals to expand and improve Medicare in the $3.5 trillion infrastructure bill which includes:
- Expanding Medicare to include coverage for dental, vision, and hearing services
- Allowing Medicare to negotiate lower prescription drug prices
- Lowering the Medicare eligibility age
- Implementing a cap on out of pocket expenses where currently there is none
- Engage in advocacy work needed to urge the North Carolina Congressional delegation and the Biden administration to support the passage and implementation of the H.R. 1976 – The Medicare For All Act of 2021.
