After journeying 273 miles on foot, Adam O’Neal, Republican Mayor of Belhaven, North Carolina, arrived on the lawn of the US Capitol earlier this week for a special Moral Monday gathering. O’Neal hiked to Washington, DC to protest the closing of Vidant Pungo Hospital in rural Beaufort County, NC, and to call attention to the impact of his state’s failure to expand Medicaid through the Affordable Care Act (ACA).

“We the people need to stand together to produce health care for us all,” wrote O’Neal before embarking on his first steps of his 15-day trip to the Capitol. Over 100 members of O’Neal’s community as well as folks from the NAACP-NC chapter, including Rev. Dr. William Barber, joined him in solidarity.

Vidant Pungo Hospital in Belhaven was forced to close on July 1, in part because of North Carolina’s refusal to expand Medicaid. Only days later, Portia Gibbs, a 48-year old mother of three, died of a heart attack and other health complications while awaiting transport to the next nearest hospital – over 75 miles away. “She spent the last hour of her life in a parking lot at a high school waiting for a helicopter,” explained O’Neal on Monday.

“If the governor and the Legislature don’t want to accept Medicaid expansion, they need to come up with another program to assure that rural hospitals don’t close,” said O’Neal. “They’re allowing people to die to prove a point. That is wrong, and I’m not going to be a party to that.” He continued, “Rural citizens dying should not be soldiers of the South’s defiance to the new health care law.”

Rural hospitals in states such as Virginia, Georgia and Tennessee – which have all refused Medicaid expansion – will soon be closing or cutting vital health care services. Many of these hospitals serve poorer populations with higher numbers of uninsured individuals. In North Carolina, according to O’Neal, the rejection of Medicaid expansion costs the state’s health care system $2 billion a year, denying hundreds of thousands of low-income individuals access to care.

A recent study released by George Washington University found that community health centers in states that have expanded Medicaid subsidies have seen 2.9 million patients gain health coverage in 2014. O’Neal is calling for this kind of progress to occur in North Carolina, explaining that the situation has become “do-or-die”.

Twenty-seven states and Washington, DC have already expanded Medicaid, leading to a 15.3 percent increase in Medicaid enrollment in those states. Medicaid is our nation’s health insurance program for low-income families and individuals. The program – celebrating, along with Medicare, its 49th anniversary today – also funds health centers that provide care for under-served communities. Historically, the majority of Medicaid beneficiaries – over 22 million in 2009 – have been women. Though programs differ by state, before the ACA Medicaid expansion, Medicaid covered only pregnant women, children under 8, adults with dependent children, the elderly, the differently-abled and the blind. The ACA, however, now allows states to expand Medicaid eligibility to all Americans with incomes below 138% of the federal poverty level. There is no deadline for states to opt into ACA Medicaid expansion and eligible individuals can enroll in Medicaid at any time.

Media Resources: McClatchy Washington Bureau 7/28/14; Washington Post 7/28/14; The Carolina Mecury 7/14/14; Kaiser Family Foundation 6/10/14, 5/15/13; US Department of Health and Human Services 6/4/14; Feminist Newswire 5/15/14; Think Progress 7/15/14; 4/30/14; Healthcare.gov

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