AURORA, N.C. — There is one doctor’s office in Aurora, North Carolina, a rural Beaufort County town of 450 on the Pamlico River. But ECU Health plans to shutter the Vidant Health Family Medicine clinic by the end of March, closing the only doctor’s office for miles in this eastern North Carolina farming community.
A new deal to expand Medicaid coverage to another estimated 600,000 people, announced last week by leaders in the General Assembly, will help keep clinics open and get more health care resources to people in rural communities.
“This is really going to be a game changer,” said Kim Schwartz, CEO of the Roanoke Chowan Community Health Center. “Having Medicaid expansion for this population is going to be huge across the state.”
North Carolina has resisted expanding Medicaid since it was approved by Congress during the Obama administration. But rural health care workers and advocates are applauding the move by the Republican-controlled legislature.
The ECU Health patients in Aurora will move about 25 miles west to Chocowinty, North Carolina, near Washington. In a statement, ECU said it had to close the clinic in Aurora and four others because the clinics don’t serve enough people with insurance and were losing money.
“This is an important moment for rural health care in North Carolina as our legislators have struck a deal to move Medicaid expansion and the Healthcare Access Stabilization Program (HASP) forward in the legislative process and one step closer to passage,” ECU Health CEO Dr. Michael Waldrum said in a statement.
“Medicaid expansion will provide coverage to more than 100,000 people in the East and HASP is vitally important to stabilize health care delivery in rural North Carolina,” he said. “While this won’t solve all of the challenges we face in rural health care, this is a critical and necessary step.”
The Medicaid expansion bill gives health care coverage to anyone 18 to 64 who makes 138% or less of the federal poverty levels. That’s about $18,750 for single people and $38,300 for a family of four.
Legislators are expected to pick up the measure soon, but it will likely be approved with the state budget sometime this summer.
“This will be really important to rural residents across the state. We know that eligibility will be higher in those communities,” said Mark Holmes with the UNC Gillings School of Public Health.
“This can make a real difference for hundreds of thousands of rural North Carolinians,” said Holmes, who studies the economics of health care in rural areas.
Medicaid expansion won’t solve all the problems rural communities have getting access to health care, he said, but it will mean a lot more patients in areas like Aurora will be insured.
Research from the public health school shows rural clinics and hospitals are still closing in states that have expanded Medicaid, but at a much slower rate, Holmes said.
North Carolina is one of 11 states that have not expanded Medicaid. Most are in the South. The federal government gave the states the option to expand Medicaid starting in 2014 under the Affordable Care Act. The federal government pays for the insurance coverage.
To get the remaining states to sign on and expand Medicaid, the Biden administration offered states more money to help their health care systems.
“Medicaid expansion will be transformative for access to health care in rural areas, for better mental health and for veterans, working adults and their families,” the North Carolina Department of Health and Human Services said in a statement.
“Expansion and HASP will bring $8 billion annually to North Carolina with no additional cost to the state, along with $1.8 billion which can support behavioral health, public safety support, rural health care, and other needs,” DHHS said. “North Carolina can receive an additional $1.8 billion in HASP payments if we are able to implement both these programs this fiscal year.”
Despite the deal at the General Assembly for expanding Medicaid, ECU still plans to close the five rural clinics, ECU Health confirmed. But it will help the doctors’ offices that do remain, giving health insurance to hundreds of thousands of people in places like Aurora.