Letter from our Chair, Doug Robinson, M.D.

Dear members and friends of Health Care Justice ● NC,

American healthcare is dysfunctional and deadly. Approximately 10% of us lack health insurance altogether, and 20% of us rely on Medicaid but are now at risk of losing it. We pay the most and live the sickest compared to other wealthy nations, where healthcare is a human right that is universally provided. Here, it’s a market commodity delivered by profit-driven corporations more beholden to shareholders than to patients. Healthcare is often linked to employment; losing your job can result in losing your health insurance. Employer-based or ACA marketplace insurance is increasingly too expensive, with costly co-pays, deductibles, and premiums that lead to nearly half of the insured delaying or skipping necessary care, saddling millions of them with medical debt. The shocking result, according to a recent Yale study, is that an estimated 68,000 of us die each year due to a lack of health insurance. Who knows how many of the underinsured die due to avoiding costly care? Unnecessary deaths from treatable conditions are certain to increase with cuts to Medicaid. 

By signing the One Big Beautiful Bill Act, President Trump approved nearly $1 trillion in cuts to Medicaid over 10 years. A recent study estimates that 7.6 million people will become uninsured and 16,642 will die each year as a result. Who are they? Republicans in Congress would have you believe that they are “able-bodied” young men choosing to live in their parents' basements, getting Medicaid because they refuse to work. The healthy and lazy basement dweller is meant to depict a typical Medicaid expansion beneficiary. They are targets for the onerous and ineffective work requirements that will decrease enrollment without increasing employment. 

False and degrading stereotypes are an old tool in American political rhetoric about social policy and who “deserves” government services. Ronald Regan’s 1976 “welfare queen” trope was employed as an argument for urgent welfare reform. Anne Whitesell, in her book Living off the Government?, says, “The public identity of the welfare queen—the poor, single African American woman whose poverty was caused by her laziness and promiscuity-is still the driving force in creating welfare policy.” Many 

lawmakers treat poverty as a moral failing that warrants cruelty rather than social services. Like many political tropes, the current one is false and deadly. 92% of people on Medicaid are already working, have a disability, or are performing duties like attending school or caregiving, which could qualify them for an exemption from work requirements. That leaves 8 percent of Medicaid recipients who are not working for reasons such as retirement, inability to find work, or an unspecified issue. That small group of “able-bodied” non-working beneficiaries is primarily (79%) comprised of very low-income, middle-aged or older, rural-living women who care for their elderly parents or adult children, have low levels of education, and have recently left the workforce, according to a study of census data from the University of Massachusetts. Those vulnerable women caretakers will be the real targets of work requirements. The study’s authors conclude that “we simply cannot afford a Medicaid work mandate that will do nothing to increase employment and only serves to disinsure vulnerable, impoverished older working-age women on whom their families depend.” Such women are the vulnerable insured who could lose health insurance or suffer a lapse in insurance during recertification. They will join the ranks of the uninsured and underinsured who can’t afford healthcare. Some of them will surely die as a result. 

The overarching cause of healthcare vulnerability in America is our lack of universal healthcare. Fortunately, the answer to the crisis is in plain sight. Medicare, the publicly financed single-payer national health program for seniors and people with disabilities, celebrates a very successful 60th birthday this year. We simply need to enhance and improve that popular and efficient program, making it accessible to everyone. Improved Medicare for All, as provided in the 2025 Senate and House Medicare for All Acts, will provide comprehensive, necessary medical care and prescription drugs free at the point of service with no copays, premiums, deductibles, or supplemental insurance needed. Dental care, hearing, vision, mental health, and long-term care will be included. The expense will be covered by equitable and progressive taxation, along with substantial administrative cost savings compared to the present system. Most households will end up paying less than they do now in insurance premiums and deductibles. 

Call your Representatives today and ask that they co-sponsor this important legislation. It will save lives. 

Douglas Robinson, M.D. 

Chair, Health Care Justice ● NC 

Below is a list of your Senators' and Representatives' office phone numbers.

Senator Thom Tillis: (202) 224-6342

Senator Ted Budd: (202) 224-3154

Representatives:

District 1    Don Davis                   (202) 225-3101

District 2    Deborah Ross            (202) 225-3032

District 3    Greg Murphy             (202) 225-3415

District 4    Valerie Foushee        (202) 225-1784

District 5    Virginia Foxx              (202) 225-2071

District 6    Addison McDowell    (202) 225-3065

District 7    David Rouzer             (202) 225-2731

District 8    Mark Harris                (202) 225-1976

District 9    Richard Hudson        (202) 225-3715

District 10  Pat Harrigan              (202) 225-2576

District 11  Chuck Edwards         (202) 225-6401

District 12  Alma Adams              (202) 225-1510

District 13  Brad Knott                 (202) 225-4531

District 14  Tim Moore                 (202) 225-5634

Not sure who your Representative is? You can find out here:

https://www.house.gov/representatives/find-your-representative.