Medicaid expansion has never been more vital than it is now 

June 24, 2020

When the year began, I’m sure none of us thought our daily lives would look like they do today.


Our communities are suffering great losses on every scale. From lost graduation celebrations to lost jobs too, most painful of all lost loved ones; we are grieving together and I have been so encouraged by the acts of kindness and togetherness I have seen among neighbors.


The COVID-19 pandemic has ravaged the lives and the livelihoods of all North Carolinians. More than 115K Americans have died and more than 1.1 million North Carolinians have filed for unemployment. Hundreds of thousands of North Carolinians have lost their employer-sponsored health insurance as a direct impact of the coronavirus pandemic. Not to mention those on the frontlines of this pandemic, essential workers who have been underinsured for far too long. 


We are all experiencing unparalleled levels of loss. But what we must focus on now is our ability to turn this loss into action and make the changes our state needs moving forward. We cannot destroy this virus, but we can ensure that we take care of our people.


That is why I am urging those in the General Assembly to keep our most vulnerable in their mind and expand Medicaid during this legislative session. Amid the outbreak, expanding Medicaid would give those recently unemployed and the uninsured and underinsured access to quality and affordable health care.


If the Republican-led general assembly had expanded Medicaid in 2019, more than 194,000 members of the working poor, who earn too much money to qualify for Medicaid but too little to purchase their own insurance plans, would currently have access to affordable coverage. More than half a million North Carolinians would have new access to quality and affordable health care, and would not now be choosing between putting food on the table and paying seemingly endless medical bills. 


Study after study has proven that expanding Medicaid improves lives, particularly in southern states, and numerous reports have found that expanding Medicaid would benefit every county in North Carolina, especially Wayne and Lenoir where our hospitals are struggling. 


Expanding Medicaid would create over 37,000 new health care jobs in North Carolina and boost paychecks across the state. Our rural areas would also get a much needed boost. Medicaid Expansion would bring more health care jobs to our rural areas and keep rural hospitals open, reducing the chances of a rural hospital closing by 62 percent. Additionally, expansion would help reimburse some of our struggling rural medical centers and alleviate some of the medical debt accumulating during this pandemic and economic recession.


Let me be very clear, Medicaid expansion does not mean eliminating private insurance, it simply gives those who do not have private insurance access to quality, affordable health care. I do not support a “state takeover” of your healthcare, nor would I suggest that you should lose your private insurance, if you are happy with it.  In fact, those who keep their private health insurance would save money in the long run; insurance premiums are on average lower in states that have expanded Medicaid, as there is less cost-shifting when there are fewer uninsured. 


The outbreak of COVID-19 has brought unprecedented amounts of uncertainty to the lives of us all, but one thing remains certain. Our communities are suffering and we have the power to make much-needed changes to our state’s infrastructure that would ease this suffering. 


We must act, and all do our part to help our fellow North Carolinians through this crisis, together.

Call to Action: Local leaders must work and communicate together to during this Coronavirus pandemic

March 15, 2020

It came to my attention from various sources, the public does not have a complete view of what planning is being done collectively by our elected and healthcare officials to protect our community during this coronavirus pandemic.  

As a previous USAF Medical Commander, Nurse, ECU Professor; I would like to share my advice based on 25 years of disaster work and experiences from international, national, and local health disasters. There are tenets of crisis leadership that maybe helpful for our local elected leaders to be reminded of at this time which include: 1) Continuously understanding the crisis, 2) Lead decisively, and 3) Actively Communicate.

Continuously understanding and embracing the scale of the Covid-19 will take leadership and communication skills as this is more contagious and harder to predict than the seasonal flu. In order to limit the damage during a pandemic, public trust and information is critical. Our elected officials have a moral duty to provide timely, clear, and actionable information to the public.

Leading through a pandemic takes the integration between public health, hospital and public elected leaders (Commissioners, City Council, hospital, public health officials, etc.,) and other partners (SJAFB, faith-based leaders, etc.,) to plan together and communicate to the public the collective coronavirus emergency plan for the county. Typically, this takes place in a joint operational center, and then shared on the internet, live podcast, radio, or written print or all-of-the above. As of this writing, it is unclear if a county operational center has stood up.


Communication topics could include the following: Is there a plan besides the UNC- Wayne Health Emergency Department as the port of entry for those who are sick and need a Covid-19 test? Is there going to be drive-by test screening? What does a sick person do if they don’t have insurance or a private provider? What should one do, if the private provider is overwhelmed with requests? Will there be additional triage areas (inflatable tents, etc.,) for Covid-19 sick patients? How can volunteers or retired healthcare workers assist? 

Leading decisively during a complex crisis demands leadership skills and teamwork, and we count on our leaders to keep us safe by working together to Protect us during this Coronavirus pandemic. I feel confident our healthcare leaders are operationalizing their plans now. However, I have not seen evidence that our local elected officials are engaged in joint planning with our health care leaders. For example, do our elected officials have a plan to provide students their meals when they are not in school, or how do we prevent a break-out within our homeless population? How does law enforcement manage a geographic area that has high numbers of infected people? These are just a few topics the public needs to hear about from our elected officials. 

I look forward to the first daily public interagency briefing from our county leadership (healthcare and elected) officials. Our community has shown our strength in the past, and  I know we will all do our part …so wave, not hug, call instead of visit, continue social distancing, and support our healthcare workers, emergency services, and elected officials as they all do their important jobs taking care of us.


Dr. Donna Lake, Professor at ECU College of Nursing, Colonel USAF Retired, and Candidate for NC Senate District 7


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