Despite a wave of protests, North Carolina says it will not expand Medicaid, the government-funded program that provides the poor with health care.
And that means the onset of the Affordable Care Act could do little to change the status of the 150,000 uninsured in Mecklenburg County.
"People like me who don't make enough money to pay $300 dollars a month," says Luise Korkmen, who is employed at Taco Bell. When Korkmen gets sick, "I go to the emergency room all the time," he says.
He recently went for a migraine.
"My bill was $800 just for them to give me some Tylenol," he says. "I can't pay for that."
Every year, thousands of the uninsured wind up in emergency rooms here unable to pay for their visits, but there is an alternative, and it has nothing to do with Medicaid. Many could have received care at local low or no-cost clinics like Care Ring, which is privately funded. Don Jonas is executive director there, and he says unpaid ER trips create an unnecessary burden.
"When someone's who's uninsured shows up at the emergency room, our emergency room hospital partners have to stabilize that person," Jonas says.
That can be incredibly expensive - and when those uninsured people can't pay...you do.
"The money has to come from somewhere," Jonas says.
Jonas says hospitals routinely raise rates on the insured in order to cover the costs of outstanding fees racked up by the uninsured.
"It's sort of this robbing Peter to pay Paul kind of thing," he says.
But it doesn't have to happen. There is a system of local non-profit clinics called MedLink - Care Ring is just one part - and Jonas says the more than 60, 000 people who choose the ER instead would have qualified for that assistance set aside specifically for them.
"One of the primary reasons our clinic and many others in town exist," Jonas says, "is to try to reduce those people that show up."
In addition to MedLink, there's a wide network of area doctors willing to see uninsured patients.
"We can connect them to one of these 1600 doctors that will see them at extremely reduced prices," Jonas says. "In some cases free."
Called Physicians Reach Out - the group provided $15 million worth of charity care last year in Mecklenburg County, and it could provide more, if more uninsured used the program. The key could simply be education.
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