In North Carolina, the GOP giveth and the GOP taketh away.

Tillis told the truth on health care the and Republicans would be wise to listen.

Photo credit: Anna Claire Vollers/Stateline

Thom Tillis did the right thing. He stood firm in his convictions and opposed the Senate version of the reconciliation bill that would add significantly to the deficit and take away health insurance from more than 600,000 North Carolinians. While the bill passed, Tillis stood up for his constituents while trying to shame his colleagues into rejecting the deeply flawed legislation.

North Carolina just passed Medicaid expansion in 2023. The Republican legislature finally admitted that expansion was a good idea. Within a year, more than 600,000 state residents took advantage of the move. Just as people are starting feel the benefits, they are going to take them away. The GOP will likely pay a steep and sustained political price.

Medicaid expansion had real results for people who have long ignored their health problems because they couldn’t afford health care. The move has significantly improved the quality of life for people who had to decide between food and doctors’ appointments. Last year, one friend in his 50s had his first medical check up in a decade. He fixed gum disease that had caused him to live with pain for years. He marvels at the ability to see a doctor without wondering how he’ll afford it.

Stripping Medicaid from people like him will certainly shorten the lives of people who have to go back to ignoring their health. My friend Jack died a few years before Medicaid expansion. He lived for about a year with a pain in his throat and increasing difficulty swallowing before finally seeing a doctor. By then, the tumor in his throat was inoperable. Had Medicaid been available to him, he might still be alive.

Republicans passing this legislation have very short memories. The fight over health care dominated the domestic political debate for most of the 1990s and first decade of this century. The problem gave us Barack Obama. The great debates between Hillary Clinton and Obama in the 2008 presidential primary centered on how to fix our broken health care system. The only thing that kept George W. Bush in the White House in 2004 was fear of terrorism in the wake of 9/11.

Health care had two problems. Uninsured people made up an increasing percentage of the population and the cost of health care was spiraling out of control. Initially, Democrats tried to address both problems, but as the debate stretched out, they focused more coverage than costs. Medicaid expansion reduced the number of uninsured people from more than 16% of the population to less than 10% in a few short years. It also slowed the rate of growth in costs, but they’ve still grown too fast for many people and procedures.

Controlling costs of health care should be our next battle. Instead, we’ll go backwards, watching the uninsured grow and people using emergency rooms as primary care. Instead of reducing expensive ailments with cheap preventive care, we’ll go back to paying for expensive and invasive treatments to address diseases and injuries that have become serious because they were ignored for too long. Costs will begin climbing rapidly and insurance premiums will follow. We’ve already been here and it’s unfathomable why we’re doing it again.

Ironically, the people who will hurt most live in solidly Republican areas. Rural hospitals will likely close and other providers will leave for greener pastures. Older and infirm people will lose their long-term care, forcing already struggling family to pick up the tab or the responsibility for care. Republicans just turned their backs on the working class voters they’ve been grooming.

As Thom Tillis told his colleagues, Republicans will get the blame. Donald Trump lied to the American people when he told them he would not cut Medicaid. The GOP prioritized tax cuts for the wealthiest Americans while stripping health care from the neediest.

Thom Tillis knows what’s right and finally did it. Thanks, Senator.