It was Nixon who went to China. And now the forces for Medicaid expansion in North Carolina have their own unlikely champion.

Alamance County Sheriff Terry Johnson, a conservative firebrand best known for his controversial views on immigration, has lent his support to a bill, sponsored by Rep. Donny Lambeth, a Forsyth County Republican, which pairs Medicaid expansion with a work requirement and premium payments.

“In law enforcement, we’re dealing with people in our detention centers and in our communities who need that coverage.” Johnson said in endorsement of House Bill 655. “We could be helping some of these people get back in society and make their own way.”

Johnson appeared at an April news conference with businessman and former GOP gubernatorial candidate George Little; former N.C. Rep. Chris Malone, R-Wake; Rep. Holly Grange, R-New Hanover; and the Rev. Gilbert Parker, president of the N.C. Faith Fellowship Foundation.

“Hard-working families in North Carolina are being left behind by a broken health care system,” said Grange, one of the bill’s co-sponsors. “These families earn too much to qualify for Medicaid, but not enough to afford private health insurance.”

Grange also noted the impact on veterans: “One in four veterans of Iraq and Afghanistan in North Carolina have no health care coverage and no access to the Veterans Administration.”

The news conference was sponsored by the N.C. Fund for a Conservative Future, which also cited the results of a February poll of 800 registered voters in North Carolina that showed more than 70% support for Medicaid expansion. That number included not only 90.1% of Democrats, but 66.9% of unaffiliated voters and 52.4% of Republicans.

This could be because the case for it is so obvious. Foremost, Medicaid expansion would provide care for North Carolinians who could otherwise afford none and would quite probably save lives. It also would create as many as 40,000 jobs and help struggling rural hospitals.

“This issue is monumental to us,” Chris Lumsden, CEO of Northern Hospital of Surry County, said during an April roundtable discussion among CEOs of rural hospitals in North Carolina. “(Medicaid expansion) is something we can do today that will impact patient care and economic development down the road.”

Six rural hospitals have closed in North Carolina since 2010, affecting not only access to health care but the well-being of rural economies.

“Rural hospitals are anchor institutions in their communities,” Greg Tung, a University of Colorado health economist, told NC Health News. “They are kind of a pillar of the local community and the local economy; they provide a lot of skilled, well-paying jobs for that area. So, when a rural hospital closes, it has a disproportionately large impact on that community, especially in comparison to an urban hospital closure.”

Finally, Medicaid expansion would help to address the state’s spiraling opioid crisis by providing greater access to treatment.

And, of course, this increased coverage would be almost completely funded by the federal government — using taxes North Carolinians already pay.

But don’t confuse anyone with facts. Medicaid expansion in North Carolina remains stalled in the GOP-controlled General Assembly.

Beyond politics, there is no practical reason not to do this. And some Republicans obviously agree. Despite the long odds, their voices are helpful and important. And deeply appreciated.

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