“People’s Eyes Are Starting To Open”: How Covid-19 Is Driving Support for Medicaid Expansion

In North Carolina, canvassers are working to expand Medicaid—and finding a sympathetic audience amid the pandemic.

Allison SalernoJuly 6, 2020

Down Home NC member Carrie McBane stands with fellow members in the fall of 2019, to support a petition to expand Medicaid in North Carolina. (Photo courtesy of Down Home NC)

GREENS­BORO, N.C. — Dan Bay­er sits at a lam­i­nate table in his partner’s rental duplex about din­ner­time May 7, mak­ing cold calls to res­i­dents of Cabar­rus Coun­ty, a most­ly white, rur­al coun­ty in the mid­dle of North Car­oli­na. After 50 min­utes of hangups and dis­con­nect­ed num­bers (and two peo­ple who signed the peti­tion he’s cir­cu­lat­ing), Bay­er is talk­ing with a 59-year-old African Amer­i­can man. Bay­er asks how he’s cop­ing dur­ing the pandemic.

Jasmine Wright says in the wake of the job losses brought on by Covid-19, 'People’s eyes are starting to open.'

We’re doing fine out here,” the man says. With a drawl from a child­hood spent on North Carolina’s coastal plain, Bay­er, a white man with long gray hair, eas­es the con­ver­sa­tion toward health­care. The man tells him, Med­ic­aid is some­thing a lot of peo­ple need.” Bay­er agrees and tells the sto­ry of a for­mer house­mate, an unin­sured restau­rant work­er with dia­betes. He was always hav­ing attacks,” Bay­er says. There’s a lot of peo­ple who were suf­fer­ing even before this present circumstance.”

Bay­er, 51, is a can­vass­er for Down Home North Car­oli­na, a pro­gres­sive non­prof­it found­ed in 2017 to build the pow­er of the state’s mul­tira­cial work­ing class in small towns and rur­al areas.” For the past three weeks, in a state with one of the high­est lev­els of unin­sured cit­i­zens, Bay­er and oth­er vol­un­teers have been try­ing to con­vince Cabar­rus Coun­ty res­i­dents to sign a peti­tion ask­ing the North Car­oli­na Gen­er­al Assem­bly and Gov. Roy Coop­er to expand Med­ic­aid cov­er­age to half a mil­lion more North Car­olini­ans. On July 2, Gov. Coop­er signed a Med­ic­aid trans­for­ma­tion bill that includ­ed Covid-19 relief but did not ful­ly expand Med­ic­aid. North Car­oli­na is one of 13 red states, most­ly in the South, where Repub­li­cans refused Afford­able Care Act mon­ey to expand Med­ic­aid eligibility.

The state has vot­ed almost exclu­sive­ly for Repub­li­can pres­i­den­tial can­di­dates since 1968, as the nation­al par­ty exploit­ed white con­ser­v­a­tives’ back­lash against civ­il rights gains. But the tides might be chang­ing. In 2016, a slim major­i­ty of North Car­olini­ans vot­ed for Don­ald Trump — but also elect­ed Coop­er, a Demo­c­rat and Med­ic­aid expan­sion advocate.

Down Home now has chap­ters in five most­ly white, rur­al coun­ties in cen­tral and west­ern North Car­oli­na that have expe­ri­enced severe job loss­es — an esti­mat­ed350,000 man­u­fac­tur­ing jobs statewide since NAF­TA in the ear­ly 1990s. Through deep can­vass­ing, Down Home iden­ti­fied the lack of afford­able health­care as a top con­cern for its coun­ties, also hit hard by farm consolidation.

Cabar­rus Coun­ty chap­ter orga­niz­er Jas­mine Wright, 28, who is African Amer­i­can, says in the wake of the job loss­es brought on by Covid-19, People’s eyes are start­ing to open.” The Med­ic­aid expan­sion would pro­vide health­care to hun­dreds of thou­sands of work­ers laid off from low-income jobs. Only Col­orado and Louisiana have suf­fered more job loss­es than North Car­oli­na dur­ing the pan­dem­ic. In one call, an 81-year-old white woman told Wright the best thing to do is to pray for the pres­i­dent and acknowl­edge his author­i­ty. Wright’s response was to bring the issue home. You ask them to get a lit­tle per­son­al, and I get per­son­al,” she says. It turned out the woman’s son-in-law lost his job and his health cov­er­age as a result of the pan­dem­ic. The woman end­ed up sign­ing the petition.

Before Covid-19, Down Home’s orga­niz­ing strat­e­gy focused on sto­ry shar­ing on front porch­es. Bay­er once used cues from people’s yards — whether they kept a gar­den, had pets or post­ed polit­i­cal signs — to start con­ver­sa­tions. Now, can­vassers share per­son­al sto­ries about the pan­dem­ic to find com­mon­al­i­ty. Bay­er, who has worked in fac­to­ries, ware­hous­es and as a deliv­ery dri­ver, begins his calls: I’m Dan. I’m with Down Home North Car­oli­na. We’re a com­mu­ni­ty group. We work on build­ing pow­er for work­ing folks. … We’re just call­ing folks to find out how they’re doing at the moment. … How are y’all doing?” 

Down Home’s coun­ties also face recruit­ment efforts from active white suprema­cist groups. Overt white suprema­cy has been a dom­i­nant nar­ra­tive through­out North Carolina’s his­to­ry, says Todd Zim­mer, a Down Home co-founder. It’s been used as a wedge to pre­vent the emer­gence of com­mon cause coali­tions that are mul­tira­cial,” he says. That typ­i­cal­ly looks like a white pow­er struc­ture foment­ing and per­pet­u­at­ing the oppres­sion of peo­ple of col­or. … A white suprema­cist polit­i­cal strat­e­gy dis­ad­van­tages not only peo­ple of col­or but also all poor peo­ple because low-income folks, regard­less of race, have a lot of shared con­cerns and issues.”

When Down Home’s Med­ic­aid peti­tion dri­ve began in 2019, door-to-door can­vassers gath­ered 1,200 sig­na­tures across all five coun­ties. In Cabar­rus Coun­ty this fall, can­vassers knocked on 1,559 doors and got 154 sig­na­tures. Since Coop­er issued shel­ter-in-place orders March 27, can­vassers have gath­ered 718 more across the coun­ties as of press time. Their goal is 5,000.

Wright remains opti­mistic. Even phone calls can result in deep con­ver­sa­tions, she says. One man, a 64-year-old African Amer­i­can busi­ness own­er, told Wright he believed Covid-19 is a hoax. Wright shared how she just lost two friends to the virus. I under­stand it’s not vis­i­ble to you at this point in time, but I do believe it’s real,” she told the man. By the conversation’s end, he had shared his business’s strug­gles and what he was doing to help his neigh­bors, and agreed to elec­tron­i­cal­ly sign. He also gave Wright his email address to stay updat­ed about Down Home’s work.

Alli­son Saler­no is an inde­pen­dent writer and audio pro­duc­er based in Athens, Ga.
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