RALEIGH — Dr. Charles van der Horst has been around the world as an internationally known AIDS researcher and says he’s seen poverty and limited medical care in Third World countries that can move an observer to tears.
On Wednesday, the physician from UNC Hospitals got choked up on a witness stand in Wake County District Court while describing his motives for joining one of the demonstrations this summer outside the General Assembly chambers.
The legislature had just rejected the federal government’s offer to expand Medicaid as part of the new federal health care law, and van der Horst said he was frustrated that he had not been able to present his concerns to any of the Republican leaders guiding that decision.
“This was going to have a direct impact on my patients,” van der Horst, 61, testified before tears welled in his eyes and his speech became halting.
After two days of testimony in November and a full day Wednesday, van der Horst and another defendant, Tye Hunter, were found guilty of second-degree trespass but not guilty of violating N.C. State Legislative Building rules.
Van der Horst and Hunter, a lawyer who recently stepped down as executive director of the Center for Death Penalty Litigation, immediately appealed the decision to Wake County Superior Court. They, like some of the other demonstrators found guilty of charges lodged against them during the summer protests, will seek a jury trial.
Rejection of expansion
The General Assembly rejected a Medicaid expansion that would have added between 318,000 and 500,000 low-income North Carolinians to the federal-state health insurance program for the poor.
The federal government would have paid for the expansion for the first three years and covered 90 percent of the cost afterward. But North Carolina lawmakers said the state costs would still be substantial. Republican leaders also said they worried the federal government would renege on its agreement and that the state would be left with a large bill.
Van der Horst, an advocate of the health law who has testified before Congress on medical issues, said he had tried to talk with his state legislators in February about the Medicaid expansion proposal in the Affordable Care Act and got nowhere.
By May 6, he said, his exasperation had grown, and not only was he worried about his patients, he also was worried about the financial impact the decision would have on UNC Hospitals, which treats many of the state’s indigent patients. The failure to expand Medicaid is expected to cost state hospitals nearly $600 million.
“There was this frustration that I couldn’t make my voice heard, and I thought it was going to lead to the death of my patients,” van der Horst told William Lawton, a former Wake County District Court judge brought in by the state Administrative Office of the Courts to preside over trials of some of the 900-plus demonstrators arrested this summer at the General Assembly.
Lawton spoke about van der Horst’s testimony while announcing his verdict, saying that he “has a passion I wish all doctors have.”
While on the stand, van der Horst recounted his personal reasons for protesting – the oath he took upon becoming a doctor, his immigrant parents’ belief in the U.S. Constitution and his clinical experience since the decision had been made.
Tale of two patients
Van der Horst told Lawton about the impact on two patients – one he had treated and one that another physician had seen.
Both patients had been unable to get prescriptions filled that would have been covered either by Medicaid or new Affordable Care Act regulations. One patient was diabetic with a foot ulcer unable to get antibiotics that would have been provided were he added to the Medicaid roster. Another had been losing weight for 18 months and was finally diagnosed with an illness that could be treated with prescription drugs, but his insurance company denied them.
Van der Horst said it was “incredibly frustrating” as a physician to be able to make such a diagnosis and then see the patient unable to get the necessary treatment because of such barricades.
“I think that’s what got me crying,” van der Horst said.
Van der Horst said afterward that he did not take the conviction lightly and that he never had been arrested before.
But he added that he did not regret trying to raise awareness of an issue of utmost importance to him.
“For me, I felt I was in between a rock and a hard place,” van der Horst said.
Blythe: 919-836-4948; Twitter: @AnneBlythe1