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A Ray of Hope for Kate: How Medicaid Expansion is Making a Difference in Patients’ Lives

At 41, Kate Roper received a diagnosis that changed her life and helped explain at least two decades of health issues. However, the resulting financial strain was almost overwhelming – that is, until Medicaid Expansion passed in North Carolina.


Kate has dealt with strange symptoms since her twenties, and for many years she struggled to find an answer as to what was causing her debilitating health issues. They impacted her day-to-day life and caused her to struggle financially. She tried to compare her symptoms to different diseases and get tested for them, but often doctors just saw her as a hypochondriac, she says.

Kate Roper

It wasn’t until 2022 when a tumor started visibly pushing out through her ear canal that a diagnosis could be made: jugulotympanic paraganglioma, a very rare tumor in the head or neck that makes up only 0.03% of all tumors.

“Big ole tumor in my head didn’t even make the list of possibilities — until a big ole tumor popped out the side of my head and I thought, ‘Oh, that would explain it!’” Kate says.

Most paragangliomas are slow growing, and while some can turn cancerous, most are not – though they can still cause health issues. These tumors often release hormones including adrenaline, which is the fight-or-flight hormone. This can cause high blood pressure, a rapid heartbeat, sweating, headache, and tremors.

“These tumors can look like a panic disorder and doctors can decide it’s all in your head …” Kate says, starting to laugh. “And it was – it was in a large part of my head!”

At this point, she had a diagnosis but no clear path forward without health insurance. She was enrolled in the state’s limited Family Planning Medicaid program, but it wouldn’t cover surgery. Fortunately, after about six months, a Duke Health surgeon in Raleigh, NC, removed the tumor, with Duke covering the costs.

This was a huge relief, but almost immediately Kate faced a new set of challenges. While recovering from surgery, she was unable to work. Being the full-time caregiver for her disabled spouse, they started falling behind on rent. Soon they were facing eviction from their home of 15 years.

“December was really bad for me,” she says. “I could barely get out of bed. And I needed to be able to get out of bed if the bed wasn’t going to be there anymore.”


During a visit to WNCCHS—Minnie Jones Health Center in December, Kate shared her difficult situation with a nurse practitioner. To her surprise, he said the WNCCHS Care Management team may be able to help, and Charlene Rumfelt, a medical social worker, came up to speak with her. Using a special fund that provides low-income LGBTQ+ patients with emergency housing assistance and pharmacy benefits, the WNCCHS team was able to catch Kate and her spouse up on rent, helping them avoiding eviction.

“It’s a big weight off the chest, for both of us,” says Kate.


While working on Kate’s case, Charlene noticed something else: As part of Medicaid Expansion passing in North Carolina in 2023, Kate had been automatically enrolled in full Medicaid coverage on December 1 – along with many other folks who’d been previously been enrolled in the state’s Family Planning Medicaid program.

“My reaction was to be very happy for her, because even though she still has medical issues, she’s not to have to worry about how her medical bills are going to be paid as much,” says Charlene. “It’s a relief to see our patients get added benefits, especially if they’re struggling.”

Kate says it’s a huge relief to now have health coverage, especially knowing she will need additional medical care for related hearing loss and follow-up appointments to monitor her condition.


“Once you have a paraganglioma, there’s a good chance you’re going to have another one, so they recommend yearly testing,” said Kate. “Without health insurance, that would be just near impossible.”

For now, she can focus on recovering from the effects of the tumor on her mind and body – a process she describes as “good and also scary.”

Kate is one of 600,000 North Carolinians who can now access the care they need to stay healthier, treat sickness earlier, and achieve peace of mind through NC Medicaid. Even if you were not eligible in the past, you may be eligible now.

Learn more at wnnchs.org/Medicaid-Expansion or call us at 828-285-0622. If you’d like help applying, please stop by WNNCHS—Minnie Jones Health Center with your supporting documents.

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