by Chris Fitzsimon
Governor Pat McCrory made the first big policy pronouncement of his administration Tuesday morning, throwing his support behind legislation making its way through the General Assembly that would deny health care to 500,000 low-income people by refusing to expand Medicaid under the Affordable Care Act.
Legislative leaders weren’t exactly sitting around wait for McCrory to weigh in. The Senate ignored McCrory’s plea last week to slow down and passed a bill that would refuse the Medicaid expansion and prohibit the state from setting up its own health exchange under the federal law. A House committee took up the proposal Tuesday.
Both debates were marked by a combination of misinformation about what Medicaid expansion would mean for North Carolina and a tea partyish refusal to have anything to do with the Affordable Care Act even though it’s the law of the land and has been upheld by the conservative U.S. Supreme Court.
Senate President Phil Berger even shamelessly circulated a petition against the ACA that included the lie that the law would require the government to turn over people’s health records to the IRS.
McCrory made his announcement that he was siding with the tea party wing of his party and denying health care to half a million people in a news release, not an appearance before reporters where he might have to answer difficult questions.
His statement cited a recent audit of the state’s Medicaid program as justification for his decision, as well as uncertainty about the federal government’s long term funding commitment in light of the federal budget deficit.
The audit did find some problems in the administration of part of the Medicaid program, but much of the budget problems were the result of unrealistic demands for savings included in the state budget the Republicans passed in the last two years.
Former HHS Secretary Lanier Cansler repeatedly told legislative leaders than their budget forecasts were impossible to meet but they were approved anyway.
As for the federal funding issue, the Affordable Care Act says the federal government will pay the full cost of Medicaid expansion for the first three years and 90 percent after that. There is nothing to prevent lawmakers and McCrory from including a provision in the law that rescinds the expansion if the federal funding falls below promised levels.
The expansion could also be done with a provision in the state budget which will pass this summer, giving state Medicaid officials in the McCrory Administration several months to correct some of the problems identified in the audit before expansion is approved and several months more before it actually takes place in January of 2014.
But legislative leaders are not interested in finding ways to address legitimate concerns about the Affordable Care Act. They are obsessed with thwarting its purpose to expand health care coverage.
Never mind the study form the Institute of Medicine that finds that expanding Medicaid would actually save the state money and create 23,000 jobs. This is not about health care or jobs or hospitals or the state budget. It’s about a radical right ideology.
The politics of McCrory’s late and weak announcement are also clear. He was simply unable or willing to stand up to the right-wing base in his own party, led and funded by his own State Budget Director Art Pope, that detests the Affordable Care Act and refuses to acknowledge all the benefits it could bring to people in North Carolina.
McCrory found an excuse in the recent audit to justify refusing Medicaid expansion without publicly adopting the tea party anti-health care rhetoric, but the effect is the same.
Hospitals, doctors, and most importantly 500,000 people in North Carolina without health care coverage will now suffer as a result.
So much for the hope that the thoughtful moderate Republican mayor of Charlotte was elected governor. That politician is nowhere to be seen in Raleigh.
Tuesday’s feeble news release is clear evidence of that. The Pope Administration’s reign continues.
Chris Fitzsimon is Director of NC Policy Watch and an NC Spin Panelist