Gov. Pat McCrory said Thursday he’s weighing whether to expand Medicaid, the health insurance plan for the poor and disabled, adding to signs that state Republican leaders may reconsider their opposition to extending the social program.
In addition to shaping a plan for networks of physicians and hospitals to share the risk of rising health care costs, “I’m also trying to figure out what to do with Medicaid and whether to expand that or not, because the feds are offering all this money and yet I’ve got to be concerned with the bureaucracy that could be grown because of that,” McCrory told a gathering of corporate CEOs at a Raleigh country club. “I’m doing that assessment right now.”
McCrory has said for months he’s willing to consider offering Medicaid to more of the working poor after containing costs and improving service to the 1.8 million already covered. His comments came two days after state health secretary Aldona Wos said she soon plans to present McCrory with expansion options.
Outgoing House Speaker Thom Tillis, the Republican candidate for U.S. Senate, said last week that lawmakers and McCrory should consider Medicaid expansion next year. Tillis had emphasized the legislature’s rejection of Medicaid expansion during his GOP primary campaign.
State Senate leader Phil Berger, R-Rockingham, has not changed his position opposing Medicaid expansion, spokeswoman Shelly Carver said in an email.
McCrory signed into law early last year Republican-backed legislation banning the state from expanding Medicaid without General Assembly approval.
“I’m hearing a different melody from the administration on Medicaid expansion,” said Blue Cross Blue Shield of North Carolina CEO Brad Wilson, who attended the gathering.
Wilson has urged Medicaid expansion. Hospitals and doctors demand higher payments from the state’s largest health insurer to make up for losses they suffer when uninsured people are unable to pay for medical care, translating into higher insurance premiums for Blue Cross customers, said the former aide to Democratic ex-Gov. Jim Hunt.
“When they get sick, they are going to the doctor or going to the emergency room. And they wait later because they don’t have a payment mechanism, so their health circumstance is worse. That means the cost of their care is higher,” Wilson said.
About 500,000 low-income North Carolinians could qualify for Medicaid if it is expanded. The federal government said it would cover 100 percent of the state’s expansion costs through 2016 and at least 90 percent thereafter.
Pressure to expand Medicaid with federal funds that became available this year has come from North Carolina hospital CEOs among others. Not expanding Medicaid coverage could cost North Carolina $51 billion in lost federal money and thousands of jobs over the next decade, according to a study this summer by the Robert Wood Johnson Foundation and the Urban Institute.
Twenty-seven states and the District of Columbia have agreed to expand the government health insurance program for the poor. Most of the 21 states that have not expanded are governed by Republicans.
Pennsylvania in August became the ninth state run by a Republican governor to expand Medicaid under the federal health care law. Tennessee’s GOP Gov. Bill Haslam is in talks to expand Medicaid in his state despite resistance from fellow Republicans in the state legislature.