No excuses left not to expand Medicaid
Published July 3, 2015
by Chris Fitzsimon, NC Policy Watch and NC SPIN panelist, July 2, 2015.
In case Gov. Pat McCrory and legislative leaders haven’t heard, the Affordable Care Act is here to stay.
The Supreme Court made sure of that last week by rejecting an absurd claim that Congress didn’t intend for the law to provide subsidies for people in states that didn’t set up their own health care exchanges and were instead buying coverage on the federal marketplace.
Congress clearly passed the ACA to make health care affordable to people across the country, not just in select states. The law also provides strong incentives to states to expand Medicaid and cover millions of low-income adults who don’t fall within the classifications of folks currently eligible for the program, children, seniors, people with disabilities, etc.
A factory worker laid off from his or her job in North Carolina is most likely not on Medicaid now and not eligible to sign up, left only to hope they don’t get sick or injured while they are looking for another job.
Laid off workers in 29 states and Washington D.C. can sign up for Medicaid if they meet the income eligibility requirements because those states, several with very conservative governors, have expanded Medicaid under the ACA with the federal government picking up 90 percent of the cost.
Leaders in McCrory’s own Department of Health and Human Services seem to support a Medicaid expansion plan, realizing that not only would it provide health coverage for 500,000 people in the state but it would also provide billions of dollars to North Carolina hospitals, many of whom are struggling to survive.
Then there are the jobs. A study by the N.C. Institute of Medicine released last year found that expanding Medicaid would create 25,000 jobs in the state in the first few years of expansion and 18,000 sustained jobs after that.
McCrory has so far resisted calls to expand Medicaid, though he struggles mightily to explain why. For a while he said he wanted a “North Carolina plan, not a Washington plan,” but states like Indiana and Arkansas have worked with federal officials to come up with their own versions of expansion.
In fact, every conservative state that has proposed an alternative expansion plan has had it approved by the federal government. McCrory has never come up with one as far as anyone can tell.
A few months ago he shifted his obtuse opposition to the challenge before the Supreme Court, saying the case left uncertainty about the health care law.
Now that the case is decided and the Affordable Care Act remains the law of the land, McCrory is back to his original misleading wordsmithing, saying he will “continue to push for a North Carolina plan and not a Washington plan.”
Push away Governor but you might want to come up with a plan first, or release one if you have been working behind the scenes.
House and Senate leaders continue to publicly resist calls for expansion too, more out of ideology and their dislike of President Obama than any factual reason, though they also say that North Carolina’s Medicaid system needs to be reformed not expanded.
The Senate budget includes Medicaid reform provisions that push the state toward the Senate leaders’ ultimate goal of turning the program over to out of state for profit companies. The House has passed its own version of reform that allows providers to play a great role in managing the system.
There’s nothing to prevent legislative leaders from including discussion of expansion as part of their reform efforts. That has also happened in other states.
Lawmakers could expand Medicaid now. They could also include a plan from McCrory in their final reform package. Or they could come up with a plan of their own.
The majority of people in North Carolina support expanding Medicaid like 29 other states have already done. They understand the benefits.
It’s time for McCrory and legislative leaders to listen to them and put their rigid ideology aside and come up with a “North Carolina plan” that helps 500,000 people and dozens of hospitals and the communities that rely on them. They have waited and suffered long enough
The Supreme Court has spoken. There are no more excuses left.
July 3, 2015 at 10:50 am
Norm Kelly says:
Of course this editorial supports socialized medicine. It's from Chris. He hasn't met a socialist program he doesn't like and support.
Did SCOTUS uphold socialized medicine because it's what the law said? No. For the second time, SCOTUS led by John Roberts changed the meaning of common sense, ordinarily understood English words. The law was not deemed Constitutional based on what the LAW SAYS! The law was deemed Constitutional based on what SOME decided the law SHOULD SAY!
Is this good for the country? No.
Is this good for the Socialist Party and it's supporters in the media? The allies have come together to re-write America, to change the meaning of words, and to force their socialist religion on the rest of us. Whether it's good for the country or not doesn't seem to matter. It's their agenda, their religion, that appears important.
Is this good for the future of the country? No. When people are allowed to ignore the law, then no one is safe. When people are allowed to change the meaning of words, then no one is safe. When people are allowed to ignore history, to deny history, they are doomed to repeat history. When POTUS is allowed to change the law willy-nilly, as he did in the case of auto bail-outs, then future contracts are meaningless. When the NLRB is used as a tool of socialist unions to prevent a private business from expanding when and where they want, we as a nation are doomed.
What part of ignoring law, ignoring the meaning of words, ignoring the bribe that was purposely put in place by Congress is good for our future? What part of the central planners ADMITTING they purposely attempted to bribe the states to set up their own 'exchanges' has NO MEANING!? What part of Communist Core NOT being accepted by states UNTIL the bribe was put in place has no meaning?!
Everything socialist is bad for the nation. Everything the libs/demons/media-type allies stand for is bad for the nation. Everything those like Chris, Billary, and the current occupier stand for is bad for the majority, bad for the nation, and destructive to the future of my kids & grandkids. Anyone who has kids and/or grandkids ought to be very concerned about their futures. The socialist direction of this nation, led by the Socialist Party of the US, is destructive to the future of the nation and the welfare of the next generation(s)! Everything about socialism is a failure. And no matter how loudly, how often, in how many places liberal media-type allies of the socialist party rant and rave about the benefits of socialism, it's still a failing system. Nothing about socialism compares to the success and prosperity of capitalism. No other economic system raises EVERYONE'S standard of living as well as capitalism. This includes socialism. History shows this not to be opinion but fact. Those darn fact thingys that libs CHOOSE to ignore. Kinda like Chris and SCOTUS CHOOSE to ignore that the law says that STATES must setup their own 'exchange' in order for residents to qualify for subsidies. Kinda like when libs/Chris/SCOTUS CHOOSE to ignore that the central planners TOLD US they put the bribe in place on purpose.
So, the question still exists: What do the socialists have AGAINST John Roberts that he continues to ignore the law, ignore common sense, and CHOOSE to change the law to suit the socialists? And why aren't media-types like Chris asking this question? When the shoe is on the other foot, will libs sit by quietly? Don't forget, SCOTUS sets precedent for all time. This WILL come back to bite libs.
July 3, 2015 at 11:27 am
Richard L Bunce says:
No excuses but reasons why not to expand...
1. Expansion will remove folks with income between 100% and 138% of poverty from real healthcare insurance in the ACA Marketplace with premium prerefundable tax credit and Cost Share Reduction program eligibility and force them into the very flawed Medicaid program... since Chris is undoubtedly a big government single payer fan he probably thinks of this as a good thing... I do not.
2. The Democratic majority in Congress in 2010 should not have placed a lower income limit on the ACA Marketplace premium prerefundable tax credit and Cost Share Reduction program... it should have had no lower limit and eliminated the flawed Medicaid program... but again Chris is undoubtedly a big government single payer fan... I am not.
3. Congress can at any time reduce Federal funding for State Medicaid programs, in fact the ACA has it in the baseline program. It can continue to reduce Medicaid providers reimbursement rates which results in even fewer providers accepting new or even all Medicaid patients, resulting in even worse care under the very flawed Medicaid program.
