Meck Commissioners to Legislature: Reconsider Medicaid Expansion

by David Perlmutt, Charlotte Observer, October 14, 2013.

Mecklenburg County commissioners passed a resolution Tuesday urging state lawmakers to reconsider turning down billions in federal money that would expand Medicaid coverage to 500,000 uninsured North Carolinians.

The resolution, approved 6-3 along party lines, urges Gov. Pat McCrory to call the General Assembly into a special session to reverse its previous decision and expand the state’s Medicaid coverage as part of the Affordable Care Act.

Sponsored by Democrats Dumont Clarke, George Dunlap and Trevor Fuller, all six Democrats voted for the resolution. The board’s three Republicans – Bill James, Karen Bentley and Matthew Ridenhour – voted against it.

In February, McCrory, a Republican, and Republican legislators rejected the expansion, making the state’s poorest residents ineligible for health insurance under the Affordable Care Act. They cited a concern about the ultimate cost to the state and McCrory was skeptical that the federal government would pay its share of the cost because of the budget deficit.

The Medicaid expansion was included in the law to provide insurance for people whose incomes are under 100 percent of the federal poverty level. The federal government promised to cover all the extra costs for the first three years. After 2017, the match would begin to fall, ultimately reaching 90 percent.

When the U.S. Supreme Court upheld the constitutionality of the Affordable Care Act, also known as Obamacare, it said states couldn’t be mandated to expand Medicaid.

North Carolina joined 21 other states – most with Republican governors and Republican-controlled legislatures – that chose not to accept federal reimbursement to expand Medicaid.

The Mecklenburg resolution, written by Clarke, said that an estimated 17.5 percent of the county’s residents – or about 70,000 – are uninsured and that the expansion would save the state, its counties and municipalities “substantial sums on uncompensated medical care for the uninsured.”

It noted, too, that the Republican-controlled legislature in Michigan recently approved the expansion after Republican Gov. Rick Snyder said it would save the state money and help control medical costs. It said the same happened in Arizona, where Republican Gov. Jan Brewer “led the successful effort to expand Medicaid,” despite vehement opposition from many legislators.

Those arguments didn’t sway the board’s three Republicans.

Bentley called Obamacare, “the biggest lie propagated on the citizenry ever” and “a health care injustice” that raises insurance premiums for the insured. James said the state legislature “doesn’t care what we ask them to do.” He said the hour it took to hear speakers and debate the issue “was a waste of an hour.”

Clarke said the state and Mecklenburg will lose a lot of money by not expanding Medicaid coverage that will go to other states that have decided to expand.

“It is going to hurt rural hospitals,” he said.

Dunlap said legislators need to be more compassionate for those who can’t afford health insurance. “To ask the legislature to reconsider is to ask legislators to do the greater good,” he said.

Fuller said the state will pay one way or the other.

“If you decide you don’t want to pay for it on the front end, you’ll surely pay for it on the back-end,” he said. “You’re not saving anything.”