Republicans turn up rhetoric on Medicaid expansion in North Carolina

Editorial by News and Observer, November 1, 2013.

They speak, incredibly, as if getting health care to 500,000 North Carolinians is a bad idea, something they’re not remotely interested in under any circumstances. And Gov. Pat McCrory, who portrayed himself as a nice-guy moderate during his campaign for governor, now has cast his lot with the most radically extreme forces in his Republican Party.

Under federal health care reform, North Carolina could have joined many other states, including some run by Republicans, in expanding Medicaid health care coverage to more lower-income families. New rules raising the maximum income levels would have allowed half a million more North Carolinians to qualify for Medicaid, the federal/state health insurance program for the poor.

And it would have cost the state nothing. The federal government would have covered the entire cost of expansion for three years and in 2020 would have still covered 90 percent of the cost. More North Carolinians would have had access to health care and, sometimes more importantly, to preventative care, which can keep people out of emergency rooms for routine care. Those unnecessary ER trips drive up costs for the insured because hospitals have to make up what they lose caring for people who have no insurance.

Astonishingly, North Carolina Republican lawmakers running the General Assembly said no. Their reasoning was right out of the tea party handbook: They said they didn’t trust the federal government to cover all of the costs. Period.

The federal government pays out Social Security; it has Medicare. It covers all sorts of programs that help people. But Republicans in the General Assembly say that government can’t be trusted.

That’s not their real reason, of course. This generation of Republican leadership opposes anything associated with President Barack Obama. And among the members of the tea party, there are those who demonstrated – during the last government shutdown and the fuss over raising the debt ceiling – that they were willing to let the economy go off a cliff in order to repudiate Obama. GOP leaders in Congress, noticing that the party’s poll approval ratings were in a nosedive and fearing a backlash against their irresponsibility at the polls in 2014 and 2016, backed away from that cliff at the last minute.

McCrory and the GOP leaders in the state legislature continue to stick to the tea party line, no matter what. In rejecting a call for a special session of the General Assembly in order to rethink the Medicaid decision, McCrory said, “Calling a special session to further expand Obamacare in North Carolina is out of the question.” That’ll play nicely in the dark corners of the right-wing GOP caucus.

State Senate leader Phil Berger and House Speaker Thom Tillis were even harsher. Their statement said, in part, “An expansion of Medicaid would cost North Carolina taxpayers hundreds of millions of dollars through 2021.” Not true. That statement is based on the GOP’s wishful thinking that the federal government would renege on the promise to pay all costs. The statement also said that “liberal activists” should be “protesting Obamacare, an abomination that has caused insurance premiums to skyrocket for working families.”

That’s also not true. Some, typically those with the best coverage or those who have been paying rock-bottom prices for high-deductible policies not permitted under reform, have seen their premiums go up, but to say there have been skyrocketing prices across the board is just wrong.

It doesn’t matter, of course. Republican leaders in North Carolina don’t want to hear how changing policies could help people. They don’t want to acknowledge that “Obamacare,” in forcing people to get coverage, will probably lower premiums for many. They’re perfectly content to let the poor crowd into emergency rooms or go without medicine and continue to suffer.