McCrory rejects calls for special session to expand Medicaid

by Lynn Bonner, News and Observer, October 28, 2013.

Gov. Pat McCrory rejected a call to convene a special legislative session to add more low-income residents to the state and federal health insurance program.

His comments came in response to a news conference called Monday by expansion supporters who again pushed their reasons for allowing more low-income people to sign up for Medicaid.

The GOP-controlled legislature voted this year to reject Medicaid expansion, which is an optional part of the Affordable Care Act. Those who want expansion, including two Democratic legislators, a doctor, a health policy analyst and an advocate with Protect Your Care, said at a news conference Monday that the benefits of expanding Medicaid are becoming clearer as time passes.

Other states, including those with Republican governors, have chosen to expand Medicaid, they said. For three years, the federal government is paying 100 percent of the cost of people who enroll in an expansion. The federal government support would drop in phases after the first three years, down to 90 percent by 2020.

About 1.5 million state residents are enrolled in Medicaid. The N.C. Institute of Medicine estimated that 500,000 more would sign up in an expansion.

In a statement, McCrory referred to the Medicaid system as “broken,” though expansion supporters disagree with that assessment.

McCrory and legislative leaders have been frustrated by Medicaid costs that have outrun budget projections in recent years.

“I will not sacrifice quality care for the people truly in need, nor risk further budget overruns by expanding an already broken system,” McCrory said. “Calling a special session to further expand Obamacare in North Carolina is out of the question.”

McCrory plans to present a proposal next year to change Medicaid in the state.

Those who want more low-income people insured said North Carolina tax money is being used to pay for health care for people in Arizona, New Jersey, Ohio and other states that expanded Medicaid.

Rural hospitals are in jeopardy, said expansion supporters, naming the closure of Vidant Pungo Hospital in Belhaven as a example.

Dr. Gary N. Greenberg, who works at Urban Ministries of Wake County, said politicians emphasize that people can seek care in emergency rooms. But that care really isn’t free, Greenberg said. Bills go out that aren’t paid, and the costs are redistributed.

And relying on emergency room care is “almost a recipe for the worst possible outcomes,” he said.

Greenberg said he didn't understand the arguments against expansion, “unless it’s mean-spirited, ideological politicking.”

One of the reasons Republicans gave for not expanding Medicaid was their lack of confidence that the federal government would keep its promise to pay 100 percent of the costs for three years.

A decision to expand isn’t entirely up to McCrory. His office did not immediately respond to an inquiry Monday, but it’s clear that legislative leaders who panned expansion continue to disapprove.

Senate Leader Phil Berger and House Speaker Thom Tillis sent out a statement Monday that said “liberal special interest groups” are pushing the expansion.

“An expansion of Medicaid would cost North Carolina taxpayers hundreds of millions of dollars through 2021,” the statement said. “How do these Democratic party front groups suggest we pay for it – how many teachers are they willing to fire? How high are they willing to raise the sales tax on groceries and medicine? How much are they willing to cut doctors’ and hospitals’ reimbursement rates?

“If these liberal activists were truly serious about reducing the cost of health insurance, they would be in Washington protesting Obamacare – an abomination that has caused insurance premiums to skyrocket for working families.”