Medicaid expansion not 'impossible' in North Carolina

by Chris Fitzsimon, NC Policy Watch and NC SPIN panelist, December 4, 2014.

State Senator Ralph Hise has an odd definition of impossible.

Hise said after a recent meeting of a legislative study committee meeting on Medicaid that expanding the program in North Carolina under the Affordable Care Act—which would provide health care for 500,000 currently uninsured low-income adults—would be impossible at this point.

Twenty-seven states and the District of Columbia have already managed the impossible and expanded the program, providing health care coverage to millions of people across the country with the federal government picking up most of the cost. Those include states with Democratic governors and Republican governors.

Four more Republican governors are now in discussions with the Obama Administration about expanding the program in their states.  Apparently, they don’t believe it is impossible either.

North Carolina Governor Pat McCrory, also a Republican like Hise, seems to have warmed to the idea too and the leaders of his Department of Health and Human Services are reportedly working on an expansion plan for the state.

Even outgoing House Speaker and now U.S. Senator-elect Thom Tillis thinks the General Assembly should reconsider its decision not to expand Medicaid.

And the case for expansion is not just that it would improve the lives of a half million people in North Carolina and thousands in the Senate district in the mountains that Hise represents, though you’d think that would be compelling enough.

It would create jobs, a lot of them. 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.

Imagine how fast Hise and his colleagues would rush into special session to approve legislation for any other proposal to create 25,000 jobs.

Hise also ought to ask folks at his local hospital and hospitals across the state that are staggering financially what they think of Medicaid expansion and he’d find out how much it would help them.

A study by the Urban Institute found that North Carolina hospitals are losing just over $11 billion in funding over the next 10 years if the decision not to expand Medicaid stands. That’s money that could literally help many rural hospitals stay open and operating.

Opponents of expanding Medicaid used to cite the problems with the administration of the program in North Carolina as a reason not to expand it. The problems were grossly exaggerated and McCrory and HHS Secretary Aldona Wos claimed they have fixed them anyway.  That excuse is off the table.

The only other substantive objection to expansion is that it the state can’t afford it even though the federal government would pick up the entire cost initially and 90 percent of the tab after the first few years.

That hasn’t stopped states with conservative leaders from expanding the program and hasn’t stopped North Carolina from operating a wide variety of federally funded programs for decades. And contrary to what Hise and other Senate leaders keep saying, the Institute study finds that the state would actually experience a net savings of $65 million in the first eight years of Medicaid expansion.

Add it up and it is a no-brainer.  It would improve the lives of 500,000 people, create thousands of jobs, help many rural hospitals and save the state money.

No wonder so many conservative governors and state lawmakers across the country have changed their minds and now support expanding Medicaid.

It’s not impossible to do it in North Carolina either.  All it takes is for Hise and other political leaders to put their rigid ideology aside and do what’s best for the people and the communities they are supposed to be working for.

http://www.ncpolicywatch.com/2014/12/04/medicaid-expansion-not-impossible-in-north-carolina/