No more reason to avoid Medicaid expansion
Published March 7, 2016
Editorial by Fayetteville Observer, March 7, 2016.
When the Affordable Care Act took effect, the U.S. Supreme Court struck down one important provision: The federal government, the justices ruled, couldn't force states to expand their Medicaid programs.
That fit nicely with Republican opposition to Obamacare, here and in many other "red" states. But unlike some of his GOP brethren in the General Assembly, Gov. Pat McCrory wasn't an ideologue about it. It was clear that he saw the benefits of an expansion, which mostly would be funded by Washington. Without it, hospitals would face greater financial pressures, and the "working poor" would continue to show up at emergency rooms for medical care because they still couldn't afford health insurance.
McCrory took a pragmatic approach. Medicaid in North Carolina, he said, was a "mess"; it was "broken." It was all of that, with annual cost overruns in the hundreds of millions. It was hard to justify expanding a broken system and growing those deficits any further.
But the system isn't broken anymore. It's under control. As of the end of December, the governor announced in a press release last month, Medicaid was $181 million under budget. Yes, under budget by the same kind of numbers that it once exceeded its budget.
It wasn't a fluke. That's how the numbers have been running for two years now. And our repaired Medicaid system is getting even more attention, being revamped from a program that pays medical costs for the sick to one that pays to keep people healthy. There's good reason to expect even more savings.
The improvements are a monument to former state Secretary of Health and Human Services Aldona Wos, who finally was able to slay the Medicaid beast, and her successor, Rick Brajer, who appears to be continuing the improvements.
With that accomplished, McCrory's only good objection to Medicaid expansion is gone. So are his precedents: many of his fellow Republican governors. That includes Ohio Gov. John Kasich, one of the last GOP presidential candidates still standing. Kasich, a pragmatist, ran the numbers and saw Medicaid expansion creating new jobs, keeping hospitals afloat and, of course, making people in his state healthier.
He took advantage of federal flexibility and designed a Medicaid program that fit his and his party's conservative principles.
It's time to do that here. Medicaid expansion will save lives and improve many more. It will save endangered hospitals from shutting down. And it will create thousands of new jobs in the health care industry.
There are no excuses left, governor. Let's get it done.
March 7, 2016 at 9:25 am
Richard L Bunce says:
There is an excellent reason... the households with incomes between 100% and 138% of poverty will be forced out of their very good ACA Marketplace private healthcare plan with premium tax credit and Cost Share Reduction program benefits and into a very flawed Medicaid program that many providers do not even except and all closely manage their Medicaid patient load.
The flaw was not in NC not expanding Medicaid... the flaw was in the Democratic Majority in Congress in 2010 placing the lower income limit on the ACA Marketplace tax credit and Cost Share reduction program and keeping a very flawed Medicaid program instead.
