When in doubt, don't

I’ve been listening to Governor McCrory and Republican legislative leaders talking about the expansion of Medicaid and they make one convincing point: Too many questions remain unanswered regarding the expansion of Medicaid and the feds have not provided sufficient answers to those questions to make an informed decision on the issue. North Carolina does not have to be a first responder and this isn’t a one and done situation where you get one chance to opt in or never have  the opportunity again. As momma always said, “when in doubt, don’t.”

And the same can be said, but for different reasons, regarding health insurance exchanges. This program is supposed to go into effect in October and Insurance Commissioner Wayne Goodwin’s department has done fast and good work, from what we understand, in getting us ready for it. There are still details needing completion by the feds but the biggest uncertainties regarding the exchanges come from Jones Street. The Affordable Care Act makes it mandatory that every state have one or more health insurance exchange. The only question is whether it is to be a state run, state-federal, or federally run program. This issue was broadly discussed and the House previously passed a measure for North Carolina to institute it’s own exchange program. The Senate didn’t even discuss the bill, saying there would be time to do so later. Problem is, they didn’t discuss it.  Senate Bill 4 just closed the door on North Carolina operating its own health insurance exchange, or  have the state participate in a joint exchange,  without even attempting an honest discussion, at least one not open to the public. If you don’t trust the feds to expand Medicaid why trust them to operate health insurance exchanges?

If, on the one hand, you say you don’t want to jump into something because you don’t know enough details and want to factor them into consideration it seems, on the other hand, you ought to be willing  to investigate and conduct that discussion. Now it seems the House is ready to negate their earlier endorsement of establishing state operated health insurance exchange in favor of a federal option. Maybe our legislators are privy to information we don't know…but don’t they have an obligation to inform us why they make the decisions they make?