North Carolina Democrats kicked off the legislative long session this week by filing another bill to expand Medicaid. I suspect it has a lot to do with their belief that they won races across the country by focusing on health care. If they are willing to work with Republicans on a deal, they might be successful in doing so, but not to the extent they'd prefer.
GOP members who are open to Medicaid expansion don't want it to be limitless.
From the Carolina Journal :
Some Republicans, including those behind the Carolina Cares legislation , are interested in expanding Medicaid, but not without including work requirements and provisions promoting healthy living. Participants would pay part of the coverage costs, and providers would cover the state’s share so as to insulate taxpayers from picking up any costs from people enrolled under the expansion.
Reps. Greg Murphy, R-Pitt; Josh Dobson, R-McDowell; and Donna White, R-Johnston plan to file their Carolina Cares legislation again during the 2019 session to address the coverage gap.
Senate leader Phil Berger, R-Rockingham, has remained skeptical of Medicaid expansion. He has questioned whether the program can be expanded without additional costs to the state treasury, which would require cuts in other public services or higher taxes.
Jordan Roberts, the health policy analyst at the John Locke Foundation, said Medicaid expansion is a fundamentally flawed way of providing health care for people who can’t afford the current products on the market.
In a recent JLF Policy Brief , Roberts outlined some of his objections.
“The incentives in the financing structure incentivize fraud, waste, and abuse,” Roberts said. “Studies have shown that Medicaid enrollees don’t get any discernible increases in health after being enrolled in the program.”
Expect a lot of deception and bad faith arguments to be made about this issue, of course. Democrats know it's easy to sell people on "expanding health care" when you don't lay out the costs of doing so.
From the Civitas Institute :
The state share of the cost of expansion has been estimated to be upwards of $340 million , which would be paid for by a tax increase on hospitals. State owned and/or operated hospitals would be exempt from the tax.
In a press conference today discussing the bill, the issue of actual access to care for the newly eligible was once again ignored. Since 2003, North Carolina’s Medicaid program has ballooned from about 1 million enrollees to about 2.1 million today. At the same time, the number of physicians accepting Medicaid patients plummeted by 28 percent. Expansion would stuff another 500,000 people into this already overcrowded program. Who will these patients see when they get sick? That question is never asked of expansion proponents.
In an interview with the News & Observer, Gov. Roy Cooper said NC would get $4 billion in federal money.
"And remember- this is tax money we've already paid to Washington that now can be going to other states but now will be coming here," he said.
This is false.
I'll give the Governor the benefit of the doubt and say he's not intentionally lying. He's just ignorant.
From the Congressional Research Services report on this topic in 2015:
Don't misunderstand... I don't expect anyone to actually hold the Governor accountable for spreading this fallacy. After all, governors across the nation -both Democrat and Republican- have made this false assertion without ramification.
Gov. Cooper also said the hospitals will pay the increased costs. This is not really true, either. The customers with insurance will pay for it, via increased medical bills and increased insurance premiums.
The Medicaid system is broken in America. But rather than pursue true reform to help more people get health care, Democrats push expansion of broken government programs with sunny promises of more coverage.
But coverage is not care.
Medicaid is the perfect illustration of this axiom.
Pete's Prep: Friday, Feb. 1, 2019
- The Citizen-Times reports : The sale of Mission Hospital to Tennessee-based HCA has been finalized.
- Asheville City Schools has the worst achievement gap and discipline gap in the state. You can read more about it at the Mountain Xpress .
- Early voting laws probably DON'T boost election turnout, says fivethirtyeight.com .
- The absolute worst/best example of the "Republicans pounce" framing by media.