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How much would North Carolina pay for a Medicaid expansion?

All of the congressional health reform proposals expand Medicaid to cover more parents and childless adults. Currently, it is difficult for parents to obtain Medicaid and most childless adults are excluded from the program no matter how impoverished.

After reform everyone under a certain income threshold, likely 133 percent of poverty ($14,400 for an individual), will qualify for Medicaid.

States are worried that the additional cost of new enrollees will place an undue burden on their budgets because Medicaid is a matching program where the states contribute a sizable chunk of the funding.

In different reform bills states are required to pay different amounts. In some of the proposals the federal government would pay the entire cost of the Medicaid expansion and then examine changes to the long-term matching rate.

The Georgetown University Center for Children and Families has some helpful charts to examine how much North Carolina would pay if the Senate Finance Committee bill prevails.

According to the Senate Finance Committee chart North Carolina would have 448,555 newly eligible and newly enrolled adults. Our state spends about $3,133 per adult in Medicaid so the expansion would cost about $1.4 billion. The Senate Finance Committee proposes covering 95 percent of the cost for the newly eligible, which would leave North Carolina with a bill of $70 million.

That’s a small increase in Medicaid spending to expand coverage to more than 400,000. Obviously it would be nice if the feds would foot more of the bill. But Georgetown argues that even under the Senate Finance Committee plan states are getting a pretty good deal. I agree.

4 Comments

  1. Aftercancer

    October 7, 2009 at 11:32 pm

    Instead Medicaid is currently cutting the reimbursement rates for providers of case management for the mentally ill, developmentally delayed, old and young to meet at 50 million dollar legislative demand.

    The layoffs it causes will only put more pressure on the Medicaid rolls.

  2. Bill Brandon

    October 8, 2009 at 11:31 am

    On the subject of costs facing N.C., if Health Reform based on HR3200 Employer Mandate is passed.
    (1) How will N.C. meet the requirement to begin paying 65% of the cost of family coverage of spouses and dependents for the lowest cost plan meeting federal basic benefits? Currently, State pays nothing beyond the full coverage of individual employee.
    (2) Will it move to cut its share of employee coverage to 72.5% instead of 100% since that is the minimum required by HR3200?
    (3) Would there still be a shortfall if the state suddenly started partially paying for families? How much?
    (4) Is anybody at the State level thinking about & planning for this contingency?
    See Title IV Sect. 312 of HR 3200 (p. 146 of downloadable Committee Print)

  3. Tiffany co Necklaces

    October 9, 2009 at 12:29 am

    nice,The layoffs it causes will only put more pressure on the Medicaid rolls.

  4. IBXer

    October 9, 2009 at 10:35 am

    Why on earth would anyone want their healthcare decisions to be governed by the political decisions being made by dumbasses in DC? It’s bad enough when the idiots in Raleigh have input.