Unlike the budgets proposed by the Governor and the Senate, the House budget includes no funding to expand NC Health Choice, our state’s safety net program for children who do not qualify for Medicaid.
This is a terrible move on many fronts.
For every dollar we spend on health insurance for children, the federal government spends three dollars to help fund Health Choice. That means the state is foregoing millions in federal funds that flow into local economies across North Carolina.
Moreover, if the House does not expand Health Choice, especially during an economic downturn when so many families are struggling, it will mean that the program is frozen to new children resulting in long waiting lists and discouraged parents.
We know from our experience in 2001 that when Health Choice is blocked for new entrants, it takes years to recover. We know that enrollment will plummet as parents hear that the program is closed. We will undermine years of outreach work.
Here is what I wrote in a Legislative Bulletin  last year when a freeze was proposed:
We know what will happen if Health Choice is capped in the current budget. North Carolina instituted a similar enrollment freeze from January 2001 to October 2001. The results of that brief, nine-month cap were devastating. In six months, enrollment in Health Choice dropped from 72,024 in January 2001 to 59,472 in June 2001, according to the NC Institute of Medicine. Because of the steep enrollment declines Health Choice partially reopened in July 2001 but participation in the program continued to drop for another four months until it reached a low of 51,294 in October 2001. North Carolina and health advocates across the state have spent considerable time and resources on outreach to parents who qualify for Health Choice. Once the program is capped this work is undermined. Word travels fast that the program is not accepting new applicants and enrollment plummets.
There are not many great places to save money in the budget, that I understand. But if you are looking for one of the worst places to cut, Health Choice is it.
Update: Expansion items will be added later so the House still has an opportunity to match the Governor’s commitment to children’s health insurance coverage.