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Obamacare: What happens if NC Gov, Legislature refuse Medicaid expansion, try to block exchange

There is talk from some NC politicians about how having a health exchange would be so terrible for NC and no talk about the Medicaid expansion decision under Obamacare that NC needs to make under the law.  Given this, it’s worth reviewing what happens if NC refuses to expand Medicaid and doesn’t set up a state-run exchange or tries to throw up roadblocks to a federal exchange that gets created if NC doesn’t act.

1.  500,000 North Carolinians with incomes under $15,000 a year would not be eligible for affordable health coverage through Medicaid on January 1, 2014.

2.  Any overall delay or major inefficiency in the exchange means that about 700,000 individuals would not be able to buy health coverage in the exchange and would lose the opportunity for getting thousands of dollars in new tax credits that will make coverage much more affordable for middle class families.

I wouldn’t think denying people affordable health coverage plans that are going to be available in most other states would be good politics, but what do I know?

6 Comments


  1. Frank Burns

    November 20, 2012 at 7:46 pm

    We need to be cautious and look before we leap. We need to understand fully the financial commitments that NC will face with Medicaid expansion and the exchanges before we agree to it. An open checkbook is unacceptable.

  2. Adam Searing

    November 21, 2012 at 8:07 am

    Frank – the Milliman study has plenty of financial facts in it (and no ideology from these big business consultants) – take a look.

  3. david esmay

    November 21, 2012 at 11:11 am

    Frank the Troll, you have no idea what you’re talking about and are simply parroting what you heard on Faux or read on the Heritage Heartland Civitas daisy chain.

  4. Frank Burns

    November 21, 2012 at 11:34 am

    Adam,
    As I read the Milliman Study, it makes the assumption that the State of NC has committed to form a HBE (Health Benefit Exchange). I don’t believe that has happened yet has it? Note the following statement regarding the uncertainties in the report.

    “There is tremendous uncertainty surrounding many of the projections presented in this report.
    That uncertainty stems from many sources, including imperfect data, evolving legislation and
    regulations, changing economic decisions, interdependencies of variables, and the impossibility
    of perfectly predicting the reactions of employers and consumers to decisions that most have
    not faced in the past.”

    All I’m saying I think NC needs to understand what are the future costs being imposed on the State by the Federal Government by having a HBE before we make that committment.

  5. david esmay

    November 21, 2012 at 4:47 pm

    The CBO says the ACA will save 1 trillion over the next decade. More people with insurance will lessen the over all cost of health care, and Frank, I’m sure you were watching Morning Joe today when the head of the American Small Business Institute stated the ACA will only affect the taxes of about 3% of small businesses, it will have no effect on 97%.

  6. Sana Thompson

    November 21, 2012 at 11:11 pm

    The decisions that NC makes will have a direct impact on me personally since I will be needing insurance a year from now. Is there a deadline for the states to decide on the Medicaid expansion? Who would be making the decision? The governor or the legislature?

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