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?