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NC will lose health professionals, jobs, revenue when Virginia expands Medicaid

images-1 [1]The Virginia Senate and House have both passed [2] competing versions of a state budget that each includes provisions for expanding Medicaid under the Affordable Care Act in Virginia.  The form that expansion would take still has to be worked out in negotiations between the chambers, but a final expansion would mean VA would join  a rapidly increasing number of states planning to expand coverage.  This includes a growing number of states led by Republican Governors:  Ohio, Nevada, Arizona, New Mexico, North Dakota and  Michigan [3].

Sure, the fact that Republicans in Virginia are moving to expand Medicaid makes NC’s state Senate and Governor Pat McCrory look behind the times in their continued refusal to entertain coverage expansion.  But what are the other effects on NC from the Virginia decision?  The main one is the boon to Virginia’s economy that results from expansion and the hit we take as a result.  Why?  Estimates [4] are that Virginia will create about 20,000 new jobs as a result of the expansion and those jobs will look pretty good to NC health professionals.

Indeed, the REMI business consultant study [5] done for North Carolina noted that if NC were to expand Medicaid and surrounding states like Virginia did not, NC would benefit because professionals in health care would be motivated to move here from other states given all the new jobs:

The North Carolina economy has a high concentration of healthcare firms, which attracts the young or footloose looking for employment and high wages. North Carolina would be on something of an “island” in the South if it were to participate in the Medicaid expansion because many nearby states (Virginia, South Carolina, Georgia, Alabama, Mississippi, and Texas) intend to opt-out of the expansion altogether.  This would give North Carolina an advantage in attracting households in light of the other states turning down the federal dollars and associated spending in the healthcare sector. … More migration means more people, more spending, and therefore more impact.

Now the tar is on the other foot, and VA looks to expand while NC doesn’t.  A state that expands attracts professionals to high-paying long-term jobs in their state, a shot in the arm both to tax revenues and the economy.  I guess that’s one main reason why Republicans in VA are moving towards expansion.  Too bad Republicans in the NC Senate are not only blocking expansion but spreading flat-out fear-mongering lies [6] about the Affordable Care Act.