A few clarifications on Gov. McCrory’s exchange and Medicaid decision

It feels a bit like legislative leaders took Gov. McCrory to the edge of a cliff and asked if he would prefer to jump or be pushed off. This morning he decided to jump.

Still, a few points need explanation. McCrory says he opposes an exchange because the state has not done enough work to ready itself. That claim strains credibility.

No one suggested the state would set up a state exchange in 2014. In fact, that’s not possible. What we wanted was to keep a partnership exchange. A partnership exchange is a federal exchange with the state keeping two critical functions. The first thing we would do under a partnership is consumer assistance. We are already doing that and we are a national model. We are more than ready to take on that duty, but now Washington, DC, will run that for us. The second is reviewing our own insurance plans in the exchange. The Department of Insurance has done this for years and is obviously ready to do it in 2014. Again, this goes to Washington.

After running consumer assistance and plan review in 2014 the question is then do we want to take over the exchange in 2015 or have the feds continue to operate it for us.

On Medicaid the question of long-term costs can be addressed in several ways. You could sunset the expansion without penalty once the federal match moves lower than 100 percent and reassess the financial implications to the state at that time. Or, like many states, you could scale back the expansion automatically if the federal matching rate dips below what is promised now.

If you skip out on the first three years of expansion you miss the $124 million in savings to the state and the 25,000 jobs that will be created.

The legislature clearly forced Gov. McCrory’s hand here. But it’s still important to note that the reasons given in his letter to oppose a partnership exchange and the Medicaid expansion are not reasons at all.


  1. Regina

    February 12, 2013 at 12:27 pm

    Forget all citizens of NC hoping / waiting for Exchange to afford decent healthcare, gotten through same feature Employers used to use for affordable group insurance.
    Forget retired individuals living on small incomes needing decent options for healthcare.
    Forget that most employers no longer provide any type of benefits package, to save money-although haven’t seen reflections of savings in job creations.
    Seems McCrory couldn’t wait to start cutting cutting cutting with no real regard except to reduce our IOU to Feds. NC will be ones paying for this “fiscal” responsibility.

  2. love my state

    February 12, 2013 at 12:39 pm

    there is nothing fiscally responsible about this nightmare.

  3. Doug

    February 12, 2013 at 4:34 pm

    Let the Feds take care of their own boondoggle. We know what happens when NC agrees to help run a program with promises from DC to fund it. The funding gradually dries up until we are left holding the bag. It happened a few years ago with Medicaid, look it up.

    The best thing for NC is to let the people who voted for the people in DC to be covered by their elected leaders’ plan. They will still be covered in a similar manner as if NC “partnered” with them. The only difference is that in 5-10 years when the ponzi scheme blows up, other states will be paying a large share and we will not have been on the hook all the years the Feds shift costs to the states that signed up for what looked like a “good deal” in 2013 the year of the snake.

  4. Adam Linker

    February 12, 2013 at 4:39 pm

    Just to clarify, NC still has to pay for a federal exchange. We just have no say in how much it will cost or how it gets paid for.

  5. Doug

    February 12, 2013 at 5:55 pm

    You think we will really will have a say if we “partner” with them? Look at history of the federal government. They take the view that they can over rule anything the state puts in place. We should go ahead and skip the middle step and let them…and all the other states I might add…..pay for it all then we would only be taxed once at the federal level to pay for it vs. taxed at both state and federal level. Once the federal program goes bankrupt in 5-10 years we can start the double payment, but think of the money we will save between now and then. We would also have the benefit of the people who saddle us with the program can get the blame at that time too, instead of the internal state debate that the R’s did not provide a rich enough benefit for the Medicaid program. A double win for NC.

  6. Adam Linker

    February 12, 2013 at 6:46 pm

    Uh, you aren’t double taxed for a partnership. But I see you aren’t thinking clearly. You should feel comfortable that you are getting what you want.

  7. Doug

    February 13, 2013 at 10:23 am

    So assuming this is put in place in NC. We get taxed in NC to pay an ever increasing state part of Medicaid….then get taxed at the Federal level to pay a decreasing portion (and you can bet your taxes are not going down from either entity). Keeping the Feds funding their own program, keeps NC out of this double dip the government will take. At least until DC sees they cannot fund it and sends it to the state to run. This would save at least 5-10 years lower taxes in NC from not funding this program. Luckily, we are in the latter choice and can watch as the other states crash and burn. It will be a great opportunity for NC.

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