10 things that will happen if North Carolina refuses to expand Medicaid and enact exchange

Over on Twitter this morning, Adam Searing listed 10 lousy things that we know will happen if North Carolina lawmakers and Gov. McCrory act (as expected) to refuse to expand Medicaid under the Affordable Care Act and enact the health care exchange envisioned under the ACA:

#1 – We’ll leave 500,000 North Carolinians in need without access to affordable health care
#2- We’ll put $45 million needed to finish the Medicaid IT system unnecessarily at risk
#3- We’ll turn over our consumer assistance program to the federal government
#4- We’ ll limit the ability of the NC Department of Insurance to enforce federal law in the state
#5 – We’ll turn over our ability to review insurance plans sold in the new health exchange to the federal government
#6 – We’ll limit North Carolina’s control over its insurance market
#7 – We’ll increase the cost of private insurance premiums
#8 – We’ll lose control over how to fund the NC exchange (We have to pay for exchange no matter who controls it)
#9 – We’ll lose money to establish call center for consumer questions. North Carolinians will now call Washington, DC for help
#10 – We’ll lose our chance to help community health centers, rural hospitals, and the state’s economy.

Notwithstanding all of these problems (and many more), lawmakers are expected to to do the dirty deed in both houses this afternoon. Follow Adam on Twitter for frequent updates from the General Assembly.


  1. Doug

    February 26, 2013 at 3:07 pm

    How about we list the things that will happen when we expand this program and the Feds dump the whole program down to us? It has happened in the past, and there is no way we could fund it at the NC level alone. It is a good decision to let DC make their own bed and cover these people in the way they see fit, then they can be the one’s fixing the mess when the house of cards falls.

  2. Doug

    February 26, 2013 at 3:10 pm

    Oh, and when did this blog be so in favor of states rights? “Progressives” are in favor of as much central control as possible.

    Also, how will all these premiums and costs go up if the much ballyhooed Obamacare is supposed to make premiums and costs fall like a rock? Your arguments/points do not make sense at all when you compare to what the Feds are saying.

  3. david esmay

    February 26, 2013 at 4:33 pm

    How about you list them Doug, support them with data, not faux news talking points or Heritage b.s.. The right wing nuts are the ones always whining about states rights, yet concede the creation and control of ACA exchanges to the federal government. What a bunch of duplicitous, morally vacuous morons.

  4. Frances Jenkins

    February 26, 2013 at 6:51 pm

    David, your last comment is not a sentence!!!! Brush up on that sentence structure, You might become employed by Blue Point or Blue Print or whomever. You know, the people who broke the laws of the IRS and the SBOE.

  5. Doug

    February 27, 2013 at 9:20 am

    faux talking points is what this blog post is originally all about. The debate is not complete unless you look at the effects of what will happen when the country/state goes bankrupt in the same way Greece has. You have to consider the effects of ever increasing entitlements when the average person is already struggling to pay their tax bill, and no it cannot and will not always come down to the rich….the numbers do not support it so it will always come on to the middle class in the end.

  6. Michael

    February 27, 2013 at 11:55 am

    Facts: Medicaid spending will explode once the federal match rate begins to drop & more people enroll in the program.
    2. Medicaid actually harms the people it is suppose to help How? By the quality of care? Studies of Surgeons at UVA showed that 13% more patients that were on medicaid passed away compared to those with no insurance at all and that 13% adjust for age, gender, income, etc. Medicaid patients were 97% more likely to die than those who had private insurance. Why you ask? Because Medicaid pays doctors & hospitals far less than insurance. Think that will get better with more people joining medicaid?
    In states like NY & CA who have expansive Medicaid programs Doctors were paid 62% & 71% less and as a result many Doctors refuse to take Medicaid which causes medicaid patients to go undiagnosed until it’s to late.
    3. While the expansion says it will increase the funds paid to Doctors for the first 2 years what happens after that? Fed’s scale back funding and Doctor’s Drop out.

  7. Michael

    February 27, 2013 at 12:15 pm

    4. The 500,000 that will be denied coverage due to non expansion doesn’t account for the crowding out of private insurance. Medicaid will end up replacing higher quality employer-sponsored health coverage for tens of thousands of nc residents. They will still be covered but the quality of care will decrease. Coverage is not the same as care! Medicaid has the worst health outcomes of any insurance program in the world. It makes it more difficult to get quality access to physicians and thus the care they need is harder to get than if they had their private insurance carrier. Fact UVA study of medicaid.
    5. Those who will still keep their private insurance will have increase in premiums because of cost shift due to the underpay of medicaid program to Doctors. Difference will be past to private insurers.
    who will pay an estimated $1800 more per family. Study by Milliman leading insurance consulting firm.
    This increase will make private insurance less affordable and thus increase the number of people without insurance.
    6. Fraud & Waste: Federal estimates show that 10% OF MEDICAID PAYMENTS ARE FRAUD. Many prosecutors believe that figure is closer to 30%.

  8. JCA

    March 3, 2013 at 5:43 pm

    Atta boy David, When you can’t argue facts–do some name calling. It reveals more about you then the other side

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