Aldona Wos, Secretary for the N.C. Department of Health and Human Services, put the blame Friday on the state forgoing Medicaid expansion on Insurance Commissioner Wayne Goodwin, whose office advocated to have the state run the health care exchange that was part of the larger health care reform.
On Saturday, Goodwin called on Wos to apologize for what he said were false statements.
“I am offended and truly disappointed that Secretary Wos decided to incorrectly accuse me of being the cause for the state’s rejection of Medicaid expansion,” he said, in a statement released Saturday. “That decision was not within my constitutional authority. I trust that the Secretary will swiftly issue a correction and apologize for her statement.”
N.C. Health News’  Rose Hoban attended an informational talk Wos gave about her plan to change Medicaid in Reidsville Friday night, and first reported Wos’ remarks. 
Wos said that Goodwin, a Democrat in the elected state position, was the reason why the state turned down the expansion, which would have given an estimated 500,000 low-income North Carolinians access to healthcare.
But Wos appears to have forgotten, misspoke (or not known) what actually happened.
It was the Republican-led state legislature and Wos’ boss Republican Gov. Pat McCrory that passed and signed, respectively, the law preventing North Carolina from setting up its own health care exchange and expanding Medicaid. The U.S. Supreme Court, in its ruling on the Affordable Care Act, found that Medicaid expansion was optional for states.
Goodwin and his office had spoken in favor  of the state, and not the federal government, run the health care exchange during the debate about the bill. Goodwin’s office doesn’t manage Medicaid, which falls under Wos’ department.
Wos made her comments Friday in response to a family physician who had been critical of her department’s recent push to switch the $13 billion Medicaid program to more privatized managed-care system.
From Hoban’s story :
“In reference to your roundabout way of commenting about Medicaid expansion … in North Carolina, based on our constitution, the issue of Medicaid expansion or not, actually, was the commissioner of insurance’s,” Wos said. “Just so that you all know that and are aware of that.”
Wos left quickly after the forum wrapped up.
Wos’ spokesman, Ricky Diaz, told the News & Observer  last night that Wos’ comments were taken out of context.
(UPDATE, Mon. 12 p.m.): Hoban posted the audio of the exchange here  over the weekend, so you can listen for yourself.)
“The Secretary was talking broadly about the Insurance Commissioner’s oversight authority over the health care insurance industry in North Carolina, and it is unfortunate that her remarks were taken out of context,” Diaz said, according to the News & Observer.
Goodwin released his statement about Wos’ comments Saturday afternoon, calling for a public apology from her.
Wos will be in Durham Wednesday and Greenville Thursday as part of her tour around the state to sell her Medicaid reform package. More information about times and places are on DHHS’ website here .
Wos has been no stranger to controversy, and unflattering attention in the press, since McCrory appointed her to lead the 18,000-employee agency in January. Wos, a doctor who served as the ambassador to Estonia under President George W. Bush, and her husband were significant fundraisers for the Republican Party as well as the McCrory campaign.
Her appointment to lead the state’s preK and early education division had advocated in the past against early education (click here  to read more). At the press conference announcing the department’s Medicaid reform effort, Wos responded to a question about public information by telling reporters that transparency can be “dangerous .”
The Medicaid reform effort Wos was promoting when she made the comments Friday proposes to contract the program with several managed-care groups, a move that she says can save the state money and offer better care to the low-income disabled, children and elderly who use the entitlement program. Critics have questioned whether the changes are an unwise move to privatization and have cautioned against completely abandoning the current model, where most of the Medicaid program services are delivered through the much-praised Community Care of North Carolina.
(Note: This post has changed from the initial version to correct Goodwin’s position on Medicaid expansion and to include his response to Wos’ comments. His office advocated to keep the health care exchange in North Carolina, and not run by the federal government. It did not weigh in on the expansion issue. We regret the error.)