Given the extraordinarily negative public reception to Governor Pat McCrory’s idea to privatize the NC Medicaid program and the way it fell flat in its first presentation at the NC General Assembly, you might be forgiven in thinking that this particular Medicaid “reform” was dead in the water in NC. Unfortunately you would be wrong.
Today Governor McCrory issued a press release saying he would be coordinating with the Senate and House to require the Governor’s Department of Health and Human Services to request a Medicaid waiver from the federal government. This federal waiver would allow NC to make unspecified changes to Medicaid and “create a predictable and sustainable Medicaid program for taxpayers.”
Let me translate this for you. The only reason for NC to get a “federal waiver” to change its Medicaid program in this way would be to give NC the option to sell parts of the Medicaid program off to private companies – which has been the plan here all along. Why? Because if you sell off part of our Medicaid program to a private health insurer like Amerigroup at a price lower than we pay now for delivering the same Medicaid services, then the General Assembly frees up some money in its budget. And how does a private out of state insurance company deliver the same health services for a lower price to moms and kids on Medicaid? They make it harder to get health services and they lower significantly the rates they pay to doctors and hospitals for delivering care. [My collegue Adam Linker explains how this shell game works - and how it has failed miserably in other states.]
So, what’s the big ticket item that the NC Senate and House would like to have more money for? Their tax plans, of course. The House and Senate tax plans would each cost NC over $1 billion and both the House and Senate plans would shift the tax burden onto low and middle income taxpayers, requiring a majority of taxpayers to pay more while the wealthiest people pay less. Both plans leave the state with less revenue and NC has to balance its budget, hence the rush to privatize Medicaid and free up a few dollars for those big tax cuts for the wealthy.