A new report  from the Robert Wood Johnson Foundation and Urban Institute shows the financial folly of rejecting Medicaid expansion. Currently 24 states are refusing federal funds to cover more of the uninsured, although that number is quickly dwindling as more governors and legislators get approval to implement state-specific expansion plans. If North Carolina does not act soon we will find ourselves in lonely company.
Here are the numbers. On average, the Urban Institute finds that every $1 invested in Medicaid expansion will bring $13.41 in federal funds to the state. In North Carolina the 10-year cost to expand Medicaid is $3 billion, although the savings and cost offsets mean that the state would actually save money in the budget over that timespan. At the same time our state is losing nearly $40 billion over 10 years by not expanding Medicaid. Hospitals in our state stand to lose $11.3 billion over 10 years, which is why we are seeing layoffs and closures at hospitals across North Carolina.
This financial picture has convinced even rock-ribbed Republican governors across the country to champion expanding coverage in their states. Many of these political leaders from Arkansas to Iowa, Indiana to Utah, are proposing to increase coverage by applying for a Medicaid waiver that allows these states to use federal funding to craft creative alternatives to traditional Medicaid expansion.
Arkansas led the charge on this front by using expansion funds to buy private insurance coverage for low-income individuals and families in that state. And we see that Gov. Mike Beebe certainly hasn’t suffered by doing the right thing. He currently enjoys a 60 percent approval rating  compared to 23 percent who disapprove of his policies. Despite being a Democrat his ratings are even above water with Republican voters. Compare this with Gov. McCrory who is having trouble cracking 40 percent in his approval  ratings.
Gov. McCrory could add some polish to his image by expanding health coverage to 500,000 more people, bringing $40 billion in federal funds to the state, and boosting hospital bottom lines by $11 billion. Who knows, it may even help the legislature pick its approval ratings up off the floor.