Distortions from the Right on Medicaid expansion hit a new low


State Senator and Mayland Community College “Coordinator of Special Projects,” Ralph Hise

Sensing building momentum for the expansion of Medicaid under the Affordable Care Act that would both cover hundreds of thousands of uninsured low income North Carolinians and bolster the state’s economy with billions in federal dollars, right wingers appear to have launched a new campaign of propaganda and distortion.

A prime example is this article on conservative website known as Watchdog Wire. In it, the author revives and recycles multiple absurd untruths about the supposedly ginormous cost to the state of Medicaid expansion — which she attributes to State Senator and Mayland Community College “Coordinator of Special Projects,” Ralph Hise. According to the article:

“the state would have to cover administrative costs to the tune of $2 billion per year. That’s a ’50-50 split’ said Hise.”

This is utter nonsense. As this detailed analysis by the North Carolina Institute of Medicine shows on page 5, the financial impact to the state from 2014 to 2021 if the it expanded Medicaid under the ACA is a net savings of $65 million. Hise’s “$2 billion” claim is simply out-of-thin-air malarkey.

The article also quotes Hise for the following supposedly damning criticisms:

“Expansion starts with 100 percent funding for services and drops to 90 percent by 2020. But, Hise said, if the federal government changed the plan, the state could pay much more.

And, he said, expansion would make Medicaid the largest health insurance provider in the state — bigger even than Blue Cross Blue Shield.

Since its rates are lower than private insurance, that would be bad for the economy and health care, he said.”

Each of these claims is also, in a word, baloney. Let’s take them in order:

#1 – There are two responses to the claim that the state could pay more later if the federal government “changed the plan”: a) No kidding — the same is true of every other federal program that sends money to the states. How come Hise isn’t calling for the state to turn down federal highway money or the money that comes to his employer, Mayland Community College? That said, it must also be noted that, b) the McCrory administration has already indicated that it wants to make Medicaid expansion a function of the feds maintaining the 90% reimbursement rate. In other words, Hise’s claim is simply silly.

#2 – The responses are similar for the claim about making Medicaid the state’s largest health insurer: First off, if that were true, who cares? Is it our job to worry about the future of a virtual monopoly like Blue Cross? More to the point, however, it’s probably not true anyway because the Obama administration has been handing out waivers to other Republican-dominated states to handle Medicaid expansion through private providers like – you guessed it — Blue Cross. Bottom line: Don’t worry about Blue — it will be just fine.

#3 – Finally, as for the claim that Medicaid rates are lower than than private insurance and that this is somehow a bad thing for the state, we’ll just let Hise explain to his constituents in western North Carolina who struggle with high rates of poverty, unemployment and lack of health coverage why it’s bad to have lower-cost health insurance.


  1. Rob Schofield

    November 20, 2014 at 11:24 am

    It’s also probably worth noting that in her haste to shovel propaganda, the right-wing “reporter” didn’t even do a very good job of representing Hise’s arguments — which she was apparently lifting from an Asheville Citizen-Times story. If you read that story a little more closely than the author did, it’s pretty apparent that the $2 billion to which Hise refers is mostly just the money that the state pays anyway to administer Medicaid — whether it expands or not. That said, the bottom line remains that both Hise and she are off-base; the state will still net $65 million over eight years if expansion occurs.

  2. Elaine Percival

    November 20, 2014 at 3:31 pm

    Would you expect anything other than “silliness” from the senator who sponsored Amendment One to the NC Constitution? It is my understanding that this guy serves as the ventriloquist’s dummy for his party. With his district so gerrymandered that no member of the opposition party would run against him, he seems to have credibility, while paying little attention to the needs of those he purportedly represents. How sad for those who have no voice, not even the ballot box.

  3. Bill Bush

    November 21, 2014 at 8:19 am

    The code language translation: We don’t want any black people to get insurance. We fear that we won’t get to see a doctor if others get appointments. We feel comfortable ignoring the suffering of others. If we don’t sacrifice some members of society to the richest corporations, they may come and take what we have.

  4. LayintheSmakDown

    November 24, 2014 at 2:53 pm

    Actually the “black people” can get insurance through the Obama exchange.

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