Who me? Yes you, Governor: How McCrory could still close the Medicaid gap

In case you missed it this morning, be sure to check out Adam Linker’s op-ed in this morning’s edition of Raleigh’s News & Observer. As Linker writes:

“Health insurance for more than a million North Carolinians is at stake, and Gov. Pat McCrory has two options: He can take the initiative to protect the people he has sworn to represent or he can sit back and let external forces decide our destiny.

Nearly 560,000 people have signed up for Affordable Care Act plans in North Carolina, and many of them receive tax credits to help pay their premiums. Thanks to outreach efforts by nonprofits, insurers, insurance agents and hospitals, our state ranked fourth in Affordable Care Act signups nationally.

Despite these impressive results, there are still more than 500,000 people, many of them the working poor, who do not qualify for North Carolina’s Medicaid program and who do not earn enough to purchase private insurance. Health reform set aside money for our state to provide this population with coverage through Medicaid, but first state leaders must consent to using these funds for that purpose. So far the governor and state legislature have left the money in Washington.”

Unfortunately, of course, Governor McCrory has failed to act. As Linker explains, however, it’s not too late:

“Now comes the governor’s moment.

He, along with legislative leaders, could change course and circumvent the Supreme Court by re-establishing state control over our insurance marketplace. In fact, most of the pieces are already in place. Our Department of Insurance is proactive about reviewing insurance policies. Our health care and insurance communities meet regularly and could easily form an oversight board. Our outreach and enrollment efforts are national models. All we need is for the governor to work with legislators to vest these organizations with the power to form a state marketplace.

McCrory then could release a state-specific plan to tap federal Medicaid funds to expand coverage to 500,000 additional people. This would boost local economies still staggering from the Great Recession. It would allow tens of thousands of women access to preventive screenings like mammograms and pap smears. It would allow thousands of people suffering from the disease of addiction to obtain the long-term treatment they need.

Closing this gap in coverage would not only save lives, it also would help rescue rural hospitals, which serve a disproportionately high percentage of uninsured patients and are on the verge of financial collapse.

McCrory may not realize it, but insurance for more than a million North Carolinians will be a touchstone for his administration. Claiming he has no control over the issue will not do because it’s not true. I suspect the governor and legislature will meet this test. Surely, they will not throw up their hands and surrender our fate to a few fickle Supreme Court justices and a deadlocked Congress. After all, what is the purpose of holding political office if not to secure the well-being of our citizenry?”


  1. Alex

    February 24, 2015 at 12:54 pm

    We keep talking about the money set aside in Washington for Medicaid expansion when in reality there is no money at all there. All of the additional money will have to be borrowed along with the $500 Billion that we currently borrow just to fund current entitlements. It is nothing more than an illusion that the government started just to sell folks on Obamacare along with several other big lies. It’s the old adage that if you say something long enough, people will eventually believe it

  2. LayintheSmakDown

    February 24, 2015 at 4:36 pm

    Don’t forget that we do not even have the portion that will be pushed down to the states in the near future. Didn’t we just hear a lot of whining about how we are missing the current confiscation forecast by less than 1%? Just imagine the blow to pile on more of the Medicaid toilet!

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