For years now, poor and working North Carolinians who would benefit greatly from Medicaid expansion under the Affordable Care Act have been held hostage as Governor McCrory procrastinated and offered excuses. First, the Guv claimed that the Medicaid system itself was “broken” and in need of repair before it could be expanded. Then, he claimed that it would be inappropriate to act until the U.S. Supreme Court ruled on the constitutionality of the ACA itself.
Today, McCrory is running out of excuses. The Supreme Court took care of the constitutionality question a few weeks ago and yesterday, McCrory himself laid Excuse #1 to rest.
According to a statement from the Governor’s office, Medicaid is now in the black:
“The Department of Health and Human Services reported today that the North Carolina Medicaid program ended the 2014-15 state fiscal year with $130.7 million cash on hand. This is the second consecutive year the Medicaid program has finished with cash on hand.”
What’s more, that surplus is more than enough to cover state costs of implementing expansion. As a December 2014 study from health policy wonks at the Milken Institute School of Public Health at George Washington University reported (see page 15), expansion will actually save the state more than $300 million over the next five years. In 2020, however, there will be a modest net cost to the state of $91.7 million.
The obvious takeaway? Even if the state flushed away the savings that expansion will bring between now and 2020, it can easily cover the modest bump in costs in 2020 merely by socking away the current surplus.
Not surprisingly, however, the Guv is already moving the goalposts. Yesterday’s statement included ominous and predictable language from Health and Human Services Secretary Aldona Wos in which she claimed that “North Carolina’s Medicaid budget is in far better shape, but there is still more work to be done to implement a long-term solution for our Medicaid program.”
The bottom line: The time for Medicaid expansion and the lifesaving changes it would make for hundreds of thousands of vulnerable human beings in North Carolina is long past due. Dozens of other states with less successful Medicaid programs have already proved this. Unfortunately, as he approaches the final year of his gubernatorial term, Pat McCrory continues to stall, shy away from and just generally flub what could be the single most important and beneficial state policy change in decades. Stand by for more excuses in the days and weeks ahead.