In 1988 North Carolina had the nation’s highest infant mortality rate. The state decided to tackle this tragedy in a variety of ways. One approach, championed in a bipartisan effort by Republican Governor Jim Martin, was to expand Medicaid coverage to pregnant women earning up to 185 percent of federal poverty level and creating a package of programs within Medicaid to ensure good maternity care and a safe delivery.

Pregnant women who qualify now get excellent care in Medicaid and we have made some progress with our infant mortality rates. The legislature is now set to roll back that progress.

One of the Senate budget provisions moves Medicaid eligibility for pregnant women down from 185 percent of federal poverty level to 133 percent of federal poverty level (about $15,000 in annual income). The rest of the provision is a poorly constructed attempt to provide political cover for this mean spirited move.

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Our friends over at the NC Council of Churches have posted on their blog a conversation between our own Nicole Dozier and Council of Churches Volunteer Program Associate Sandy Irving about the legislature’s decision to block Medicaid expansion.

Here is the third paragraph of the article:

Nicole goes on to note that “the good news is that God is a God of second chances. On this group’s behalf, I am entreating the lawmakers who are blessed with the option of premium-free health coverage but who rejected federal money and blocked my brothers and sisters from having the same, to change their minds and their votes and to use the gift of the Affordable Care Act to expand Medicaid.”  And she further adds that she “wants to sincerely thank the lawmakers who through their testimonies, their actions, and their votes, were upstanders for the 500,000 uninsured working adults who deserve access to care resulting in better outcomes and a stronger North Carolina and who deserve to move forward with the rest of us who will be benefiting from the Affordable Care Act.“

Please read the entire post here. As we have said, rejecting Medicaid makes no moral or economic sense.

I’m not sure who is in charge of Gov. Pat McCrory’s twitter feed but apparently they are impressed with themselves. Here’s a tweet they sent out:

The problem is that the administration did not get an “A” from the Triangle Business Journal. The Governor received an “A” rating from about 340 people who clicked on the online poll hosted on the TBJ website. And McCrory got a C, D, or F from about 511 voters. 41 percent of the voters rated the Governor’s performance as a “D” or “F”. And this is from a rather conservative readership.

As many people know, businesses with more than 50 employees will need to offer affordable insurance to their workers or potentially pay a penalty. The fee is then used to offset some of the costs of providing those employees tax subsidies in the new health benefit exchanges. Many people do not realize, however, that businesses in states that do not expand Medicaid will face steeper penalties than companies in states that expand Medicaid.

The reason for this discrepancy is that a business only faces penalties when their employees get subsidies in the exchange. If a company does not offer affordable health insurance, but its employees qualify for Medicaid, the employer does not get penalized. Also, in states that do not expand Medicaid the subsidies will reach down to people earning 100 percent of federal poverty level. That means more people will get subsidies and more businesses will get penalized.

We’ve known all of this. Until now, however, no organization had quantified how much more in penalties employers might face. Now the tax services company Jackson Hewitt has released an analysis saying the amount of additional employer fees for North Carolina ranges between $65 million and $98 million.

This is just another reason why blocking Medicaid expansion and sending our federal funds to other states is a bad idea.

According to his public schedule Gov. Pat McCrory will reject funds to insure 500,000 more people in our state at a closed door bill signing at 4:30pm today.

We have detailed the tremendous costs to the state of rejecting this federal money. It will mean more people delay necessary health care treatments. It will mean a population that is sicker and dies sooner. It will mean rural hospitals will continue to struggle with a mixture of federal cuts (including some in sequestration) and financial pressure from treating the uninsured. It will mean that our Community Health Centers will continue fighting to stay afloat. It will mean that many of the terrible health disparities that exist in our state will persist.

Remember, Gov. McCrory did not have to sign this legislation. He could have vetoed it. He could have let it take effect without his signature. Instead, he is lending this ill advised move his active endorsement. It is too bad that he won’t face the public as he writes them off.