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Out-of-state activist J. Scott Moody will be making the rounds on Monday in North Carolina to say that expanding Medicaid will hurt our economy.

Moody is from a South Carolina outfit called State Budget Solutions and he travels the country speaking out against policies disfavored by conservatives. His schtick is releasing cut-and-paste reports showing the economic harm done by the programs he opposes.

For example, in 2012 he lit off to New Hampshire to warn that allowing same sex marriage in that state would result in economic devastation and a “demographic winter.” You have to read the entire news article of his visit to capture his arguments in all of their glory, but this is one of my favorite parts:

Also, according to Moody, when same-sex couples adopt, they place the child in a situation where one or both of their parents isn’t their biological parent. However, according to Moody, statistics have shown that a relationship with a stepparent is not the same as a relationship with a biological parent and stepparents tend to not have the same bond or pay the same attention as the biological parent. Moody did not provide charts or actual sources for this claim.

These days Moody is taking a break from attacking adoptive parents and is focusing on Medicaid expansion. Moody has made presentations in several states and published opinion pieces arguing that an expansion of the public sector will crowd out private sector spending. This analysis is about as sophisticated as his arguments that gay marriage will destroy the economy and that stepparents don’t pay attention to their children.

Actual economists have responded to Moody everywhere he has spoken to point out that he is wrong. A good example is from Dr. Sven Wilson at BYU when Moody visited Utah to warn them of the dangers of federal funds flowing to the state. Again, you should read the entire piece but here’s a taste of Wilson’s response:

Many economists argue that spending on Healthy Utah will further expand the economy by generating new jobs and new private spending as the money works its way through the economy. Economists call this effect a multiplier. As a conservative, free-market economist, I think multipliers are generally small. But no serious economist of any political stripe thinks the multiplier is negative, which is what Moody is suggesting.

Imagine someone saying that when tourists spend their money in our state, their purchases end up costing us jobs and hurting our economy. Who would believe that? But that is exactly the argument Moody is making about Healthy Utah.

Luckily, we already have a study on the economic impacts of Medicaid expansion in North Carolina using respected REMI models. That study concludes that expansion will grow our economy, create 43,000 jobs, and provide much needed revenue to county and state budgets. It will also provide affordable coverage to 500,000 North Carolinians and bolster rural health care in the state. States that have already expanded coverage, like Kentucky, are seeing these positive economic predictions realized.

We aren’t seeing the winter Moody predicted in 2012. Instead the economy keeps heating up despite gay marriage sweeping the nation. I suspect we will see similar results as more states expand insurance coverage.

 

Commentary

Consumer organizations have asked the Obama Administration for months to give people who find out during tax filing season that they owe a penalty for not buying health insurance another chance to enroll. Today Health & Human Services announced that they will do just that.

In meetings and public forums we have found that many people are confused about whether or not they will be fined for not having coverage. We, along with other consumer advocates, knew that thousands of folks will find out about the penalty when they file taxes. Before the announcement today, that would have been too late, as open enrollment for health insurance ended February 15.

In federal marketplace states like North Carolina this special enrollment period will run from March 15 to April 30 for those who are uninsured and learn that they must make the shared responsibility payment.

Here are additional parameters as outlined by HHS for taking advantage of this new enrollment opportunity:

  • Currently are not enrolled in coverage through the FFM for 2015,
  • Attest that when they filed their 2014 tax return they paid the fee for not having health coverage in 2014, and
  • Attest that they first became aware of, or understood the implications of, the Shared Responsibility Payment after the end of open enrollment (February 15, 2015) in connection with preparing their 2014 taxes.

This is good news for North Carolinians and will help ensure that we aren’t penalizing people for not having reliable information.

Commentary

GovBeshear_300Today in the Joint Appropriations Committee at the NC General Assembly there was a suggestion that closing the insurance coverage gap in states has proven much more expensive than first anticipated. Just after the conclusion of our legislative meeting Kentucky Governor Steve Beshear held a press conference addressing this very issue. In his statement to the media Gov. Beshear said claims that Kentucky could not afford Medicaid expansion have been “buried under an avalanche of facts.”

He went on to say:

An avalanche of facts that demonstrate to the satisfaction of anyone and everyone with an open mind that Kentucky can indeed afford to take care of its people. In fact, we can’t afford not to do so.

The focus of Gov. Beshear’s press conference was a new report from the Urban Studies Institute at the University of Louisville showing that the first year of expansion saved millions of dollars and created thousands of jobs in Kentucky. In addition, health care providers were paid an addition $1.16 billion for services.

The report also shows that for the FY17-18 state budget Kentucky will pay a biennial total of $247.6 million for expansion, which will be offset by $511.8 million in savings and additional tax revenue.

We have similar studies in NC showing that covering 500,000 more people would create jobs and boost state revenues. We just need more policymakers willing to listen to the facts flowing from states that have already made the wise decision to invest in the health of their people.

Commentary

NC Left Me OutA group of coalition partners working in North Carolina to close the Medicaid coverage gap has launched a new website called NC Left Me Out to collect stories of people who make too much for Medicaid and too little for private insurance. As the website explains, the Affordable Care Act specifically allocated funds to provide affordable insurance coverage to approximately 500,000 people in our state. Unfortunately, the Governor and the legislature have blocked those funds from coming to North Carolina. Many of the individuals and families who could use this money to get insurance coverage work in low-wage professions like construction, day care, and food service.

At a press conference today Dana Wilson, a woman in the coverage gap who suffers from MS, shared her story. You can watch her video here.

The legislature and the Governor need to hear from more people like Dana, the working poor who are being unfairly denied coverage. If you are in the coverage gap please consider sharing your story on the NC Left Me Out website. If you want to support the campaign then you can sign up as well.

Every week a new Governor shows the leadership to formulate a plan for extending insurance coverage to people in the Medicaid gap. Last week the conservative state of Indiana had a plan approved. States like Wyoming and Utah are moving forward with similar ideas. We need Governor McCrory to show us his plan for closing the coverage gap. He has publicly hinted that he wants to design a state-specific Medicaid waiver. Great, let’s get moving. Every day that we wait is another day people like Dana suffer.

We need to continue telling our stories to the media, to legislators, and to the Governor. If the economic arguments and moral arguments don’t win the day, maybe looking into the eyes of those who have been denied coverage will begin changing minds.

Commentary

We have written before about King v. Burwell, the case that will be heard before the US Supreme Court to determine whether or not health insurance subsidies can flow to states that refused to establish state-based marketplaces under the Affordable Care Act. As John Stewart has noted, justices would have to be more literal than Amelia Bedelia to find for the plaintiffs, but we live in strange times where anything seems possible.

The next question then is if the Supreme Court strikes down subsidies how many people would it impact? Now Kaiser Family Foundation has a helpful interactive map to estimate an answer. KFF researchers think more than 13 million people nationally, and about 1 million people in North Carolina, would lose tax credits if the Supreme Court denies subsidies to federal marketplace states. For most of these folks insurance would immediately become unaffordable. This is especially true because prices would most likely spiral upward as younger, healthier enrollees lose coverage.

That is a stunning figure. It would be like the Supreme Court cutting the number of North Carolinians receiving Medicare in half.

The cruel truth is that Congress could easily fix this problem by adding a few words to the Affordable Care Act, but they are so obsessed with repealing the legislation that they are unlikely to repair it. The state legislature could also provide a patch by at least establishing a governance structure for a state-based marketplace, but they are also unlikely to move. After all, the federal government stands ready to pay the state to expand insurance to 500,000 more state residents and that hasn’t gained any legislative traction.

So, we wait, while medical care for 1 million North Carolinians hangs in the balance.