The U.S. House of Representatives is set to vote on the American Health Care Act today which seeks to strip the health care coverage extended to millions of Americans in recent years, shift the cost of health care onto middle and low income consumers and give the wealthiest taxpayers a tax cut.
It has been called by many the greatest redistribution upward in memory.
It is also a cost shift onto states. North Carolina policymakers would have to find an estimated $6.6 billion over 10 years to maintain the Medicaid program alone. To do so, state policymakers will have to raise taxes or cut services or cut off people from health care or cut payments to providers. At a time when North Carolina’s leaders are contemplating their existing spending priorities with a tax code that continues to fall short of the needs, finding an additional $6.6 billion over ten years will be impossible without many of these steps.
The proposed restructuring of Medicaid represents unnecessary changes to a program that serves the state’s most vulnerable residents efficiently and with the goal of improving health outcomes of all North Carolinians. This is a retreat by the federal government that will leave state policymakers responsible for the rationing of care and fallout from the health care industry.
Over time, as my colleague Luis Toledo detailed in recent analysis, these pressures on state government will grow. The adjustment of the amount that the federal government will provide to North Carolina is not sufficient to keep up with the cost of services nor will it allow the state to contend with the next public health crisis or emerging treatments for existing diseases.
The loss of health care coverage through the dismantling of the Affordable Care Act and the restructuring of Medicaid will ripple through North Carolina, impacting families, health care providers and, yes, the economy.