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From a an AP story by Emery Dalesio this afternoon:

Mooresville Graded School District Superintendent Mark A. Edwards — honored last year as one of the country’s best administrators — described walking into a supermarket with his teenage son while the two discussed whether the boy had an interest in teaching. The evening chat was interrupted when Edwards recognized one of his teachers mopping an aisle, a second job she held after school hours to make ends meet, Edwards said.

The latest Gallup poll shows a continuing decline in the number of uninsured Americans while the federal government reports 4 million people have already enrolled in new health options under the Affordable Care Act.  This reality collides harshly with the continuing effort by conservatives in North Carolina to blame the Affordable Care Act for their self-created problems.

Gallup uninsured poll

Gallup uninsured poll

Monday night this week we had a great educational forum in Marion, NC on giving details of the Affordable Care Act in NC and the opportunity for expanding Medicaid to fill the coverage gap for low income people in our state. Big thanks to City Councilman Billy Martin who helped coordinate the event and got us into the wonderful community building constructed by the Civilian Conservation Corps nearly a century ago. Below Nicole Dozier gives the lowdown on the ACA and you can read the article advertising our meeting here. We are heading down east to Beaufort County next and will be back up in the foothills and all over the state in the coming months.

Marion ACA/Medicaid Community Mtg 3-3-14

Adobe ReaderScreenSnapz002No, I’m not overstating the case. This year, the NC Department of Health and Human Services has hired a $250/hr Medicaid consultant, paid a $210,000 annual salary to a former Louisiana Medicaid director who stayed in NC less than a year, and hired a guy a year out of college for $85,000 a year to be chief spokesperson.  Governor McCrory, DHHS Secretary Wos – I have a message for you:  Save our taxpayers some serious money and look a little closer to home for your expertise.  For instance, take the graduate programs in public policy at Duke and UNC-Chapel Hill.

This week students on the Duke-UNC Student Medicaid Reform Team released a comprehensive, detailed, thoughtful, realistic and highly impressive report on Medicaid Reform in North Carolina.  Titled “A New Health Reform Framework For North Carolina” the 66 page document sets out a plan for NC Medicaid that uses both private health insurers and the current public program to expand coverage, recommends concrete ways to better integrate mental health services and contains detailed estimates of costs and benefits of the proposed changes. It short, the student team directly and comprehensively responds to the charge given to the DHHS Medicaid Reform Commission.

Governor, Secretary Wos, I have to tell you.  Hiring these students could really help North Carolina in general and the Department of Health and Human Services in particular.  Especially when you consider what all the highly paid consultants, high profile meetings, and extensive public relations blitz produced at your final Medicaid Reform Commission meeting this week.  The sole document given out at the meeting this week where your big, new revolutionary reform plan was to be presented  consisted of a two-page overview of what how you hope to use different payment mechanisms for doctors and hospitals in NC’s current Medicaid program.  Two pages!  And after all that work and money spent.  I would advise a call to the Duke and UNC public policy schools very quickly and see if you can get some of these students to commit to their home state before they get snapped up by other employers.

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NC HHS Sec. Aldona Wos

NC HHS Sec. Aldona Wos

Yesterday, Governor Pat McCrory’s DHHS Secretary, Aldona Wos, unveiled the administration’s long-awaited reform plan for Medicaid.  One of McCrory’s favorite talking points on Medicaid has been how “broken” the system is and how he’s going to “fix” it.  Setting aside the past year of missteps in which McCrory and Wos did more than any Governor and Secretary in history to discredit and cause problems for NC’s award-winning Medicaid program, what does the administration’s plan yesterday tell us about the future prospects of Medicaid and health care for the poor in NC?  Here’s my take:

1. Surrender:  The Governor completely surrendered by backing down from his former big plans to sell off substantial parts of the Medicaid program to private, out-of-state insurance companies.  The proposal yesterday to use “Accountable Care Organizations” or ACOs is simply, at its core, a new way to pay existing or new networks of doctors, hospitals and other health care providers.  Paying health providers as a group for each illness a patient gets rather than piecemeal for every test and procedure is supposed to get providers focused on quality and efficiency, especially when payments go up if patients are healthier. ACOs represent gradual evolution in health care and not “major reform.”

2.  Missing the boat on Medicaid expansion: The Governor also made it clear that he has no intention of solving the coverage gap for the 500,000 poor North Carolina citizens who would be eligible for Medicaid coverage if he led the charge to expand Medicaid using the billions of dollars in federal money available to our state. Conservative governors and legislators around the country – whether in New Hampshire or Utah – are coming up with innovative solutions to cover their citizens with all the new federal money available.  By leaving an expansion proposal out of his plans to change Medicaid, our Governor is renouncing any claim to national moderate leadership on this issue, leaving billions of federal tax dollars collected from North Carolinians to go to states that do expand and hurting hundreds of thousands of his own constituents.

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