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McCrory contradictionsGovernor Pat McCrory announced a disastrous and destructive decision yesterday in an interview with an AP reporter. When asked whether he would recommend closing the insurance gap that currently leaves a half-million North Carolinians too poor to qualify for Obamcare subsidies and too well-off to qualify for Medicaid, the Guv said: “I will not make any recommendation as to whether or not we extend insurance for the uninsured until the court case because there are so many ramifications of the court case.”

As the story also noted: “The court’s oral arguments are next month and a ruling is expected in the summer, about when the legislature traditionally seeks to adjourn. That could push any legislative action on a recommendation to 2016.”

This means that a half-million struggling North Carolinians will have to wait at least another year for the health insurance they were promised and deserve. In all likelihood, thousands will die unnecessarily. Meanwhile, tax dollars paid by North Carolinians will flow to other states in which Governors (many of the Republican) have had the vision and courage to put human life ahead of politics.

The decision comes after months of dithering by the Governor and in spite of the clear signals sent by his Department of Health and Human Services officials that Medicaid expansion is both the right thing to do and essential to save lives.

The bottom line: If this is truly is his final word on this matter, Pat McCrory has now, officially, made the worst and most destructive decision of his governorship — a decision that puts supposed concerns about bureaucratic hassles ahead of saving human lives. Meanwhile, millions of people in Ohio and Arizona and other conservative states  enjoy access to decent and affordable health insurance on our nickel. Let’s hope and pray the U.S. Supreme Court does the right thing this summer, but whatever happens then and thereafter, Gov. McCrory has now seized the mantle from former chief naysayer Senator Phil Berger and cemented his legacy as the person who denied decent and affordable health care to a half-million of his fellow Tar Heels unnecessarily.

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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.

News
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Supreme courtIn case you missed it yesterday, be sure to check out this article by NC Policy Watch’s Sharon McCloskey about North Carolina’s support for the provision of subsidies to low-income residents purchasing Obamacare.

Last week, Attorney General Roy Cooper signed on to a brief, on behalf of North Carolina, supporting these subsidies for low-income enrollees on the federal exchange.

In a number of lawsuits filed in federal courts, ACA opponents have argued that the law as written limits those subsidies to those who purchase on a state exchange and not, as interpreted by the Internal Revenue Service, to purchasers on either a state or federal exchange.

That interpretation would exclude North Carolinians, as well as the residents of the 33 other states in which governors opted to join the federal exchange rather than construct one of their own, from receiving the aid.

The lawsuit has been through several appeals and will now be heard by the U.S. Supreme Court on March 4th.

Twenty-two other states also signed the brief and collectively argue that a challenge to the subsidies should be rejected because they weren’t informed that residents of their state would be harmed if the state chose to use the federal exchange.

Most experts agree that a decision limiting subsidies to purchasers on state exchanges would cripple Obamacare.

The non-partisan Urban Institute projects that in 2016, the loss of subsidies in the 34 states using the federal exchange would deprive more than 9.3 million Americans of almost $29 billion in financial assistance — an average of $3,090 per eligible person — and increase the number of uninsured by about 8.2 million people nationally.

To read the full article, visit Policy Watch’s main page here.

Commentary
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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
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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.

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