Commentary

Voters in battleground states say the ACA is here to stay

The following is a press release from our friends at ActionNC about powerful polling that shows most voters in battleground states want to move on from the obsession with repealing health reform to a mature discussion of how to improve the law. After more than five years the Affordable Care Act is getting some age on it, and we have learned important lessons from implementation. But we can’t make the law better if lawmakers don’t first accept that it’s a law that is here to stay. As usual, the public has to lead our leaders.

FOR IMMEDIATE RELEASE

October 7, 2015

Contact: Kevin Rogers, 919.862.4009

kevin@actionnc.org

Survey Shows that Voters Believe “ACA is Here to Stay”
Elected Officials Need to Improve Law; Not Repeal It

(Raleigh, NC) — A new survey shows that the majority of likely voters in five key battleground states – Florida, Nevada, Ohio, Pennsylvania and Virginia – believe the Affordable Care Act is here to stay (64%) and that Congress should work to improve the law (71%).

The survey, which was released by Community Catalyst and Service Employees International Union (SEIU), found that likely voters prefer a candidate who will work to improve the law over one who would repeal it (55% vs. 40%). Most agreed elected officials should “stop wasting time” trying to repeal the law (58%) and instead focus on a variety of improvements to lower the cost of care.

“These research findings confirm what we continue to hear over and over across North Carolina. People are frustrated with repeated efforts to repeal the ACA. It’s time to recognize that the law is here to stay.” said Kevin Rogers, Policy Director for Action NC. “We need to move forward to find ways to continue to lower health care costs for people and address issues such as high copayments and escalating drug prices.”

“Voters understand that the law has led to some important outcomes such as guaranteeing coverage for people with pre-existing health conditions. This research shows that they now want their elected officials to work together to make improvements that favor patients over insurance companies and pharmaceutical companies,” said Rogers.

The survey showed strong support across party lines for improvements that are being considered to lower health care costs, including:

  • Require hospitals and other health care providers to be transparent about their prices so people understand what the cost of services will be before they use them (75% strongly support)
  • Change the way insurance companies pay doctors and hospitals to create incentives to keep people healthy rather than paying providers based on the number of tests and procedures they give (64% strongly support)
  • Give Medicare the power to negotiate drug prices (63% strongly support)
  • Expand tax credits to small businesses to help the afford employee health insurance (61% strongly support)
  • Give state insurance commissioners more authority to push back on insurance companies that want to hike up insurance premiums (57% strongly support)

The survey was conducted by PerryUndem Research/Communication September 15-19, 2015; 1,005 adults who said they were likely to vote in the 2016 elections and have a history of voting in the 2012 or 2008 elections responded. The margin of error is +/- 3.1 percentage points.

You can read more about the poll results here.

Commentary

North Carolina’s uninsured rate falls, but gains are muted by failure to expand Medicaid

North Carolina’s uninsured rate fell in 2014 thanks to the implementation of federal health reform but data released today show our state is leaving many citizens behind by refusing to expand Medicaid.

The Census Bureau today released the country’s official data on health insurance rates, which shows that 1.27 million North Carolinians lacked health insurance in 2014 compared to 1.5 million uninsured North Carolinians in 2013. Expanding Medicaid would have resulted in a more dramatic drop in the uninsured rate.

We see that many of the states that expanded Medicaid such as West Virginia and Kentucky now have single-digit uninsured rates whereas North Carolina’s uninsured rate was 13 percent in 2014 compared to 15.6 percent in 2013. The Affordable Care Act is working, but it would work better if policymakers stopped blocking coverage for the working poor families who don’t earn enough to buy private insurance and don’t currently qualify for Medicaid.

A study by George Washington University released last year shows that expanding Medicaid in North Carolina would extend coverage to 500,000 more people while creating 43,000 jobs and attracting $21 billion in federal funding over five years.

Nationally, the Census data show that the uninsured rate dropped to 10.4 percent last year, down from 13.3 percent in 2013. These numbers reflect individuals who were uninsured throughout the year. The Affordable Care Act helped more than 8.8 million people gain health insurance coverage.

It’s not too late for North Carolina to catch up with the rest of the nation. The Governor could propose, and the legislature could adopt, a state-specific plan to close the coverage gap at any time.

Commentary

New NC Medicaid surplus more than enough to pay state costs of expansion through 2020

Medicaid expansionFor years now, poor and working North Carolinians who would benefit greatly from Medicaid expansion under the Affordable Care Act have been held hostage as Governor McCrory procrastinated and offered excuses. First, the Guv claimed that the Medicaid system itself was “broken” and in need of repair before it could be expanded. Then, he claimed that it would be inappropriate to act until the U.S. Supreme Court ruled on the constitutionality of the ACA itself.

Today, McCrory is running out of excuses. The Supreme Court took care of the constitutionality question a few weeks ago and yesterday, McCrory himself laid Excuse #1 to rest.

According to a statement from the Governor’s office, Medicaid is now in the black:

“The Department of Health and Human Services reported today that the North Carolina Medicaid program ended the 2014-15 state fiscal year with $130.7 million cash on hand. This is the second consecutive year the Medicaid program has finished with cash on hand.”

What’s more, that surplus is more than enough to cover state costs of implementing expansion. As a December 2014 study from health policy wonks at the Milken Institute School of Public Health at George Washington University reported (see page 15), expansion will actually save the state more than $300 million over the next five years. In 2020, however, there will be a modest net cost to the state of $91.7 million.

The obvious takeaway? Even if the state flushed away the savings that expansion will bring between now and 2020, it can easily cover the modest bump in costs in 2020 merely by socking away the current surplus.

Not surprisingly, however, the Guv is already moving the goalposts. Read more

Commentary

Time for public health action

After reading this fact sheet from the American Public Health Association (APHA), it is apparent that NC policymakers need to take action in order to improve our state’s public health. If our state legislators were assigned a grade for how they are investing in NC’s public health, it would not be a passing grade. The following statistics show there is much room for improving NC’s public health rankings:

  • Ranks 8th for prevalence of diabetes amongst adults.
  • Ranks 47th for the availability of dentists.
  • Ranks 10th for infant mortality.
  • Ranks 47th for the amount invested in each person’s public health needs. NC spends $11.73 per year per resident.
  • Ranks 5th for the number of children living in poverty.

While these numbers are unimpressive at best, there are some public health areas that NC has improved on. First, the high school graduation rate has improved, but then again the Senate budget proposes tax cuts that lower the number of teacher assistants, which could negate the progress made. Second, NC has made great progress in reducing air pollution, but then again the House wants to cut auto emissions tests in some counties.

Even though the sequester led to significant cuts in public health funding, there is federal funding available to address the poor rankings listed above. NC could receive funding to help the following:

Fifteen percent of North Carolinians are uninsured and 500,000 people are in the Medicaid coverage gap. These are people that could seek primary preventative health care that will yield better health outcomes such as prenatal and maternity care to ensure healthy outcomes after childbirth. Research has shown that children eligible for Medicaid miss fewer school days, have higher educational attainment. and their families have more financial security. There are also 150,000 people in NC in the coverage gap with mental health and substance use disorders that need ongoing treatment. The Affordable Care Act has written into law that the federal government will cover 100% of Medicaid expansion costs until 2016 and up to 90 percent of costs starting 2020. Ensuring coverage to one half million North Carolinians is one public health act that will pull NC up the rankings.

Commentary

Editorial roundup: Driver’s ed, SCOTUS decisions, Loretta Lynch, gerrymandering and the ACA

Editorial writers have penned several good ones across North Carolina in recent days.

This morning’s Winston-Salem Journal is on the mark when it reminds the state Senate that driver’s education should remain in the public schools. As the editorial notes: “It’s not just a matter of money, but of public safety.”

In an editorial entitled “There’s a better way than political gerrymandering,” the Fayetteville Observer says this:

“In one of its final decisions before ending its term this week, the U.S. Supreme Court upheld Arizona’s use of an independent commission to draw congressional districts.

We hope the leaders of the N.C. Senate took note. The decision gives them one less reason to resist a bipartisan initiative to create a redistricting commission here.”

An editorial in Raleigh’s N&O comments on native daughter Loretta Lynch’s return to the state yesterday by noting her sterling qualifications to be the nation’s new Attorney General and blasting the GOP Senators who filibustered her nomination:

“Disgracefully, both of North Carolina’s Republican U.S. senators, Richard Burr and Thom Tillis, opposed Lynch’s nomination on thin and blatantly partisan grounds. They embarrassed themselves more than they did Lynch, and Tillis as a freshman failed the political character test.”

The Charlotte Observer expounds thoughtfully on “Three more Supreme Court decisions that could – and should – have an impact on North Carolina.”

And, finally, in case you missed it, a Tuesday editorial in the Asheville Citizen-Times gets it right with this take on the Affordable Care Act:

“The Affordable Care Act is here to stay. It’s time for critics to stop trying to repeal it and start trying to improve it.

The Supreme Court put the final nail in the repeal-ACA coffin last week when it upheld health-care subsidies in states that have not set up their own insurance exchanges. By a 6-3 vote the justices recognized a drafting error for what it was and rejected the notion that Congress would have deliberately written a law to guarantee it would not work….

The ACA is not perfect. The unwieldy law is too complicated for many Americans and it faced an embarrassingly rocky rollout as thousands were unable to access the website. Its effect on the labor force is yet to be fully ascertained, but there’s always the threat of reduced employee hours and a smaller workforce if people don’t need a job for benefits.

We’re all up for discussing ways to improve the ACA. But the opposition is going to have to bring concrete solutions to the table to build off of the plan instead of continuing to face a fruitless battle to tear it down.”