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Medicaid expansionOur old NC Policy Watch colleague Adam Searing had a great post last week on the Georgetown University Health Policy Institute blog, Say Ahhh! that explains why Medicaid expansion is fast reaching the tipping point as states that once said “no” are now seeing the light. Let’s hope North Carolina come to their sense soon.

It’s getting harder and harder for Governors to say no to the great deal being offered to them through the Medicaid expansion option.  Just last week Pennsylvania reached agreement with the federal government on a Medicaid expansion waiver and news stories show possible movement in Wyoming, Utah and Tennessee.

This new momentum forward shows that more state leaders are willing to stand up to those with intransigent ideological views to find a common sense approach towards managing their state’s finances and health care system.  Three factors are driving the change:

Hard Numbers

Before January 1, 2014 – the first day states that accepted the federal Medicaid expansion could open their programs – the costs of not doing so were largely theoretical.  Now that a growing majority of states have expanded coverage, the choice on Medicaid is no longer a hazy public policy debate but one where hard numbers on the cost of not expanding coverage are now available between the states that expanded coverage and those that have not. Read More

Commentary

As expected health care played a major role in the first debate between Sen. Hagan and Speaker Tillis.

Tillis took two major lines of attack against Sen. Hagan on health care: he chastised Hagan for saying that people could keep the insurance plan they like, and he criticized the policy of setting minimum standards for insurance plans. He also mentioned at the end of the debate that people will pay 11 percent more for insurance next year but that was a strange sidebar claim with no evidence to support it. Insurance policies are not yet posted and have not even completed regulatory review.

On the first point Tillis chose his words carefully. Koch brother groups in North Carolina keep claiming that thousands of people in the state lost their insurance. The Tillis camp apparently realizes that this is a ridiculous assertion. So Tillis said that thousands of people received cancellation notices from their insurance company. This thrust was parried by Hagan when she pointed out that the plans were continued when she and other members of Congress pressured the Obama Administration to keep the policies in place. She also noted that insurers continued selling non-compliant insurance plans to consumers after the Affordable Care Act was signed without adequately explaining that the policies would have to change after 2014.

On the second point Tillis argued that people should be able to purchase any insurance plan they want without regulations on what is covered. The Affordable Care Act imposes some standards on insurance policies. Hagan didn’t spent much time responding to this charge, although she could have noted that his push for mandating that insurance cover Autism treatments directly contradicts his criticism of health reform. The problem with deregulating insurance is twofold. Read More

Commentary

Medicaid expansionIn case you missed it, be sure to check out this story in the Charlotte Observer by Ann Doss Helms and Tony Pugh about North Carolina’s ongoing and self-destructive refusal to accept federal dollars to expand Medicaid to hundreds of thousands of North Carolinians in need. As the Helms and Pugh report:

North Carolina taxpayers could spend more than $10 billion by 2022 to provide medical care for low-income residents of other states while getting nothing in return, a McClatchy Newspapers analysis shows.

The Affordable Care Act tried to expand Medicaid to millions of low-income, uninsured adults. But many Republican-led states, including both Carolinas, opted out of the plan championed by President Barack Obama.

If the 23 states still rejecting Medicaid expansion stick with that decision, they’ll contribute $152 billion over 10 years to states that take the federal money, the analysis shows. North Carolina would be one of the top five contributors.

In other words, because of the refusal by Gov. McCrory, House Speaker Tillis and Senate President Pro Tem Berger to expand Medicaid, North Carolina is contributing to the utterly nonsensical situation in which it and other poorer states are subsidizing the provision of health care to low income people in wealthier states that have already expanded Medicaid.

The article also cites a pair of business economy experts for the proposition that the failure to expand is holding back the state’s economy: Read More

Commentary

Doesn’t it seem that the nation’s progress and momentum in implementing the Affordable Care Act (and, in particular, Medicaid expansion) is starting to resemble the slow but steady (and inevitable) progress on marriage equality?

Talking Points Memo has the story today of the latest conservative state to be talking openly of a plan to expand Medicaid — it’s our neighbor to the west Tennessee:

In a growing trend, Tennessee looks like it will be the next Republican-led state to move toward expanding Medicaid under Obamacare.

Right now, of course, North Carolina is in the “no” camp on both issues. The bet here, however, is that this won’t be the case come the 2016 election.

Click here and here to see two maps that reveal the trends.

Uncategorized

Bloomberg News published a fascinating story yesterday (“Obamacare Losing Power as Campaign Weapon in Ad Battles”) about the gradual, but steady demise of the Affordable Care Act as a campaign issue for conservatives in the 2014 election. In illustrating the altered political landscape, the story features a North Carolina woman whose views have been changed dramatically.

“Republicans seeking to unseat the U.S. Senate incumbent in North Carolina have cut in half the portion of their top issue ads citing Obamacare, a sign that the party’s favorite attack against Democrats is losing its punch.

The shift — also taking place in competitive states such as Arkansas and Louisiana — shows Republicans are easing off their strategy of criticizing Democrats over the Affordable Care Act now that many Americans are benefiting from the law and the measure is unlikely to be repealed.

“The Republican Party is realizing you can’t really hang your hat on it,” said Andrew Taylor, a political science professor at North Carolina State University. “It just isn’t the kind of issue it was.”

The party had been counting on anti-Obamacare sentiment to spur Republican turnout in its quest for a U.S. Senate majority, just as the issue did when the party took the House in 2010. This election is the first since the law was fully implemented.

Now, Republicans are seeking a new winning formula, with the midterm election less than three months away.”

The story continues with the powerful example of a 44 year-old former Romney supporter from Raleigh: Read More