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Notwithstanding the unceasing efforts to undermine and obstruct the Affordable Care Act, America’s health care law continues to pile up an impressive list of accomplishments. The latest was detailed this morning in this post by Tara Culp-Ressler at Think Progress:

“For the first time in a decade, the number of people struggling to pay their medical bills has started to decline, according to a new survey released on Thursday by the Commonwealth Fund. The researchers attributed the historic drop to the number of people gaining insurance under the health care reform law.

Between 2012 and 2014 — as Obamacare’s main coverage expansion took effect — the Commonwealth researchers found that the number of people who had issues paying for health treatment dropped from 41 percent to 35 percent. Over the same time period, the people who skipped out on health services because they couldn’t afford them declined from 43 percent to 36 percent:

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CREDIT: Commonwealth Fund

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CREDIT: Commonwealth Fund”

Commentary

mc-1Governor Pat McCrory emerged from his much-publicized meeting with a handful of other governors and President Obama at the White House  Tuesday breathlessly declaring that Obama is open to considering waivers to allow North Carolina to crafts its own version of Medicaid expansion under the Affordable Care Act.

But that shouldn’t be news to McCrory or anybody else.  Nine states, most of them with Republican governors, have already expanded Medicaid with waivers from the feds or have been in discussions with the Obama Administration about waivers for their own versions of the program.

Neighboring Tennessee is the latest state with Republican leadership to move forward, with Governor Bill Haslam unveiling a proposal for Medicaid expansion last month. 

Apparently McCrory had to fly to Washington to figure out that the Obama Administration was willing to work with state officials who are developing their own Medicaid plan.  Or maybe he just wanted us to know he was talking tough with Obama.

I presented a very strong argument for more flexibility if we even consider Medicaid expansion, so we can have a North Carolina plan instead of a Washington plan, and especially a plan that would encourage more people to get a job or get training before we expand another government program,” McCrory said after the meeting.

While it’s too bad it took McCrory much longer than many Republican governors to realize the Obama Administration was willing to work with the states to provide health care for people who need it, at least he seems to finally understand it.

There’s also the head-scratching logic that more people will have to get a job before Medicaid is expanded, as if only people who are working need to be able to see a doctor, not to mention the people with chronic illnesses whose lack of access to treatment prevents them from working in the first place.

But maybe now McCrory can get on with what he should have done already, following the lead of his Republican colleagues across the country by expanding Medicaid in North Carolina and providing health care coverage for several hundred thousand low-income people and creating thousands of jobs in the process. It is past time.

Commentary

Reporter Dylan Scott at Talking Point Memo has the details of another wonky but important way that the Affordable Care Act is succeeding in holding down health care costs:

The medical-loss-ratio requirement mandates that insurance companies spend at least 80 percent of premiums on actual health benefits. It is one of the various provisions intended to help shape the behavior of insurance companies, making the market more efficient and cost-effective for consumers. Administrative costs are kept down, meaning that more of people’s money is going to real care.

“The medical loss ratio requirement and rate review mandated by the ACA put downward pressure on premium growth,” officials from the federal Centers for Medicare and Medicaid Services wrote in their report. Overall private insurance spending, of which premiums are a part, grew at a 2.8-percent rate — the lowest since at least 2007.

As Larry Levitt, vice president at the non-partisan Kaiser Family Foundation, put it to TPM in an email: “That is how it’s intended to work.”

In other words: Still more evidence that the ACA is insuring more people (and thereby saving tens of thousands of lives) and holding down overall health care costs.

Click here to read the entire story.

 

Commentary
Hisemug

State Senator and Mayland Community College “Coordinator of Special Projects,” Ralph Hise

Sensing building momentum for the expansion of Medicaid under the Affordable Care Act that would both cover hundreds of thousands of uninsured low income North Carolinians and bolster the state’s economy with billions in federal dollars, right wingers appear to have launched a new campaign of propaganda and distortion.

A prime example is this article on conservative website known as Watchdog Wire. In it, the author revives and recycles multiple absurd untruths about the supposedly ginormous cost to the state of Medicaid expansion — which she attributes to State Senator and Mayland Community College “Coordinator of Special Projects,” Ralph Hise. According to the article:

“the state would have to cover administrative costs to the tune of $2 billion per year. That’s a ’50-50 split’ said Hise.”

This is utter nonsense. As this detailed analysis by the North Carolina Institute of Medicine shows on page 5, the financial impact to the state from 2014 to 2021 if the it expanded Medicaid under the ACA is a net savings of $65 million. Hise’s “$2 billion” claim is simply out-of-thin-air malarkey.

The article also quotes Hise for the following supposedly damning criticisms: Read More

Commentary

Pat McCrory press eventAt some point, it’s got to rankle Pat McCrory. The man has been Governor of the state and, effectively, the head of a party with huge legislative majorities for nearly two years now, but when it comes to making laws and policies, he might as well be, well, the Mayor of Charlotte.

Lest anyone think the recent election (in which McCrory’s ally Thom Tillis got elected to the U.S. Senate) did anything to change this situation, State Rep. Nelson Dollar spoke up yesterday to make sure that everyone knows it did not.

The subject was Medicaid expansion under the Affordable Care Act — an urgent and life-saving proposition that the Guv has finally come around on and that makes eminent political, economic, moral and common sense. Conservative Republican governors in several states have already successfully led efforts to expand Medicaid in their states to large and beneficial effects.

Unfortunately, Rep. Dollar — an occasional voice of reason on Medicaid in recent months and, for now, chair of the House Appropriations Committee — is having nothing to do with expansion for the time being. Like the reactionaries in the state Senate, Dollar staked himself out yesterday as an opponent — at least until the state has “a better idea of what the lay of the land is.”

But, of course, mapping “the lay of the land” — both as to whether Medicaid will be sold off and privatized (a terrible idea that Dollar has rightfully opposed) and whether John Roberts will have a change of heart in the latest Supreme Court challenge to the ACA — will take several months at least. Thus to delay consideration of expansion until such matters have been clarified is to all but kill the whole idea (and doom several thousand more people to premature deaths for lack of health insurance) for 2015.

Which brings us back to the Mayor, er uh, the Governor. How will he respond to this broadside against what would clearly be his most important policy accomplishment and first successful effort to lead the General Assembly rather than serve as its affable and pliant rubber stamp?

Let’s hope this latest humiliation stirs up some anger and resolve in McCrory to take charge of the situation and become the one who’s giving the orders in Raleigh for a change.  Whatever happens will be a strong indicator as to whether McCrory really wants to become the Governor of North Carolina or remain in his current and mostly ceremonial role as the state’s chief ribbon cutter and the General Assembly’s errand boy.