Archives

Commentary

Medicaid expansionIn case you missed it over the weekend Ned Barnett of Raleigh’s News & Observer had an on-the-money column about the latest  bizarre claim from the McCrory administration that we can now expand Medicaid under the Affordable Care Act because they have “fixed” what was a “broken” system. As Barnett notes:

“It’s good news that the governor is now open to doing the right thing about Medicaid expansion. Even Tillis now says he might favor it. Refusing to do it could cost the state $51 billion in lost federal money over the next decade, according to a report from the Robert Wood Johnson Foundation.

But this change of position shouldn’t pass without a look at the rationale for not doing it in the first place. Wos’ reign at DHHS has been marked by massive provider payment problems, an exodus of staff, plummeting morale and expensive consultants hired to fill in the gaps. Now she’s saying that the administration of Medicaid has been fixed and it’s ready to take on a half-million new recipients.

If that turnaround is true, Wos has accomplished an amazing feat of introducing efficiency and accountability. Yet there’s nothing to suggest that is the case. DHHS under Wos remains an agency riddled by vacancies and burdened by a reputation for administrative dysfunction that has discouraged top applicants. But the Medicaid program itself was never “broken”. It has operated in North Carolina for decades and in recent years has successfully held down administrative costs compared with the national average. Medicaid’s “out-of-control costs,” which Republican legislators say busted the state budget, reflect wishful budgeting. Simply putting a number in the budget won’t hold down costs. People need treatment, and when there’s a recession Medicaid rolls grow. With the economy now improving, Medicaid costs are coming in under budget.”

In other words: It’s great that McCrory and Wos want to expand Medicaid and even fine if they want to delude themselves about the reasoning, but anyone who’s been paying attention knows their claims and rationales are bogus.
Commentary

Art Pope 3Phil BergerThe talk about Medicaid expansion for North Carolina in 2015 from political leaders without much power to do anything about it continues. Gov. McCrory and his HHS Secretary keep talking about expansion as does, rather amusingly, lame duck Speaker/U.S. Senate candidate Thom Tillis. Obviously, expansion would be a terrific thing and is horrifically overdue as the current absurd obstructionism is literally costing thousands of lives per year — all in the name of nothing but conservative ideology.

Sadly, however, neither of these stances by McCrory or Tillis will amount to a hill of beans come next legislative session unless the real conservative bosses in North Carolina politics give their assent. Those two bosses, of course, would be Senate President Pro Tem Phil Berger and the most important conservative power broker in state politics, Art Pope. After all, the General Assembly has already passed a law to prevent McCrory from doing the deed without their approval and, for all we know, Tillis could well be reduced to trolling the halls of the General Assembly next year as a lobbyist or McCrory lackey.

Meanwhile, there are few if any positive signals from Berger and Pope to be found. Berger says he’s still opposed and Pope…well, his hirelings continue to spout mean-spirited nonsense and gibberish on the subject.

Of course, all of this could change. The powers-that-be in the health care industry want expansion and understand the tremendous good it would do — both for people and in need and, perhaps even more importantly from the corporate perspective, their profits. Add to this the fact that conservative majorities in the General Assembly could be slightly smaller next year and there’s certainly reason to hope that the politics on the issue will continue to improve.

That said, when you’re dealing with true right-wing believers who don’t even bat an eye as their policies literally result in thousands of unnecessary deaths per year, it’s hard to see what’s going to bring about the change of heart. Moreover, at this point in his governorship, Pat McCrory gives literally no indication that he has the ability lead or shape the debate.

Commentary
Funeral

Photo: NC NAACP

As the North Carolina NAACP holds a “Denial of Medicaid Funeral Procession” today, it’s worth considering some of the facts and data surrounding the impact of North Carolina’s ongoing refusal to expand Medicaid under the Affordable Care Act:

The North Carolina Institute of Medicine’s 2009 Access to Care study begins with this statement: “The lack of health insurance coverage is the foremost barrier to accessing health care services.”

In the report’s introduction it continues:

In a statewide survey of adults, nearly half of the uninsured in North Carolina reported forgoing necessary care due to cost, compared to 10% of individuals with insurance coverage. Lack of coverage also adversely affects health as the uninsured are less likely to get preventive screenings or ongoing care for chronic conditions. Consequently, the uninsured have a greater likelihood than people with coverage of being diagnosed with severe health conditions (such as late stage cancer), being hospitalized for preventable health problems, or dying prematurely. In fact, adults who lack insurance coverage are 25% more likely to die prematurely than adults with insurance coverage.

A Families USA report in 2010 estimated that before the Affordable Care Act passed nearly 1,000 North Carolinians died each year between 2005 and 2010 due to lack of health insurance.

What has changed is that the states now have an unprecedented tool for saving lives. North Carolina now has the opportunity to extend health insurance coverage to nearly all low-income adults, the majority of whom are working. The federal government will finance nearly the entire cost of this coverage expansion. Not expanding coverage is not only morally misguided but it is also fiscally irresponsible. Read More

Commentary

The debate over women’s rights has been front and center in the North Carolina U.S. Senate race for months now — often with a lot more heat than light on the subject. I f you’d like to get up to speed on what’s really at issue in Washington — both in our high courts and in the halls of Congress, you won’t want to miss the next N.C. Policy Watch Crucial Conversation: Breakfast with Judy Waxman, Vice President for Health and Reproductive Rights at the National Women’s Law Center

NCPW-CC-2014-10-21-reproductive-rights-judy-waxman

Judy Waxman is the Vice President of Health and Reproductive Rights at the National Women’s Law Center, where she leads the center’s team of advocates, who are at the forefront of major legal, public policy and educational initiatives to protect and advance women’s health and reproductive rights. Prior to joining the center, Ms. Waxman served as Deputy Executive Director at Families USA for over a decade.

Especially in the aftermath of the Supreme Court’s recent and now infamous ruling in the Hobby Lobby case, you won’t want to miss the opportunity to hear from one of the nation’s leading experts in this critically important and fast-evolving field.

Cosponsored by: North Carolina Women United, the North Carolina chapter of the National Organization for Women and Women AdvaNCe.

When: Tuesday, October 21, at 8:15 a.m. — Breakfast will be available at 8:00 a.m.

Where: Center for Community Leadership Training Room at the Junior League of Raleigh Building, 711 Hillsborough St. (At the corner of Hillsborough and St. Mary’s streets)

Space is limited – pre-registration required.

Cost: $5, admission includes light breakfast.

Click here to register

Questions?? Contact Rob Schofield at 919-861-2065 or rob@ncpolicywatch.com

Commentary

Conspiracy kooksThere’s very little that right-wing opponents of President Obama and the Affordable Care Act aren’t willing to claim in public about America’s increasingly successful and transformative health care law. From “death panels” to imaginary massive tax hikes to allegations about global conspiracies and plots to impose martial law and suspend the Constitution, the loony conspiracy theories are as endlessly creative as they are delusional.

As a general matter, the kookiness does seem to be somewhat on the wane of late as the ACA slowly but surely moves millions of new people onto the insurance rolls while helping to contain the growth in health care costs. Heck, even the McCrory administration has finally recognized that North Carolina must expand Medicaid under the ACA.

For a few true believers and unrepentant, whatever-it-takes propagandists, however, the battle is still on and just about any anti-Obamacare claim — however preposterous — will do. For a classic example, check out this post by a staffer over at the Locke Foundation entitled “Medicaid Expansion Could Steer Resources Away From the Most Vulnerable.” Here, as best as can be determined, is the “argument”: Read More