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A new report from the Robert Wood Johnson Foundation and Urban Institute shows the financial folly of rejecting Medicaid expansion. Currently 24 states are refusing federal funds to cover more of the uninsured, although that number is quickly dwindling as more governors and legislators get approval to implement state-specific expansion plans. If North Carolina does not act soon we will find ourselves in lonely company.

Here are the numbers. On average, the Urban Institute finds that every $1 invested in Medicaid expansion will bring $13.41 in federal funds to the state. In North Carolina the 10-year cost to expand Medicaid is $3 billion, although the savings and cost offsets mean that the state would actually save money in the budget over that timespan. At the same time our state is losing nearly $40 billion over 10 years by not expanding Medicaid. Hospitals in our state stand to lose $11.3 billion over 10 years, which is why we are seeing layoffs and closures at hospitals across North Carolina.

This financial picture has convinced even rock-ribbed Republican governors across the country to champion expanding coverage in their states. Many of these political leaders from Arkansas to Iowa, Indiana to Utah, are proposing to increase coverage by applying for a Medicaid waiver that allows these states to use federal funding to craft creative alternatives to traditional Medicaid expansion.

Arkansas led the charge on this front by using expansion funds to buy private insurance coverage for low-income individuals and families in that state. And we see that Gov. Mike Beebe certainly hasn’t suffered by doing the right thing. He currently enjoys a 60 percent approval rating compared to 23 percent who disapprove of his policies. Despite being a Democrat his ratings are even above water with Republican voters. Compare this with Gov. McCrory who is having trouble cracking 40 percent in his approval ratings.

Gov. McCrory could add some polish to his image by expanding health coverage to 500,000 more people, bringing $40 billion in federal funds to the state, and boosting hospital bottom lines by $11 billion. Who knows, it may even help the legislature pick its approval ratings up off the floor.

 

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Veteran Washington Post columnist Dana Millbank gets things just about right in this new essay about the stubborn refusal of the state’s conservative political leaders to expand Medicaid under the Affordable Care Act. Millbank’s column was inspired by Belhaven mayor Adam O’Neal’s march to Washington that was designed to highlight the plight of his small town that lost its hospital thanks the state’s Medicaid decision:

O’Neal arrived on Capitol Hill carrying his hiking pole and wearing trail shoes, shorts and a “Save our Hospital” T-shirt. He was accompanied by about 250 supporters, most affiliated with labor unions, and by civil rights leaders. The hospital closure disproportionately affects African Americans. But Gibbs is white, and so is Crystal Price, who, with her young son, joined the mayor on the stage.

Price, 27 and an employee at Wendy’s, has no health coverage and spoke tearfully about her cervical cancer. “They don’t want to expand Medicaid, so families like mine .?.?. have to decide if we’re going to pay for our children’s health care or our own,” she said. “How many have to bury their loved ones, and how many children like my own will have to grow up without a parent because you want more money in your pockets?”

For O’Neal, any ideological doubts about Obamacare are dwarfed by the disgrace of a young working mother unable to get cancer treatment.

“I mean, that’s wrong,” he said. “Conservatives — everybody — should think that’s wrong.”

Read Millbank’s entire column by clicking here.

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This morning consumer advocacy group Families USA released a report along with the NC Community Health Center Association and the NC Justice Center showing that most people who stand to benefit from closing our state’s health insurance gap are working. Many of these folks are in low-wage service jobs. The report also examines the top occupations in North Carolina where employees would benefit from Medicaid expansion.

There are 59,000 construction workers who would benefit from Medicaid expansion and 56,000 food service workers. When these employees are in good health we are all better off. Construction workers at home with a serious illness and food preparers with untreated diseases decrease productivity and threaten public health.

Chid care workers and home health aides are also disproportionately impacted by our state’s stance on Medicaid expansion, which means that the people who help nurture our children and tend to the elderly can’t take care of their own health needs.

It is a positive sign that Gov. McCrory says that he is keeping the door open to Medicaid expansion in the state. Still, this passive stance will not move us anywhere. If we are going to prevent unnecessary deaths, extend needed preventive care, and help the people who make our food and care for our kids then we need the Governor to lead.

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Winston Churchill famously stated that “Democracy is the worst form of government, except for all the others.” One is increasingly tempted to offer the same assessment of Obamacare.

Is it flawed and messy? Absolutely. Could we call envision a scenario in which each of us — acting as philosopher kings — could craft a better system? Sure.

But when it gets down to the nitty-gritty of making something work in a huge, complex and wildly diverse nation, the following AP story tells you what you need to know about Obamacare on July 24, 2014:

A new study estimates that more than 10 million adults gained health insurance by midyear as the coverage expansion under President Barack Obama’s law took hold in much of the country.

The study published Wednesday in the New England Journal of Medicine found that the share of Americans ages 18 to 64 without insurance dropped by a little more than 5 percentage points.

States that embraced the law’s Medicaid expansion saw significant coverage gains among low-income uninsured people. About half the states have expanded.

The law offers subsidized private insurance for middle-class people who don’t have access through their jobs and expanded Medicaid for low-income adults.

The latest study results are in line with findings by Gallup and with estimates from the Congressional Budget Office.

Read the AP article by clicking here.

 

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Here are two morning editorials that ought to be a “must reads” for North Carolina’s conservative political leaders:

The first comes from the Fayetteville Observer and it’s entitled “Yes, Republicans can expand Medicaid too.” As it notes:

Last month, hundreds of representatives from North Carolina hospitals and other health-care institutions brought a united message to Raleigh: Cuts in the Medicaid program are causing them serious economic harm. Further cuts could be disastrous.

That doesn’t begin to consider the financial drain that comes from treating the thousands of North Carolinians who have no health insurance at all – those who are ineligible for Medicaid but too poor to afford conventional health insurance. By law, hospitals must treat them if they show up in the emergency room, even though there is no chance that they can pay their bill….

That’s one reason why officials in Republican-led Indiana changed their minds about Medicaid participation in May, developing a hybrid state-federal system that will bring coverage to more low-income residents there.

Indiana Gov. Mike Pence, a Republican, is using the supplementary Medicaid money to fund a state health-insurance plan for low-income residents. But it will have the same net effect in bringing coverage to those who don’t have it.

That’s a lesson in that for our GOP leaders, who have resisted participation in Obamacare. Don’t resist. Take the money and build a program that works.

The second comes from the Wilmington Star News. It’s entitled: “Instead of bullying children fleeing violence, put blame where it belongs.”

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