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The Charlotte Observer had an article yesterday about the nonprofit public hospital system Carolinas Health Care cutting $110 million from its budget next year, largely in management positions that are currently vacant.

The large hospital system cited the need for cuts as stemming from decisions by both North Carolina and South Carolina politicians to turn down federal Medicaid expansion dollars, as well as other decisions made at the state and federal level related to Medicaid and Medicare. The $4 billion hospital system — which operates 40 hospitals in the Carolinas and Georgia — says it’s been left treating large numbers of poor patients unable to access health insurance or pay their health bills.

North Carolina is one of 21 states to opt out of the Medicaid expansion, which would provide health care for an estimated 400,000 low-income North Carolinians who are currently uninsured. (Click here for updated list of where different states stand on expansion).

From the Observer article:

[Carolinas HealthCare CEO Michael} Tarwater blamed much of the financial stress on cutbacks in state and federal programs. For example, he said North Carolina legislators have for a second year declined to accept federal funds to expand Medicaid. That contributed to the system’s unreimbursed charges, which rose to $668 million in the first half of this year, an increase of 9.4 percent over last year.

“We’re not treating this as a crisis … but it is a challenge,” Tarwater said. “I can assure you we have a solid plan, and we have the team in place to carry it out. I’m certain that we’ll emerge stronger and more competitive.”

 

You can read the entire article here.

Commentary
Cover me

Image: NC AIDS Action Network – www.ncaan.org

A new report from the Pew Charitable Trusts makes clearer than ever just how mean-spirited and morally bankrupt the decision of state lawmakers and Governor McCrory to turn down federally-funded Medicaid coverage for hundreds of thousands of  low-income North Carolinians is turning out to be. The report, “Southern States Are Now Epicenter of HIV/AIDS in the U.S.” tells the story of a woman from New York named Deadra Malloy who had successfully managed her HIV infection for decades while living in New York where public subsidies made medication affordable. When she moved to North Carolina and then South Carolina, however, all that changed. Soon she was skimping on necessary drugs and quickly wound up in the hospital with pneumonia.

As the story notes, the woman’s case is sadly typical:  Read More

Commentary

Thom_Tillis_official_portraitWhen I last posted about the Senate debate between Speaker Thom Tillis and Sen. Kay Hagan I had listened to the exchange on radio but I had not yet watched the video. Watching television coverage of the debate one could hardly miss that Tillis was, once again, wearing a blue lapel pin from the science and advocacy organization Autism Speaks.

The pin highlights an important question that the media and voters should be asking Tillis: Where does he stand on minimum coverage requirements for insurance?

The primary argument Tillis pushes against the Affordable Care Act and Sen. Hagan is that the health law set a new floor for health insurance benefits. That’s why some plans were initially cancelled. It’s why some plans cost more than before the enactment of reform. But for the Autism community setting minimum standards for insurance was one of the most important parts of the Affordable Care Act. In fact, Autism Speaks and the Autism Society are still doing critical work to ensure that insurance companies are adhering to these new mandates.

Moreover, Tillis personally advocated for a bill expanding on the minimum requirements set by the ACA by mandating insurance coverage for the diagnoses and treatment of Autism Spectrum Disorder.

Assuming that Tillis was sincere in his support of new insurance requirements it’s difficult to see how he could object to the health reform law establishing similar mandates. And if he supports minimum requirements in general but opposes specific coverage mandates in the ACA then he should specify which services he would make optional for insurance companies. Would he say that insurers can go back to not covering pregnancy? What about prescription drugs?

The answers to these questions cut to the core of the Speaker’s opposition to health reform and voters need to know where he stands.

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

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