Medicaid expansionIn case you missed it, the best editorial of the weekend dealt with the most important failure of North Carolina’s political leadership in recent years. The essay in Raleigh’s News & Observer was entitled:

NC losing funding and savings with Medicaid holdout: By balking on Medicaid expansion, N.C. forgoes billions of dollars and a chance to cut costs.”

As the editorial noted:

“In medicine, the small things can matter most. And it is the neglect of the small things that can lead to the biggest costs.

That’s why preventative care is so important and early intervention so significant. And that’s why North Carolina’s stubborn refusal to expand Medicaid is so wildly irresponsible and hugely expensive. As a result of its intransigence, the Republican-led General Assembly is struggling to find tax revenue on one end and turning away billions of dollars on the other.”

The piece goes on to explain how North Carolina’s award-winning nonprofit Medicaid manager, Community Care NC, is saving millions upon millions of dollars and thousands of lives already and to lament the toll in both categories that is being taken by the state leadership’s pigheaded refusal to close the Medicaid gap for hundreds of thousands of lower-income, working people. It also cites report which holds up the astounding amount in federal funds the state is foregoing:

“The report estimates that forgoing federal Medicaid expansion from 2013 to 2022 will cost North Carolina $39.6 billion. In addition, the state’s hospitals will lose out on $11.3 billion in federal funds intended to offset cuts in their Medicare and Medicaid reimbursements as required under the Affordable Care Act, which anticipated that all states would expand Medicaid.

That’s more than $50 billion in federal funding forgone over 10 years. Meanwhile, the state would have to spend about $3 billion for its share of expansion. That is a mindboggling deal to refuse so that conservatives can express their pique over ‘Obamacare.’

Republican leaders say they’re worried about being saddled with a higher entitlement cost if the federal government reneges on its promise to pay its full share, but the design and history of Medicaid do does not support that concern. Meanwhile, there are billions of reasons to expand Medicaid now.”

Amen. Read the entire editorial by clicking here.


MarijuanaA bill to legalize medical marijuana, introduced by Representative Kelly Alexander, was considered by the House Judiciary I Committee today. Despite heart-wrenching testimony from veterans and others with serious medical conditions, the committee took less than thirty seconds to vote to give the bill an unfavorable report.

If passed, the bill would have allowed North Carolinians to obtain prescriptions and legally buy cannabis from licensed distributors. The distributors in turn would have purchased the plant from licensed growers, who would have been regulated by the Department of Agriculture. The bill would have taxed each sale of marijuana at 5% and created a revenue for the state.

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Health careHard numbers and real life stories documented the impact of the Affordable Care Act today at an event in Durham commemorating the law’s fifth anniversary. “The Impact of the Affordable Care Act on Women” was a roundtable discussion that featured knowledgeable women from throughout Triangle region.

Women experts and advocates from Duke Regional Hospital, Enroll America North Carolina, the Durham County Commission, and Wake and Franklin Health Services were among those attending the event sponsored by the office of Congressman G.K. Butterfield and the U.S. Department of Health and Human Services at the Community Health Coalition in Durham. Congressman Butterfield joined the discussion via telephone and issued a call to action to continue the effort to reduce the number of uninsured in North Carolina. According to Butterfield, “Like the Civil Rights Act, the ACA is critical to ending discrimination, especially for women.”

Millions of women, of course, benefited directly from the ACA’s bar on being denied insurance because of “preexisting conditions” as well as the provision of subsidies to make health care more affordable. Women are more likely to experience social conditions such as poverty that act as barriers to accessing and utilizing health care.

Region Four of administrator, Dr. Pamela Roshell and senior advisor Stephanie Owens from HHS also participated in the panel and shared that, despite the numerous misconceptions about and attacks on the ACA, data show that 14.1 adults and 2.3 million children have gained health insurance and can now access primary and wellness care as a result of its implementation. In North Carolina, 560,000 residents are now insured as a result of the ACA – 70,000 of these individuals in the Raleigh-Durham area. Dr. Roshell congratulated our state on its enrollment and how the numbers are sending the message the ACA is needed and is working.

The roundtable discussion proceeded Read More


Tara Culp-Ressler at Think Progress has one very impressive list:

More than 16 million people have gained insurance.

According to the most recent data from the Obama administration, about 16.4 previously uninsured Americans have gotten coverage under the law, either by purchasing private plans on the new state-level marketplaces or by gaining public insurance through the Medicaid expansion. That translates to a 35 percent reduction in the national uninsured rate, which is the largest drop in the number of Americans going without health care over the past four decades.

You don’t have to take the Obama administration’s word for it. In addition to the federal government’s data, multiple outside surveys have confirmed dramatic drops in the uninsured rate thanks to Obamacare.

Health reform is costing less than expected.

Earlier this month, the Congressional Budget Office (CBO) announced that implementing Obamacare over the next ten years will cost $142 billion less than the nonpartisan agency had previously predicted. That represents an 11 percent reduction from an earlier CBO projection released at the beginning of this year — and stands in sharp contrast to Obamacare opponents’ dire predictions about how the law was going to cripple the economy.

CBO officials have repeatedly slashed their cost projections for the law, largely because of a historic slowdown in national health care spending over the past several years that’s resulted in slower premium growth. There are multiple factors contributing to the dramatic slowdown in annual medical costs, and it’s unclear exactly how big of a role the Affordable Care Act has played. But the cost saving provisions included in Obamacare certainly haven’t hurt.

Employers aren’t cutting their workers’ benefits. Read More


Out-of-state activist J. Scott Moody will be making the rounds on Monday in North Carolina to say that expanding Medicaid will hurt our economy.

Moody is from a South Carolina outfit called State Budget Solutions and he travels the country speaking out against policies disfavored by conservatives. His schtick is releasing cut-and-paste reports showing the economic harm done by the programs he opposes.

For example, in 2012 he lit off to New Hampshire to warn that allowing same sex marriage in that state would result in economic devastation and a “demographic winter.” You have to read the entire news article of his visit to capture his arguments in all of their glory, but this is one of my favorite parts:

Also, according to Moody, when same-sex couples adopt, they place the child in a situation where one or both of their parents isn’t their biological parent. However, according to Moody, statistics have shown that a relationship with a stepparent is not the same as a relationship with a biological parent and stepparents tend to not have the same bond or pay the same attention as the biological parent. Moody did not provide charts or actual sources for this claim.

These days Moody is taking a break from attacking adoptive parents and is focusing on Medicaid expansion. Moody has made presentations in several states and published opinion pieces arguing that an expansion of the public sector will crowd out private sector spending. This analysis is about as sophisticated as his arguments that gay marriage will destroy the economy and that stepparents don’t pay attention to their children.

Actual economists have responded to Moody everywhere he has spoken to point out that he is wrong. A good example is from Dr. Sven Wilson at BYU when Moody visited Utah to warn them of the dangers of federal funds flowing to the state. Again, you should read the entire piece but here’s a taste of Wilson’s response:

Many economists argue that spending on Healthy Utah will further expand the economy by generating new jobs and new private spending as the money works its way through the economy. Economists call this effect a multiplier. As a conservative, free-market economist, I think multipliers are generally small. But no serious economist of any political stripe thinks the multiplier is negative, which is what Moody is suggesting.

Imagine someone saying that when tourists spend their money in our state, their purchases end up costing us jobs and hurting our economy. Who would believe that? But that is exactly the argument Moody is making about Healthy Utah.

Luckily, we already have a study on the economic impacts of Medicaid expansion in North Carolina using respected REMI models. That study concludes that expansion will grow our economy, create 43,000 jobs, and provide much needed revenue to county and state budgets. It will also provide affordable coverage to 500,000 North Carolinians and bolster rural health care in the state. States that have already expanded coverage, like Kentucky, are seeing these positive economic predictions realized.

We aren’t seeing the winter Moody predicted in 2012. Instead the economy keeps heating up despite gay marriage sweeping the nation. I suspect we will see similar results as more states expand insurance coverage.