Archives

NC HHS Sec. Aldona Wos

NC HHS Sec. Aldona Wos

Yesterday, Governor Pat McCrory’s DHHS Secretary, Aldona Wos, unveiled the administration’s long-awaited reform plan for Medicaid.  One of McCrory’s favorite talking points on Medicaid has been how “broken” the system is and how he’s going to “fix” it.  Setting aside the past year of missteps in which McCrory and Wos did more than any Governor and Secretary in history to discredit and cause problems for NC’s award-winning Medicaid program, what does the administration’s plan yesterday tell us about the future prospects of Medicaid and health care for the poor in NC?  Here’s my take:

1. Surrender:  The Governor completely surrendered by backing down from his former big plans to sell off substantial parts of the Medicaid program to private, out-of-state insurance companies.  The proposal yesterday to use “Accountable Care Organizations” or ACOs is simply, at its core, a new way to pay existing or new networks of doctors, hospitals and other health care providers.  Paying health providers as a group for each illness a patient gets rather than piecemeal for every test and procedure is supposed to get providers focused on quality and efficiency, especially when payments go up if patients are healthier. ACOs represent gradual evolution in health care and not “major reform.”

2.  Missing the boat on Medicaid expansion: The Governor also made it clear that he has no intention of solving the coverage gap for the 500,000 poor North Carolina citizens who would be eligible for Medicaid coverage if he led the charge to expand Medicaid using the billions of dollars in federal money available to our state. Conservative governors and legislators around the country – whether in New Hampshire or Utah – are coming up with innovative solutions to cover their citizens with all the new federal money available.  By leaving an expansion proposal out of his plans to change Medicaid, our Governor is renouncing any claim to national moderate leadership on this issue, leaving billions of federal tax dollars collected from North Carolinians to go to states that do expand and hurting hundreds of thousands of his own constituents.

Read More

Medicaid gap2In case you missed it yesterday, the Wall Street Journal featured a powerful article on the terrible toll that is resulting from the failure of 25 states (including North Carolina) to expand Medicaid under the Affordable Care Act. The article – “Millions trapped in health-law coverage gap” tells the story of low-income workers like Ernest Maiden of Birmingham, Alabama who make too much to qualify for their own state’s Scrooge-like Medicaid programs, but not enough to qualify for federal subsidies under the ACA. (There are as many as 500,000 Ernest Maiden’s in North Carolina):

“Ernest Maiden was dumbfounded to learn that he falls through the cracks of the health-care law because in a typical week he earns about $200 from the Happiness and Hair Beauty and Barber Salon.

Like millions of other Americans caught in a mismatch of state and federal rules, the 57-year-old hair stylist doesn’t make enough money to qualify for federal subsidies to buy health insurance. If he earned another $1,300 a year, the government would pay the full cost. Instead, coverage would cost about what he earns.

‘It’s a Catch-22,’ said Mr. Maiden, an uninsured diabetic. Read More

Medicaid expansionThe drumbeat calling on state leaders to reverse course and accept federal Medicaid dollars in order to provide health insurance to hundreds of thousands of poor North Carolinians continues to grow louder and louder.

As this morning’s Greensboro News & Record editorial argues (after citing a new report by the accounting firm Jackson-Hewitt that the failure to expand will lead to tens of millions of dollars in tax penalties for North Carolina businesses):

“A society and an economy are stronger when people are healthier. Expanding Medicaid coverage could help North Carolina achieve that goal. If that could spare employers tens of millions of dollars in tax penalties at the same time, our pro-business governor should explore that opportunity.”

Meanwhile, be sure to check out this essay by Duke writer and doctor Laura Musselwhite in  Raleigh’s News & Observer in which she points out: Read More

Blue CrossWe’ve often given Blue Cross Blue Shield of North Carolina a hard time down through the years here at The Pulse, but today the insurance giant deserves credit for admitting it screwed up and taking action to correct its recent error of cancelling polices of same-sex couples.

According to BCBSNC boss Brad Wilson: “We should have more thoughtfully considered this decision, with full appreciation of the impact it would have on same-sex married couples and domestic partners. We’re sorry we failed to do so.”

Good for Wilson and BCBSNC. You can read the company’s entire statement by clicking here.

The people with the best jobs on the Internets (i.e. the writers at The Onion) have put together an excellent summary of where things currently stand when it come to the implementation of the Affordable Care Act:

Nation Recalls Simpler Time When Health Care System Was Broken Beyond Repair

WASHINGTON—With the Affordable Care Act now making it possible for a greater number of Americans to purchase medical coverage, the nation looked back this week and fondly recalled a simpler time when its health care system was broken beyond any hope of repair. Read More