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In a new post this afternoon, Jesse Cross-Call at the Center on Budget and Policy Priorities reports the latest confirmation that North Carolina is shooting itself in the foot with its stubborn and shortsighted refusal to expand Medicaid to hundreds of thousands of uninsured people under the Affordable Care Act.

As a growing number of reports increasingly make clear, a state’s decision whether to expand Medicaid as part of health reform has real-life effects on its residents and its businesses.  In the 26 states and the District of Columbia that have expanded Medicaid (see map), the positive benefits are already playing out.  Here’s some of the latest information:

  • Hospitals are providing less uncompensated care.  In Arizona, hospitals reported that the Medicaid expansion is the chief reason for a 30 percent decline in the amount of uncompensated care they have provided so far this year, compared with a year ago.  The Colorado Hospital Association found a similar decline in charity care through April when it surveyed hospitals in 15 states that have expanded Medicaid and 15 that have not.
  • Medicaid expansion is driving large gains in health coverage.  A survey conducted by the Urban Institute finds that while the uninsurance rate is dropping across the country, states that have expanded Medicaid have seen a drop in the percentage of non-elderly adults who are uninsured by more than one-third — a 37.7 decline — while the uninsured rate fell by only 9 percent among states that haven’t expanded.  A survey from the Commonwealth Fund found a similar trend. Read More
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MedicaidThere’s new and compelling evidence that North Carolina’s model for delivering Medicaid (Community Care North Carolina -CCNC) is a winner — notwithstanding the often-bumbling oversight provided by embattled state DHHS Secretary Aldona Wos and the attempt by Senate leaders to sell the program off to a private managed care company. (It’s worth noting that the flawed sell-off idea was once also touted by Gov. McCrory and Sec. Wos as well until the two gradually came to their senses over the past year).

Today, in a letter to state Medicaid directors throughout the country, the Centers for Medicare and Medicaid Services at the national DHHS announced today that they are launching a new national collaborative initiative called the “Medicaid Innovation Accleerator Program.” The goal of initiative is “to improve care and improve health for Medicaid beneficiaries and reduce costs by supporting states in accelerating new payment and service delivery reforms.”

The letter announcing the initiative holds up three examples of state innovation success in Ohio, Washington and North Carolina. Here’s what it has to say about North Carolina: Read More

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Medicaid 3As state lawmakers and Gov. McCrory argue about ways to cut public outlays for Medicaid — the public health insurance system for people of low income — the lead editorials in North Carolina’s two largest newspapers offer some straightforward and compelling truths this morning that ought to guide their discussions:

1) Service cuts harm real people in need and 2)  Things ain’t gonna’ improve as long as Dr. Aldona Wos runs the show.

As Raleigh’s News & Observer reminds us, when legislators cut services to save money (even though, as the editorial notes, per person costs are down and quality of service is up) they make life hell for people like Mason Leonard and his mom Colleen:

“Mason Leonard, 14, of Cary is severely disabled. He was brain-damaged at birth and cannot care for himself. He can’t be left alone, can’t feed himself or look after any of his needs.

But thanks to a few Medicaid services, he receives therapy, gets out a little, gets trained in things like making his bed, which, when he accomplishes it, is considered a big step….

A Medicaid policy change last year, for example, eliminated weekend hours for teaching Mason how to function with basic skills. His mother understandably fears what new hardships further “reform” will produce.

Here is what the public needs to understand about the budget cutting and reform conducted under the banner of ‘efficiency.’ For each cut, for each decision to eliminate some benefit, a disabled person such as Mason Leonard or a poor person with no alternative for care except what Medicaid provides and their caregivers and family members suffer discomfort or pain.”

And then there’s this bit of plain truth from the Charlotte Observer: state Health and Human Services Secretary Aldona Wos simply has to go. As the Observer notes: Read More

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In case you missed it, Mike Meno of the ACLU of North Carolina posted the following insightful essay last Friday about action by the state House to allow physicians to recommend an oil derived from marijuana for treating certain epilepsy symptoms:

Marijuana legalizationNC House Overwhelmingly Approves Marijuana Extract for Epilepsy, but Ignores Countless Others Who Could Benefit from Compassionate Laws

Yesterday, the North Carolina House of Representatives overwhelmingly approved a bill that would allow neurologists to recommend an oil derived from marijuana compounds to certain patients suffering from epileptic conditions. The legislation was inspired in part by 7-year-old Charlotte Figi, who made national news on CNN for a chronic, debilitating condition that could be relieved only through the marijuana-based treatment. Charlotte suffered up to 50 painful seizures a day before her parents discovered that an oil derived from a strain of marijuana that was high in the cannabinoid CBD (cannabidiol) but low in the psychoactive cannabinoid THC (tetrahydrocannabinol) virtually ended her seizures entirely and allowed her to live a happy and healthy life. Read More

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…is highlighted in this fine editorial in the Charlotte Observer entitled: “Expand Medicaid – It has value in NC.” To quote:

“N.C. lawmakers don’t seem inclined to reconsider their unwise decision not to expand Medicaid. But that doesn’t mean we should stop shouting loudly why they should. A new Robert Wood Johnson Foundation report last week underscores the value for the Tar Heel state.

The report looked at the Affordable Care Act’s impact in 14 large U.S. cities. Charlotte was among the seven cities in states where lawmakers opted not to expand eligibility for Medicaid. Even so, the number of uninsured Charlotte residents is expected to drop by 36 percent, or 63,000, by 2016 because of ACA. That was the highest drop among cities with no Medicaid expansion. Among all states, North Carolina has the fifth-highest ACA federal online sign-up.

The report points out that had North Carolina expanded the state’s Medicaid program for low-income and disabled residents, the decrease in uninsured in Charlotte would be even greater – an estimated 57 percent. That would be an additional 36,000, bringing the number of Charlotte residents gaining insurance to 99,000 by 2016. Read More