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Today in the News and Observer I detail yet another one of these crazy changes hidden deep in the GOP budget recently passed by the NC Senate. This one is a doozy—it kicks off pregnant women who currently get Medicaid and tells them to go buy private insurance. A half-hearted attempt at political cover is provided by saying that somehow (it’s unworkable) the state will pay part of the private premium if these lower income women qualify. However, under the Affordable Care Act, Medicaid was supposed to be expanded, not cut, an expansion already rejected by the NC Senate. The latest cynical attempt to attack “Obamacare” just doesn’t work and it ignores the great bipartisan legacy of our state’s efforts to attack our awful infant mortality rate problem:

Back in 1989, shortly after news that North Carolina had the highest infant mortality rate of any state in the nation, Republican Gov. Jim Martin created a task force to seek solutions to this national embarrassment after he already had been pushing for changes to address the problem. Solutions championed by Martin included expanding Medicaid to many more pregnant women in 1987.

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Over the weekend, Governor Pat McCrory continued on his theme of “Medicaid is broken and costs are out of control” in a number of interviews. This reflects the talking points in this week’s NC Senate budget release that blame Medicaid for every budget woe in the state. It’s enormously disappointing that McCrory is not being challenged in these interviews with some basic facts about NC Medicaid that show far from being broken, it is actually a model program in reducing costs. In fact, why not ask him about this one easy chart? Over the last twenty years North Carolina has gone from an annual growth rate in Medicaid costs of 14% to today’s 3.5% growth rate (the lowest in the nation). North Carolina leads the nation in reducing Medicaid growth responsibly.

nc medicaid annual cost growth

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E-cigYou’ve got to hand it to the tobacco corporations and their high-priced lobbyists; when it comes to deceptive messaging and tactics, no one does it better than the merchants of death.  Apparently, nearly a century of practice really does make perfect in developing lies and half-truths and massaging them into feel-good media messages and legislation.

Consider the latest case in point in North Carolina. Big tobacco is currently ramming through legislation in both houses of the General Assembly that sounds as if it is all about motherhood and apple pie. The bill (which as been introduced and advanced in both the Senate and the House at the behest of the industry) operates under the title: “Prohibit E-Cigarette Sales to Minors.” 

“Electronic cigarettes” of “E-Cigarettes,”  as you probably have heard, are just the latest  tool for delivering life-threatening poison (i.e. addictive nicotine) to humans. E-cigs are already being advertised throughout the country as a hip and semi-safe alternative to traditional cigarettes. They’re already finding their way into schools and other places young people look for ways to be cool.   

Prohibiting their sale to kids sounds like a good idea, huh?

Unfortunately, Read More

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pinocchio statuteIn announcing his plan to privatize North Carolina’s award-winning Medicaid program, Community Care of NC, Governor Pat McCrory laid out five key reasons that in his view privatization is necessary.  The only problem?  None of them hold up under the even the most cursory scrutiny.  I’ll thoroughly debunk each in turn:

McCrory’s #1 claim why NC should privatize:  “[NC Medicaid Community Care] does not focus on measuring and improving overall health outcomes for recipients”

Community Care is proven to provide much better access to health care services that results in measurable improvements in health shown through changes in health service use.

For example, an exhaustive study last year of how children and others on NC Medicaid are using health services found that children with asthma enrolled in Community Care spent much less time admitted to the hospital and in the emergency room than children not enrolled.  At the same time these children with asthma spent more time in their family doctor’s office and getting medication to manage their condition.  This is the very definition of a better health outcome.

And Community Care doesn’t stop there.  CCNC has a detailed process for measuring quality of care delivered by providers statewide and encouraging better quality– the “Quality Measurement and Feedback” program.

McCrory’s #2 claim why NC should privatize:  “[NC Medicaid Community Care] lacks a culture of customer service and operates in silos, making it difficult for recipients to know where to go to receive the right care”

Governor McCrory might want to take a look at the actual Medicaid card sent to people on Medicaid when they sign up.   It includes the name, address and phone number of the Medicaid recipient’s family doctor or health practice printed right on the card.  You don’t get much easier direction as to who to call first when you get sick than that.

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Health careIt would seem like a no-brainer.  The NC Senate passed and the NC House is expected to act shortly on a bill that would reject expanding Medicaid to 500,000 North Carolinians under the Affordable Care Act.  If that wasn’t enough, the bill would also reject the establishment of a state-federal partnership health exchange under Obamacare where people can buy health plans with tax credits to make coverage more affordable.  When NC was on track to develop a state/federal partnership health exchange the state received $74 million in Affordable Care Act money two months ago to update our computer systems and establish the exchange.  The no-Obamacare bill would force NC to return this money.

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