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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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There was criticism of NC’s innovative Community Care of NC program and the NC Medicaid program as a whole in yesterday’s audit of Medicaid being trumpeted by the McCrory Administration.  Let’s take a broader look at the facts.  For the period 2007-10 (the latest year annual stats are available) North Carolina’s annual spending growth in Medicaid was 3.5% – almost half the national average and the lowest rate of spending growth of any Medicaid program in the United States.  A “broken” program?  No.

Today’s headlines highlight a audit of the state Medicaid program that shows an over $1 billion shortfall.  ”Shocked, shocked, I tell you!” are Republican Governor Pat McCrory and DHHS Secretary Aldona Wos that the Medicaid agency did not meet its budget:

Dr. Aldona Wos, secretary of the state Department of Health and Human Services, said at the news conference that the agency will change the way it operates. “Cost overruns will not be tolerated and will not be acceptable,” she said. “There’s a budget for a reason.”

But the major finding in the audit, the one that has gotten all the headlines, that NC’s Medicaid program wasn’t able to meet the budget set for it by the Republican majority in the General Assembly (and passed over former Democratic Governor Perdue’s veto) shouldn’t be a surprise to anyone.  As former DHHS Secretary Lanier Cansler said on August 4, 2011:

“It’s just really going to be next to impossible to achieve this budget, and I’m not sure where the legislature will go with that,” Cansler said. “The fact that this budget plays into next year (means next year) is going to be a difficult budget year as well.”

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Bills filed in the NC Senate and House today (See SB4) declare that NC must reject federal grant money to set up a Obamacare health exchange and that NC should not expand Medicaid that is 100% paid for by the federal government over the next three years under Obamacare (and 93% thereafter).  There are plenty of consequences here for NC, but here are three main ones:

1.  NC will have to return most of the $74 million federal grant it just got to help set up the exchange.  The majority of this money is to be for modernizing the state computer systems under Medicaid.

2.  Only legal immigrants under 138% federal poverty level will be able to get help with health care costs while 500,000 of NC’s citizens under 138% federal poverty level will be barred from getting affordable health care under Medicaid. Read More

Yesterday a large number of groups released a letter urging Governor McCrory to expand Medicaid under Obamacare to allow people making under $15,000 a year in income to get health coverage.  Our friends at Action NC have a petition for individuals to sign too urging the Governor to act on this commonsense change, paid for entirely by the federal government for the first three years (the feds pay 90% of the costs into the future).  500,000 of our fellow citizens are counting on NC to let them get quality health care for the first time on January 1, 2014.  Let’s help.