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The beneficial impacts of Obamacare continue add up, but unfortunately, North Carolina isn’t getting its fair share. That’s that’s one of the takeaways from a new report distributed yesterday on the fifth anniversary of the law. As health policy expert Tara Culp Ressler of Think Progress reports:

“According to a new report from the Department of Health and Human Services (HHS), hospitals saved at least $7.4 billion last year, thanks in large part to reforms under Obamacare. The savings reflect a reduction in the so-called “uncompensated care” that hospitals provide to uninsured Americans, and are even greater than HHS officials predicted they would be at the beginning of this year.

Since people without insurance typically don’t have any means to cover their medical bills, the cost of their treatment ends up falling on the hospital itself. Therefore, as more people gain coverage, it become less expensive for hospitals to care for their patients. More than 16 million previously uninsured Americans have gotten covered under Obamacare, contributing to the biggest drop in the national uninsurance rate over the past four decades.”

If states like North Carolina had gotten on board with closing the Medicaid gap, things would be even better:

“The savings have been most pronounced in the states that agreed to accept Obamacare’s optional Medicaid expansion, which seeks to extend public insurance to additional low-income people. Nearly 70 percent of the savings documented in the HHS report — a total of $5 billion — occurred in the 29 states that have expanded Medicaid. And, if every state had agreed to add more people to their Medicaid rolls, their hospitals could have saved an extra $1.4 billion.”

In other words, here’s more confirmation that,  in addition to helping hundreds of thousands of working people in need, Medicaid expansion would do wonders for some of the most important businesses in North Carolina (especially in rural North Carolina) hospitals. It’s hard to imagine that state leaders can resist taking this obvious and long overdue step much longer.

Commentary

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.

 

News

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Rep. Renee Ellmers showed up to a panel at the South By Southwest conference Sunday to talk about how big data can transform poverty policy. Ellmers, who was also here on Saturday to talk about broadband competition in the communications space, appeared at this panel in place of Rep. John Delaney (D-MD), who sponsored a Social Impact Bond bill last summer that was one of the topics of discussion.

Ellmers spoke alongside Kevin Corinth of the conservative American Enterprise Institute and Michele Jolin, Managing Director of America Achieves.

The repeated theme of the session focused on making results-oriented, evidence-based policy solutions.

Corinth emphasized divorcing emotion from policy decisions and the importance of crafting legislation that works for people rather than causes.

Ellmers agreed that there is “a lot of emotion on both sides” of the political spectrum and that a results-oriented effort presented a bipartisan opportunity to address issues like poverty, homelessness and mental illness.
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Commentary

In case you missed it this morning, be sure to check out Adam Linker’s op-ed in this morning’s edition of Raleigh’s News & Observer. As Linker writes:

“Health insurance for more than a million North Carolinians is at stake, and Gov. Pat McCrory has two options: He can take the initiative to protect the people he has sworn to represent or he can sit back and let external forces decide our destiny.

Nearly 560,000 people have signed up for Affordable Care Act plans in North Carolina, and many of them receive tax credits to help pay their premiums. Thanks to outreach efforts by nonprofits, insurers, insurance agents and hospitals, our state ranked fourth in Affordable Care Act signups nationally.

Despite these impressive results, there are still more than 500,000 people, many of them the working poor, who do not qualify for North Carolina’s Medicaid program and who do not earn enough to purchase private insurance. Health reform set aside money for our state to provide this population with coverage through Medicaid, but first state leaders must consent to using these funds for that purpose. So far the governor and state legislature have left the money in Washington.”

Unfortunately, of course, Governor McCrory has failed to act. As Linker explains, however, it’s not too late:

“Now comes the governor’s moment.

He, along with legislative leaders, could change course and circumvent the Supreme Court by re-establishing state control over our insurance marketplace. In fact, most of the pieces are already in place. Our Department of Insurance is proactive about reviewing insurance policies. Our health care and insurance communities meet regularly and could easily form an oversight board. Our outreach and enrollment efforts are national models. All we need is for the governor to work with legislators to vest these organizations with the power to form a state marketplace.

McCrory then could release a state-specific plan to tap federal Medicaid funds to expand coverage to 500,000 additional people. This would boost local economies still staggering from the Great Recession. It would allow tens of thousands of women access to preventive screenings like mammograms and pap smears. It would allow thousands of people suffering from the disease of addiction to obtain the long-term treatment they need. Read More

Commentary

McCrory contradictionsGovernor Pat McCrory announced a disastrous and destructive decision yesterday in an interview with an AP reporter. When asked whether he would recommend closing the insurance gap that currently leaves a half-million North Carolinians too poor to qualify for Obamcare subsidies and too well-off to qualify for Medicaid, the Guv said: “I will not make any recommendation as to whether or not we extend insurance for the uninsured until the court case because there are so many ramifications of the court case.”

As the story also noted: “The court’s oral arguments are next month and a ruling is expected in the summer, about when the legislature traditionally seeks to adjourn. That could push any legislative action on a recommendation to 2016.”

This means that a half-million struggling North Carolinians will have to wait at least another year for the health insurance they were promised and deserve. In all likelihood, thousands will die unnecessarily. Meanwhile, tax dollars paid by North Carolinians will flow to other states in which Governors (many of the Republican) have had the vision and courage to put human life ahead of politics.

The decision comes after months of dithering by the Governor and in spite of the clear signals sent by his Department of Health and Human Services officials that Medicaid expansion is both the right thing to do and essential to save lives.

The bottom line: If this is truly is his final word on this matter, Pat McCrory has now, officially, made the worst and most destructive decision of his governorship — a decision that puts supposed concerns about bureaucratic hassles ahead of saving human lives. Meanwhile, millions of people in Ohio and Arizona and other conservative states  enjoy access to decent and affordable health insurance on our nickel. Let’s hope and pray the U.S. Supreme Court does the right thing this summer, but whatever happens then and thereafter, Gov. McCrory has now seized the mantle from former chief naysayer Senator Phil Berger and cemented his legacy as the person who denied decent and affordable health care to a half-million of his fellow Tar Heels unnecessarily.