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The Alliance for a Just Society along with Action NC released a report today titled “The Promise of Quality, Affordable Health Care for Women: Is North Carolina Delivering?” The answer, in a word, is no.

Overall the report gives our state a C- on women’s health when looking at a range of measures from health outcomes to access. Most abysmal is the state’s ranking on health insurance coverage. There we merited a D-. The uninsured rate among non-elderly women in NC is nearly 17 percent. There are also tremendous racial disparities in uninsured rates. Nearly 19 percent of black women are uninsured in the state, according to the report, and almost 39 percent of Latinas are uninsured. Our state ranks 50 out of 50 for uninsured rate among Latinas.

The grades don’t climb much higher from there. On women’s access to health services we earned a mediocre C and on health outcomes we get a C-. This is a report card we might want to hide in the couch cushions.

But there’s good news that could boost our lackluster scores. As the report recommends, expanding Medicaid would put a major dent in our uninsured rate, help close the health disparity gap, and improve outcomes.

NC lawmakers once famously claimed that Medicaid expansion has nothing to do with women’s health. This report card, and hundreds of thousands of women across the state, beg to differ.

Commentary

The lead editorial in Raleigh’s News & Observer this morning rightfully laments the fact that North Carolina’s economic recovery appears to be petering out while other states rebound more quickly.

In the end, however, there’s no mystery. The persistence of unemployment points to how badly the job market deteriorated and how tax cuts and spending cuts do little to restore it. North Carolina has cut taxes in a way that disproportionally benefits higher earners while expanding taxes or removing exemptions that helped middle-income and low-income earners and retirees. Tax breaks for the wealthy tend to go into savings while a tax break for lower income earners would have gone directly into the economy.

North Carolina’s cuts in state funding for education have an outsized impact on the economy. Unlike many states where local governments bear most of the cost of schools, North Carolina funds education primarily from the state level. Meanwhile, North Carolina’s refusal to expand Medicaid has cost the state’s economy billions of dollars in federal funds and reduced or blunted employment by hospitals.

There’s not much state government can do to escape the influence of the national economy. But states can do more to soften the effects of a national recession and speed the effects of a recovery. North Carolina should spend aggressively on education, participate fully in the Affordable Care Act and focus tax breaks lower down the income scale.

That’s not being done, and the economic pain is being extended.

Meanwhile, an editorial in the Charlotte Observer offers a glimmer of hope on this front in the form of additional confirmation from the McCrory administration that it has finally recognized one of its biggest blunders when it comes to pumping dollars into the state’s economy — the failure to expand Medicaid:

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Commentary

Conspiracy kooksThere’s very little that right-wing opponents of President Obama and the Affordable Care Act aren’t willing to claim in public about America’s increasingly successful and transformative health care law. From “death panels” to imaginary massive tax hikes to allegations about global conspiracies and plots to impose martial law and suspend the Constitution, the loony conspiracy theories are as endlessly creative as they are delusional.

As a general matter, the kookiness does seem to be somewhat on the wane of late as the ACA slowly but surely moves millions of new people onto the insurance rolls while helping to contain the growth in health care costs. Heck, even the McCrory administration has finally recognized that North Carolina must expand Medicaid under the ACA.

For a few true believers and unrepentant, whatever-it-takes propagandists, however, the battle is still on and just about any anti-Obamacare claim — however preposterous — will do. For a classic example, check out this post by a staffer over at the Locke Foundation entitled “Medicaid Expansion Could Steer Resources Away From the Most Vulnerable.” Here, as best as can be determined, is the “argument”: Read More

Commentary

If there’s one story that’s been notably and inexplicably under-reported in the mainstream news media this week it’s been this one. As  our former colleague Adam Searing, to his credit, reported Monday:

In two interviews over the last few days, North Carolina’s Secretary of the Department of Health and Human Services Dr. Aldona Wos and NC’s Medicaid Director Dr. Robin Cummings address the question of Medicaid expansion in NC:  How soon, the presentation of options for policymakers and whether the state should create its own unique plan are discussed.  Both officials comment on the fact that the federal government is working with states to create state-tailored plans and seem clear that North Carolina’s Governor will be presented with options for expansion that can be taken to NC’s General Assembly.  No timeline is discussed, but NC’s legislature reconvenes in January 2015.

Click here to watch Health and Human Services Secretary Aldona Wos and Medicaid Director Robin Cummings finally confirm plans to do what advocates, providers and economists have been demanding for nearly two years: expand Medicaid.

News
Wos-and-Nichol

DHHS Secretary Dr. Aldona Wos (left), and Gene Nichol of the UNC School of Law (right)

If you missed it over the weekend, there are two-must read stories on where North Carolina stands in expanding Medicaid.

The Winston Salem Journal’s Richard Craver had a sit down interview with state DHHS Secretary Dr. Aldona Wos, in which Wos said she would “soon” be recommending expanding the state Medicaid program to Gov. Pat McCrory.

So, how soon is soon? Craver writes:

“Everyone needs to know that Medicaid expansion is complicated,” Wos said, slowing down to pronounce each syllable in “complicated.” “There is no flipping of a switch.”

She said physical and behavioral health care system expansion must come first so the system is able to absorb additional participants.

“Our state has to have industry adapt to providing enough health-care providers, and that is a process,” Wos said.

Wos said a key element of building DHHS’ foundation is “getting new skills in finance, economists and actuaries, that are absolutely critical to our organization.”

“If I am allowed to continue on this path, I guarantee you we will have that foundation. The rest of the process is building upon that foundation with standards, with flexibility built in.”

“We’re not too far away. Soon.”

Gene Nichol,  director of the UNC Center on Poverty, Work and Opportunity,  – who does not speak for UNC – wrote in Saturday’s Raleigh News & Observer that the longer the state goes without expanding Medicaid, the more lives are lost.

Here’s an excerpt from Nichol’s opinion piece:

‘The consequences for poor people of being excluded from health care coverage are real and dramatic. Losses in health, losses in emotional well-being, losses in financial capacity, losses in opportunity. And, for some, it’s worse.

A recent Harvard study indicates a significant number of our sisters and brothers will experience premature and preventable deaths as a result of the General Assembly’s rejection of Medicaid expansion. Many “low-income women will forgo breast and cervical cancer screenings, diabetics will (fail to receive) necessary medications,” blood pressure pills and other preventative measures will be denied, “diagnosis and treatment of depression” will be diminished.

As a result, the scholars estimate, the number of Tar Heels who will perish at the hand of our politics may well exceed a thousand a year. The wound inflicted by the Medicaid vote is grievous, deep and sometimes mortal.

I’ve wondered how it feels to cast a vote that means thousands might needlessly die. I can’t get my arms around it. Looking in the mirror must become tougher duty. I can see not wanting to dwell on it.

But when you make a decision that means people may lose their lives, surely you have to do more than offer empty slogans and nonsense-laden talking points to defend it. Surely you have to show you’ve done something more than merely taken instruction, more than mindlessly repeated what you’ve been told – like some malfunctioning teleprompter.

At least you ought to show that you’ve thought it through for yourself. That you’re not just siding with one gang or the other or proving your antipathy for various adversaries.

When politics becomes lethal, responsibility ascends.’

Read the full story in the Winston-Salem Journal here, and the full Point of View column by Nichol here in the News & Observer.

(Note: Nichol is a board member of the N.C. Justice Center, the larger anti-poverty non-profit that N.C. Policy Watch is a part of).