Commentary, News

Wake Forest researchers: NC should close the Medicaid gap now

Medicaid expansionStill more experts have weighed in in favor of following the lead of dozens of other states and expanding Medicaid in North Carolina. A new report by a pair of Wake Forest University professors of health law says that North Carolina leaders are making a mistake by refusing to act. Click here to read “Medicaid Expansion Costs in North Carolina: A Frank Discussion.”

Here’s the conclusion:

“There is no denying that Medicaid expansion in North Carolina will have some costs. And, for those who distrust the federal government with a fiery passion, there may be nothing that can convince them to consider this major expansion of federal support. However, a more dispassionate examination of the issues greatly reduces well-founded concerns over expansion costs to the state.

Several expert studies have calculated what actual expansion costs would be, and what portion of those costs the state would actually bear. Expansion funding, like an iceberg, has both a visible tip, and a much larger hidden part below the surface. The tip of expansion costs, which are several billion dollars a year, is the 10 percent that the state would have to pay. The federal government pays the rest. That much larger, 90%-hidden part of the iceberg represents not a cost to the state, but instead money coming into the state.

This new federal funding melts throughout the state’s economy. The increased federal funds would create new well-paying jobs and boost economic activities that increase tax revenue without increasing tax rates. Expansion would also create savings for the state by reducing what it has to spend both on existing Medicaid recipients, and on other non-Medicaid programs like mental and substance abuse treatments and medical care for inmates. And, federal funds reduce what state and local governments currently pay for free care that now goes to low- income people who lack insurance. All told, these economic benefits and savings to state and local governments will approximately equal the extra costs to the state of expansion.

That math works as long as the federal government does not reduce what it will pay for North Carolina residents on Medicaid. Although the ACA has survived every one of the legal and political challenges it has faced, there is no guarantee that federal support will continue forever. However, it would be both illogical and extremely difficult for the federal government to back out of its deal with the states now. Even if some risk remains, states are not defenseless; they can take several steps to protect themselves, in the form of triggers, sunsets, or waivers.

The question, then, for the people and the leaders of North Carolina, is whether a small cost and a small risk are prices worth paying to provide insurance coverage to several hundred thousand people who cannot afford coverage on their own, even though the majority of them are working.”

Commentary

An early start to your New Year’s resolutions: Get health coverage

Enroll America

Image: www.enrollamerica.org

Despite policymakers’ attempts to repeal all or parts of the Affordable Care Act (ACA) nearly 60 times, the ACA works. What’s more, the law is clearly here to stay. On both occasions that all or specific provisions of the ACA have been to the Supreme Court, the health care law has remained largely intact. In 2014, the ACA enhanced the well-being of nearly 460,000 North Carolinians who were able to obtain affordable health care coverage.

Now, it’s time once again for the uninsured to enroll. Open Enrollment 3 started on November 1 and goes until January 31, 2016. As of December 5, nearly 200,000 people in North Carolina had applied for health care coverage through the Marketplace. Today, December 15, is the deadline to enroll for health coverage starting on January 1, 2016.

Even though there has been much attention paid to increasing premiums for coverage purchased through the Marketplace, many North Carolinians will still receive financial help. The average amount of financial assistance received by ACA enrollees is $315 per month. Further, the majority of enrollees selected plans costing less than $75 per month.

Another fiscal consideration is that the penalty for not enrolling in a plan is increasing to $695 per person or 2.5 percent of one’s household income, whichever is higher. 2016 will also be the first year that people will not receive an additional grace period or special enrollment period around the tax deadline. Even though the financial impact of obtaining health coverage is significant for many households and individuals, having access to health care gives one peace of mind. The ACA mandates the coverage of essential health benefits ranging from maternity and newborn care to mental health and substance use disorder treatment.

Unfortunately, hundreds of thousands of North Carolinians will not qualify for health coverage through the ACA, do not have access to employer based health insurance, and are ineligible for Medicaid. Our state policymakers have failed to extend health coverage through Medicaid expansion to home health care workers, parents, office clerks, and school bus drivers.

One year ago, the Cone Health Foundation released a report highlighting the benefits of Medicaid expansion. If our state legislators would have chosen to expand Medicaid, 29,000 jobs would have been created this year. In addition to the approximately 200,000 (and counting) North Carolinians who will have health coverage starting in the new year by enrolling in the ACA, according to the report 300,000 people would have gained health coverage if policymakers had decided to expand Medicaid this year. Let’s start 2016 on a healthy note, enroll for health coverage today and encourage your state policymakers to expand Medicaid to 500,000 North Carolinians in the coverage gap.

Commentary

Some uncomfortable questions about Eden’s looming brewery closure

State Senate Leader Phil Berger has some questions about the news that MillerCoors is going to close its long-time facility in Eden, Rockingham County, laying off 520 people in the process. Last night, he and fellow Rockingham legislator Bert Jones sent a letter to the U.S. Senate Subcommittee on Antitrust, Competition Policy and Consumer Rights with a list of questions they urged the panel to pursue in an effort to determine whether the Eden brewery closure falls afoul of federal anti-monopoly regulations.

The Senator’s efforts are admirable given the enormously negative impact the plant’s closure would have on the rural community, which already has one of the state’s highest unemployment rates. And we sincerely hope that the brewery remains open, staving off the kind of mass layoffs that proved so disastrous to the human and economic fabric in rural communities like Kannapolis.

But after years of watching the legislature systematically dismantle the very state investments that protect jobless workers and promote community resiliency in times of high unemployment, workers in Rockingham and across North Carolina have some questions for Senator Berger as well:

  1. Why should Rockingham workers lose their unemployment benefits if they can’t find a job after 12 weeks ? If the brewery closes, 520 workers will lose their jobs through no fault of their own. Given that there are already twice as many unemployed workers as available job openings in Rockingham County (according to NCWorks), it will be mathematically very difficult for most these laid off workers to find new jobs. Thanks to the policies enacted by the General Assembly in 2013, Rockingham County workers will only have 12 weeks to find a job before they lose their unemployment benefits—the lowest duration offered for temporary wage replacement in the nation.
  1. Why should these laid off workers in Rockingham County lose food assistance after just three months if they can’t find employment in a job market without enough jobs? Since welfare reform in 1990s, the federal government has required able-bodied adults with no dependents to find a job, be engaged in skills training, or participate in other qualifying activities after three months of receiving food assistance or lose this assistance altogether. At the same time, federal law allows states to request waivers from this time limit in economically distressed counties where jobs are not available. Unfortunately, the General Assembly banned the state from offering this waiver in 2015, despite the 77 counties that qualified due to weak labor markets. In effect this move will significantly reduce access to food assistance for workers living in those counties, including Rockingham, after July 1 when the prohibition goes into effect.

Read more

Commentary

Day Three of “Altered State: How 5 years of conservative rule have redefined North Carolina”

altered-state-bannerIn case you missed it, be sure to check out today’s third installment in our new special report: “Altered State: How 5 years of conservative rule have redefined North Carolina.” Today’s story, “Yanking away the ladder: Legislature blocks and cuts programs that help people climb out of poverty,” is written by reporter Sarah Ovaska-Few and it tells the real life stories of average North Carolinians who have suffered mightily as the result of the anti-government policies implemented by the state’s conservative political leadership. Here’s the opening:

“David Turner’s spine and back issues cause him nearly constant pain and distress, keeping him inside his house most days and unable to meet with clients for his web design business or care for his two children.

A medical test would clear Turner for steroid shots to lessen the pain, but the $5,000 price tag is too steep for the Gaston County family with an annual income of less than $20,000 and no health insurance.

The Turners are stuck in what’s known as the Medicaid expansion gap, a hole created when North Carolina’s legislature rejected federal money that would have expanded the program to cover a half-million of the state’s lowest-income adults.

The Turners essentially make too little to qualify for federal subsidies that would make health insurance on the open market affordable and aren’t sick enough to get health care through the existing Medicaid program, which primarily serves low-income children, elderly and disabled persons. (Their children are enrolled in Medicaid.)

‘We’re hanging on by a thread,’ said Karen Turner, who has diabetes but delayed treatment so the family can afford her husband’s pain medications.

If David Turner had access to medical care, there’s a good likelihood that he would be able to work more, earn more, pay more taxes and better support his family. North Carolina is one of 20 states that has not expanded its Medicaid program to cover poor adults, even though the federal government would cover most of the costs. North Carolina accounts for 10 percent of all the nation’s adults that fall into the Medicaid gap, according to the Kaiser Family Foundation.

A central element in the five-year reign of conservatives has been a fundamental change in how state government views and treats its poorest and most vulnerable citizens. The 2013 decision to reject Medicaid expansion is part of a broad effort to cut, limit or eliminate programs that provide ladders to help poor families climb out of poverty and find better futures.”

Click here to read the entire story.

Commentary

Mother of famed basketball star Len Bias helps make the case for Medicaid expansion

At yesterday’s NC Policy Watch Crucial Conversation luncheon, Dr. Lonise Bias, the mother of famed basketball star Len Bias who died tragically in 1986 from cocaine abuse, told of her journey from the tragedy of losing two sons to becoming a national spokesperson for the cause of combating substance use disorder. Dr. Bias was joined at the event by by Jeff Matkins, one of North Carolina’s  leading advocates for expanding Medicaid under the Affordable Care Act to help provide health coverage to tens of thousands of North Carolinians battling addiction.

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