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A new report from Cone Health Foundation and Kate B. Reynolds Charitable Trust finds that North Carolina lost out on billions of dollars and thousands of jobs by refusing to close the Medicaid coverage gap in 2014 and 2015. If the state acts in 2016, however, we can recoup some lost ground by covering 500,000 more people. Such a move would create 43,000 new jobs by 2020 and reap $1 billion in tax revenue for the state and counties. Closing the coverage gap would save the state budget more than $300 million by 2020.

As followers of this blog know the state had a chance, starting in 2014, to expand Medicaid eligibility to all individuals and families earning less than 138 percent of the federal poverty level. More than half the states have now opted into this deal and they are attracting a huge return on investment. This new report is the first of its kind in the nation that takes a detailed look at every county in the state and uses a nationally respected model to estimate the impact of Medicaid expansion on tax revenue, job creation, business activity, and coverage.

The results are startling. In Robeson County expanding Medicaid would generate more than 700 jobs. In Moore County it would create nearly 500 jobs. In Nash County it would create more than 300 jobs. This is the equivalent of a fleet of new large employers locating in dozens of communities across the state. The increased economic activity will produce more county tax revenue at a time when many local governments are sputtering by on fumes. For Wake County, Medicaid expansion would net more than $25 million in tax revenue. It would earn Guilford County more than $11 million.

New data confirms in finer detail what we have always known, expanding Medicaid eligibility is a no-brainer. Thankfully, Gov. McCrory seems to be moving to the right (or should I say correct) side of this issue. Now that the federal government is allowing governors and legislators the flexibility to design state-specific expansions Wyoming, Indiana, Utah, and Tennessee — hardly redoubts of liberalism — are starting to embrace expansion. We should follow suit.

This is a rich report that deserves a close reading. You can find some reporting on it here, here, here, and here.

 

 

News
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There’s an interesting article today from North Carolina Health News about fast-food workers who make too much to qualify for Medicaid in North Carolina but make too little to afford health care on their own.

North Carolina is one of several states that declined to expand coverage of Medicaid in the state, after the state legislature passed a law in early 2013 preventing  expansion that Gov. Pat McCrory signed.  The situation has left hundreds of thousands of low-income workers unable to afford health care on their own and without access to the federal subsidies that would make health care more affordable.

Among those people are a 35-year-old Durham man whose worked for a decade making pizzas at Dominos.

From the article, by Hyun Namkoong:

The Feb. 15 deadline to sign up for health insurance coverage on the federal Healthcare.gov website is quickly approaching, and low-wage workers like DeAngelo Morales and Isaac McQueen are stuck between a rock and hard place.

McQueen, 35, a father of two, has worked at Domino’s Pizza for 10 years as a pizza maker. He says he doesn’t qualify for subsidies offered under the Affordable Care Act. He also doesn’t qualify for Medicaid after North Carolina declined to expand the program to adults who make more than 49 percent of the federal poverty level, which works out to $9,697 a year for a family of three.

“I [make] too much money,” he said with an ironic laugh.

McQueen said there was a plan on the federal health insurance exchange that cost $80 a month, but he couldn’t afford it.

Instead, his health insurance plan is based on hope and faith.

“[I’m just] hoping and praying to God I don’t get sick, because I can’t afford any substantial medical bills,” he said.

 

You can read the entire piece here.

 

Commentary
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Hisemug

State Senator and Mayland Community College “Coordinator of Special Projects,” Ralph Hise

Sensing building momentum for the expansion of Medicaid under the Affordable Care Act that would both cover hundreds of thousands of uninsured low income North Carolinians and bolster the state’s economy with billions in federal dollars, right wingers appear to have launched a new campaign of propaganda and distortion.

A prime example is this article on conservative website known as Watchdog Wire. In it, the author revives and recycles multiple absurd untruths about the supposedly ginormous cost to the state of Medicaid expansion — which she attributes to State Senator and Mayland Community College “Coordinator of Special Projects,” Ralph Hise. According to the article:

“the state would have to cover administrative costs to the tune of $2 billion per year. That’s a ’50-50 split’ said Hise.”

This is utter nonsense. As this detailed analysis by the North Carolina Institute of Medicine shows on page 5, the financial impact to the state from 2014 to 2021 if the it expanded Medicaid under the ACA is a net savings of $65 million. Hise’s “$2 billion” claim is simply out-of-thin-air malarkey.

The article also quotes Hise for the following supposedly damning criticisms: Read More

Commentary
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Pat McCrory press eventAt some point, it’s got to rankle Pat McCrory. The man has been Governor of the state and, effectively, the head of a party with huge legislative majorities for nearly two years now, but when it comes to making laws and policies, he might as well be, well, the Mayor of Charlotte.

Lest anyone think the recent election (in which McCrory’s ally Thom Tillis got elected to the U.S. Senate) did anything to change this situation, State Rep. Nelson Dollar spoke up yesterday to make sure that everyone knows it did not.

The subject was Medicaid expansion under the Affordable Care Act — an urgent and life-saving proposition that the Guv has finally come around on and that makes eminent political, economic, moral and common sense. Conservative Republican governors in several states have already successfully led efforts to expand Medicaid in their states to large and beneficial effects.

Unfortunately, Rep. Dollar — an occasional voice of reason on Medicaid in recent months and, for now, chair of the House Appropriations Committee — is having nothing to do with expansion for the time being. Like the reactionaries in the state Senate, Dollar staked himself out yesterday as an opponent — at least until the state has “a better idea of what the lay of the land is.”

But, of course, mapping “the lay of the land” — both as to whether Medicaid will be sold off and privatized (a terrible idea that Dollar has rightfully opposed) and whether John Roberts will have a change of heart in the latest Supreme Court challenge to the ACA — will take several months at least. Thus to delay consideration of expansion until such matters have been clarified is to all but kill the whole idea (and doom several thousand more people to premature deaths for lack of health insurance) for 2015.

Which brings us back to the Mayor, er uh, the Governor. How will he respond to this broadside against what would clearly be his most important policy accomplishment and first successful effort to lead the General Assembly rather than serve as its affable and pliant rubber stamp?

Let’s hope this latest humiliation stirs up some anger and resolve in McCrory to take charge of the situation and become the one who’s giving the orders in Raleigh for a change.  Whatever happens will be a strong indicator as to whether McCrory really wants to become the Governor of North Carolina or remain in his current and mostly ceremonial role as the state’s chief ribbon cutter and the General Assembly’s errand boy.

Commentary
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Medicaid expansionICYMI, the Washington Post ran a powerful column over the weekend by man from Durham by the name of David Tedrow. In it, he explains how: a) the Affordable Care Act literally saved his life and b) the current threats of repeal by congressional Republicans leave him living in fear for his own survival.

As Tedrow puts it:

“The Obamacare subsidies saved my life. Now, I’m scared the Supreme Court is going to gut them.”

But, of course, Tedrow’s story is just one of thousands. And sadly, there are thousands more who will never get to tell their stories because North Carolina Republicans refuse to expand Medicaid.

In other words, the hard and plain truth at this point is this: The Affordable Care Act is saving lives each and every day of people who would have died for lack of health insurance, but thousands more could be saved if conservative lawmakers and Governor McCrory would halt their shameful blockade — not next year or somewhere down the road, but immediately. As Chris Fitzsimon noted yesterday in a story about McCrory’s current notion to call a special session on corporate business subsidies:

“Here’s a better idea. Listen to Rev. William Barber and call a special session to expand Medicaid instead. That will create thousands of jobs after all and even House Speaker and Senator-elect Thom Tillis now thinks it’s worth considering.”
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