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Art Pope 3Phil BergerThe talk about Medicaid expansion for North Carolina in 2015 from political leaders without much power to do anything about it continues. Gov. McCrory and his HHS Secretary keep talking about expansion as does, rather amusingly, lame duck Speaker/U.S. Senate candidate Thom Tillis. Obviously, expansion would be a terrific thing and is horrifically overdue as the current absurd obstructionism is literally costing thousands of lives per year — all in the name of nothing but conservative ideology.

Sadly, however, neither of these stances by McCrory or Tillis will amount to a hill of beans come next legislative session unless the real conservative bosses in North Carolina politics give their assent. Those two bosses, of course, would be Senate President Pro Tem Phil Berger and the most important conservative power broker in state politics, Art Pope. After all, the General Assembly has already passed a law to prevent McCrory from doing the deed without their approval and, for all we know, Tillis could well be reduced to trolling the halls of the General Assembly next year as a lobbyist or McCrory lackey.

Meanwhile, there are few if any positive signals from Berger and Pope to be found. Berger says he’s still opposed and Pope…well, his hirelings continue to spout mean-spirited nonsense and gibberish on the subject.

Of course, all of this could change. The powers-that-be in the health care industry want expansion and understand the tremendous good it would do — both for people and in need and, perhaps even more importantly from the corporate perspective, their profits. Add to this the fact that conservative majorities in the General Assembly could be slightly smaller next year and there’s certainly reason to hope that the politics on the issue will continue to improve.

That said, when you’re dealing with true right-wing believers who don’t even bat an eye as their policies literally result in thousands of unnecessary deaths per year, it’s hard to see what’s going to bring about the change of heart. Moreover, at this point in his governorship, Pat McCrory gives literally no indication that he has the ability lead or shape the debate.

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People fear the unfamiliar. It’s human nature. When a new threat emerges, our minds often race about it — even when the same old threats are far more worrisome.

This is one reason a healthy (heh) number of my friends are anxious about the Ebola virus. Maybe yours are, too. Heck, maybe you are. Well, here’s the good news: while certainly a frightening disease, Ebola is unlikely to be a widespread public health threat in this country.

There’s bad news, however. Another, less flashy threat to public health is far more dangerous to people in North Carolina and states like it. (The additional bad news: it’s also deeply troubling that Americans are more concerned about a disease killing one person inside our borders than the nearly 5,000 Ebola has killed in Africa so far. That’s a topic for another day.)

The real public health threat is the failure of some American states, including the Old North State, to expand Medicaid.

Medicaid expansion would help more of our neighbors get health insurance, which is vital in preventing the advance of disease — and the early deaths that come with that disease. Here in North Carolina alone, about half a million people lack health insurance that would have been covered had we made the choice to expand Medicaid.

What does that mean? It means more preventable deaths every year. A team of researchers for Harvard found that failure to expand Medicaid could mean as many as 1,145 more deaths in North Carolina every year.

Based on those numbers, that’s about three more preventable deaths in North Carolina every day. Think about the math of that. Read More

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Medicaid expansionConservative political support for one of the central components of Obamacare continues to grow. The latest conversion: North Carolina House Speaker Thom Tillis.

This is from a story by reporter Craig Jarvis in Raleigh’s News & Observer about Tillis’  televised appearance on Time Warner Cable’s “Capital Tonight” show last evening:

Medicaid: Asked if he thought it would be likely that the state legislature would expand Medicaid coverage after refusing to do so previously, Tillis said it might make sense once the state has better control of the financing of the program, which is notorious for its cost overruns.

He said he didn’t have an ideological objection to expanding the coverage. But he said when the state auditor told the previous governor that money was being wasted on it, the appropriate response would not have been to make it bigger and more costly.

“I would encourage the state legislature and governor to consider it if they’re completely convinced they now have the situation under control,” Tillis said.

In other words, the Speaker is echoing the McCrory administration’s imperfect but mostly encouraging line on the issue. Let’s fervently hope that Tillis’ successor as House Speaker and Senate President Pro Tem Berger adopt this same common-sense stance so that the matter can be disposed of as early in 2015 as possible.

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The ideologues on the far right may continue to scream for “repeal” of Obamacare, but the evidence continues to pile up that this is simply not something that’s going to happen. That was the analysis delivered by Judy Waxman of the National Women’s Law Center at this morning’s NC Policy Watch Crucial Conversation breakfast in Raleigh. Waxman noted that amendments to the ACA are certainly likely — indeed, she thinks they are essential — but based on decades of experience in Washington and her numerous political and policy contacts around the country, she believes repeal is simply not in the cards.

Waxman’s analysis is consistent with this AP story that ran on several North Carolina news sites this morning. This is from the version that ran in Raleigh’s News & Observer under the headline “GOP governors don’t see ‘Obamacare’ going away”:

Nine Republican governors have expanded Medicaid for low-income people in their states, despite their own misgivings and adamant opposition from conservative legislators. Three more governors are negotiating with the Democratic administration in Washington.

Rather than demanding repeal, the governors generally have sought federal concessions to make their decisions more politically acceptable at home. That approach is in sharp contrast to the anti-Obamacare fervor of their party in Congress.

Ohio Gov. John Kasich says he doesn’t think there will be a repeal in Washington, even if Republicans win a Senate majority and consolidate their hold on the House in next month’s election.

“That’s not gonna happen,” the Republican governor told The Associated Press during a recent re-election campaign swing.

This take on the situation is consistent with the views expressed recently and repeatedly by the McCrory administration of late that Medicaid expansion in North Carolina under the ACA should and will occur in the near future.

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Funeral

Photo: NC NAACP

As the North Carolina NAACP holds a “Denial of Medicaid Funeral Procession” today, it’s worth considering some of the facts and data surrounding the impact of North Carolina’s ongoing refusal to expand Medicaid under the Affordable Care Act:

The North Carolina Institute of Medicine’s 2009 Access to Care study begins with this statement: “The lack of health insurance coverage is the foremost barrier to accessing health care services.”

In the report’s introduction it continues:

In a statewide survey of adults, nearly half of the uninsured in North Carolina reported forgoing necessary care due to cost, compared to 10% of individuals with insurance coverage. Lack of coverage also adversely affects health as the uninsured are less likely to get preventive screenings or ongoing care for chronic conditions. Consequently, the uninsured have a greater likelihood than people with coverage of being diagnosed with severe health conditions (such as late stage cancer), being hospitalized for preventable health problems, or dying prematurely. In fact, adults who lack insurance coverage are 25% more likely to die prematurely than adults with insurance coverage.

A Families USA report in 2010 estimated that before the Affordable Care Act passed nearly 1,000 North Carolinians died each year between 2005 and 2010 due to lack of health insurance.

What has changed is that the states now have an unprecedented tool for saving lives. North Carolina now has the opportunity to extend health insurance coverage to nearly all low-income adults, the majority of whom are working. The federal government will finance nearly the entire cost of this coverage expansion. Not expanding coverage is not only morally misguided but it is also fiscally irresponsible. Read More

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