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Medicaid gap2In case you missed it yesterday, the Wall Street Journal featured a powerful article on the terrible toll that is resulting from the failure of 25 states (including North Carolina) to expand Medicaid under the Affordable Care Act. The article – “Millions trapped in health-law coverage gap” tells the story of low-income workers like Ernest Maiden of Birmingham, Alabama who make too much to qualify for their own state’s Scrooge-like Medicaid programs, but not enough to qualify for federal subsidies under the ACA. (There are as many as 500,000 Ernest Maiden’s in North Carolina):

“Ernest Maiden was dumbfounded to learn that he falls through the cracks of the health-care law because in a typical week he earns about $200 from the Happiness and Hair Beauty and Barber Salon.

Like millions of other Americans caught in a mismatch of state and federal rules, the 57-year-old hair stylist doesn’t make enough money to qualify for federal subsidies to buy health insurance. If he earned another $1,300 a year, the government would pay the full cost. Instead, coverage would cost about what he earns.

‘It’s a Catch-22,’ said Mr. Maiden, an uninsured diabetic. Read More

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Puppy millsFew developments are surprising these days in the through-the-looking glass world of the North Carolina General Assembly, but the recent developments surrounding “puppy mills” legislation takes a very large cake.

As was reported last week in multiple places, one of the North Carolina Senate’s most powerful members, Senate Rules Committee Chairman Tom Apodaca, issued a statement in which he said that the Senate would not move legislation on this subject in 2014 because of its objection to the “tactics” of bill supporters — specifically the fact that a supporter meeting with Senator Bill Rabon openly recorded the Senator’s inflammatory comments on the subject and then made them public.

This was apparently not an idle threat by Apodaca. Yesterday, N.C. Policy Watch obtained an email sent by another lawmaker (Senator Bill Cook of Beaufort County) to a concerned constituent in which he recited Apodaca’s threat verbatim (see the bottom of this post for the full text). Read More

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Medicaid expansionThe drumbeat calling on state leaders to reverse course and accept federal Medicaid dollars in order to provide health insurance to hundreds of thousands of poor North Carolinians continues to grow louder and louder.

As this morning’s Greensboro News & Record editorial argues (after citing a new report by the accounting firm Jackson-Hewitt that the failure to expand will lead to tens of millions of dollars in tax penalties for North Carolina businesses):

“A society and an economy are stronger when people are healthier. Expanding Medicaid coverage could help North Carolina achieve that goal. If that could spare employers tens of millions of dollars in tax penalties at the same time, our pro-business governor should explore that opportunity.”

Meanwhile, be sure to check out this essay by Duke writer and doctor Laura Musselwhite in  Raleigh’s News & Observer in which she points out: Read More

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Alex Kotch(Cross-posted from the website Vocativ.com)

Obamacare is actually good. No, really

By Alex Kotch

I’m a low-income PhD student with a shaky health history and limited earning capacity. The Affordable Care Act should improve my quality of life. But will it?

This isn’t the answer you tend to hear on the news, but yeah, it will. Dramatically.

Here’s my background. I’m a 30-year-old, soon-to-be PhD graduate with an expected income in 2014, the first year of Obamacare, not much above the minimum wage. My $190-a-month student health plan runs out the day Obamacare starts. I’m a nonsmoker, but I have had some serious health issues in the past. In the eyes of health insurers, I’m hardly a solid bet. So Obamacare should, if it’s fit for purpose, help me out of a bind when I go to change my plan. Let’s see if that holds up. Read More

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In some ways, you have to hand it to the McCrory administration for the way it has manipulated messages and public opinion on the state’s health insurance system for poor people, Medicaid.

The McCrory team came into office with a cynical and ideologically-based plan to sell off what has been a successful public program to private corporations. The key to making such a plan politically feasible, therefore, was to convince the news media and the public that the program was somehow “broken.” How better to do this than to repeatedly allege and attempt to show that the program had supposedly massive cost overruns?

And so the P.R. campaign began. Following up on the decision of the conservative General Assembly to demand unreasonable program savings and then complain about “runaway expenses” when the absurd targets weren’t met, the administration helped generate new “audit” numbers that supposedly showed a similar trend — all, of course, the fault of past Democratic governors.

For months the plan worked well as right-wing politicians and think tanks and numerous reporters dutifully repeated the “Medicaid is broken” mantra despite ample evidence to the contrary. The dishonest rap had the added bonus of helping to justify the decision not to expand Medicaid under the Affordable Care Act. It even provided a convenient excuse for dozens of other draconian budget cut to education and other essential services.

Now, however, the truth is starting to come out and the P.R. plan is faltering. Read More