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The beneficial impacts of Obamacare continue add up, but unfortunately, North Carolina isn’t getting its fair share. That’s that’s one of the takeaways from a new report distributed yesterday on the fifth anniversary of the law. As health policy expert Tara Culp Ressler of Think Progress reports:

“According to a new report from the Department of Health and Human Services (HHS), hospitals saved at least $7.4 billion last year, thanks in large part to reforms under Obamacare. The savings reflect a reduction in the so-called “uncompensated care” that hospitals provide to uninsured Americans, and are even greater than HHS officials predicted they would be at the beginning of this year.

Since people without insurance typically don’t have any means to cover their medical bills, the cost of their treatment ends up falling on the hospital itself. Therefore, as more people gain coverage, it become less expensive for hospitals to care for their patients. More than 16 million previously uninsured Americans have gotten covered under Obamacare, contributing to the biggest drop in the national uninsurance rate over the past four decades.”

If states like North Carolina had gotten on board with closing the Medicaid gap, things would be even better:

“The savings have been most pronounced in the states that agreed to accept Obamacare’s optional Medicaid expansion, which seeks to extend public insurance to additional low-income people. Nearly 70 percent of the savings documented in the HHS report — a total of $5 billion — occurred in the 29 states that have expanded Medicaid. And, if every state had agreed to add more people to their Medicaid rolls, their hospitals could have saved an extra $1.4 billion.”

In other words, here’s more confirmation that,  in addition to helping hundreds of thousands of working people in need, Medicaid expansion would do wonders for some of the most important businesses in North Carolina (especially in rural North Carolina) hospitals. It’s hard to imagine that state leaders can resist taking this obvious and long overdue step much longer.

Commentary

Out-of-state activist J. Scott Moody will be making the rounds on Monday in North Carolina to say that expanding Medicaid will hurt our economy.

Moody is from a South Carolina outfit called State Budget Solutions and he travels the country speaking out against policies disfavored by conservatives. His schtick is releasing cut-and-paste reports showing the economic harm done by the programs he opposes.

For example, in 2012 he lit off to New Hampshire to warn that allowing same sex marriage in that state would result in economic devastation and a “demographic winter.” You have to read the entire news article of his visit to capture his arguments in all of their glory, but this is one of my favorite parts:

Also, according to Moody, when same-sex couples adopt, they place the child in a situation where one or both of their parents isn’t their biological parent. However, according to Moody, statistics have shown that a relationship with a stepparent is not the same as a relationship with a biological parent and stepparents tend to not have the same bond or pay the same attention as the biological parent. Moody did not provide charts or actual sources for this claim.

These days Moody is taking a break from attacking adoptive parents and is focusing on Medicaid expansion. Moody has made presentations in several states and published opinion pieces arguing that an expansion of the public sector will crowd out private sector spending. This analysis is about as sophisticated as his arguments that gay marriage will destroy the economy and that stepparents don’t pay attention to their children.

Actual economists have responded to Moody everywhere he has spoken to point out that he is wrong. A good example is from Dr. Sven Wilson at BYU when Moody visited Utah to warn them of the dangers of federal funds flowing to the state. Again, you should read the entire piece but here’s a taste of Wilson’s response:

Many economists argue that spending on Healthy Utah will further expand the economy by generating new jobs and new private spending as the money works its way through the economy. Economists call this effect a multiplier. As a conservative, free-market economist, I think multipliers are generally small. But no serious economist of any political stripe thinks the multiplier is negative, which is what Moody is suggesting.

Imagine someone saying that when tourists spend their money in our state, their purchases end up costing us jobs and hurting our economy. Who would believe that? But that is exactly the argument Moody is making about Healthy Utah.

Luckily, we already have a study on the economic impacts of Medicaid expansion in North Carolina using respected REMI models. That study concludes that expansion will grow our economy, create 43,000 jobs, and provide much needed revenue to county and state budgets. It will also provide affordable coverage to 500,000 North Carolinians and bolster rural health care in the state. States that have already expanded coverage, like Kentucky, are seeing these positive economic predictions realized.

We aren’t seeing the winter Moody predicted in 2012. Instead the economy keeps heating up despite gay marriage sweeping the nation. I suspect we will see similar results as more states expand insurance coverage.

 

Commentary

Be sure to check out Tazra Mitchell’s excellent essay over on the main Policy Watch site this afternoon: “Governor McCrory’s flat budget proposal ignores research and reality.” As Tazra explains, the state is cutting essential services to provide enrollment growth increases in education and health care. As a practical matter, everything else remains frustratingly and destructively stuck in neutral:

“With his 2015-2017 budget, Governor McCrory chose to ignore the need for reinvestment in public education, health, safety, and the other programs that improve well-being for us all. Total state investments under his 2016 fiscal year budget proposal would be 6.1 percent below pre-recession levels, adjusting for inflation. North Carolina’s lived experience shows us this is the wrong way to go—in past economic recoveries, state investments returned to and exceeded pre-recession levels far more quickly. Our former leaders understood that investing in the infrastructure of opportunity spurs economic growth.

Governor McCrory’s spending plan, in large part, freezes state investments at a time when his priority should be to roll back harmful budget cuts enacted since the downturn. His budget for the 2016 fiscal year increases year-to-year spending by nearly $439.8 million, or two percent, but the costs of enrollment growth in public schools, the UNC system, and the Medicaid/Health Choice programs are estimated to slightly exceed that year-to-year increase. That means every new dollar, on net, is dedicated to funding enrollment growth rather than replacing budget cuts that stifle economic mobility or pursuing new initiatives to position the state competitively.

And despite promises that the 2013 tax cut for the wealthy would deliver a huge boom to the economy, North Carolina has experienced nothing of the sort. Job growth has largely followed national trends in recent years, but we still have not gotten back to the level of employment—when accounting for population growth—that was the norm before the recession. Wages in North Carolina have slipped further behind the national average and are not even keeping up with inflation, which means many people’s paychecks do not go as far as they did before the downturn.

So the promise of an economic boost from tax cuts has failed to pan out, but state leaders are sticking with those cuts rather than reinvesting in the long-term building blocks of opportunity and prosperity like schools and environmental protection.”

Click here to read the entire article.

News

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Rep. Renee Ellmers showed up to a panel at the South By Southwest conference Sunday to talk about how big data can transform poverty policy. Ellmers, who was also here on Saturday to talk about broadband competition in the communications space, appeared at this panel in place of Rep. John Delaney (D-MD), who sponsored a Social Impact Bond bill last summer that was one of the topics of discussion.

Ellmers spoke alongside Kevin Corinth of the conservative American Enterprise Institute and Michele Jolin, Managing Director of America Achieves.

The repeated theme of the session focused on making results-oriented, evidence-based policy solutions.

Corinth emphasized divorcing emotion from policy decisions and the importance of crafting legislation that works for people rather than causes.

Ellmers agreed that there is “a lot of emotion on both sides” of the political spectrum and that a results-oriented effort presented a bipartisan opportunity to address issues like poverty, homelessness and mental illness.
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NC Budget and Tax Center

Last week, Governor McCrory unveiled his two-year budget proposal for July 2015 through June 2017. He has since touted how his plan reinvests in the public services and programs that are essential for economic opportunity and quality of life. However, a close look at his 2016 fiscal year (FY2016) spending plan reveals that he fails to reinvest in a meaningful way in the critical public structures that benefit us all. Genuine progress will continue to be hampered until state lawmakers build a tax system that can adequately match the needs of a growing economy.

Governor McCrory’s proposed budget for FY2016 increases year-to-year spending by nearly $439.8 million, or 2 percent. This is in sharp contrast to past recoveries when state investments were far quicker to return to, and advance beyond, pre-recession levels. Enrollment growth in public schools, the UNC system, and the Medicaid/Health Choice programs is estimated to exceed the year-to-year increase in spending in the governor’s proposal, totaling nearly $442.6 million in FY2016. That means every new dollar increase, on net, is dedicated to funding enrollment growth (see chart below).

It also means that non-enrollment expansion items in the proposal are made possible by cutting or allowing spending to expire for other vital programs that are already stripped bare from previous underinvestment. That’s like rearranging the deck chairs on a sinking ship. Read More