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If there’s one story that’s been notably and inexplicably under-reported in the mainstream news media this week it’s been this one. As  our former colleague Adam Searing, to his credit, reported Monday:

In two interviews over the last few days, North Carolina’s Secretary of the Department of Health and Human Services Dr. Aldona Wos and NC’s Medicaid Director Dr. Robin Cummings address the question of Medicaid expansion in NC:  How soon, the presentation of options for policymakers and whether the state should create its own unique plan are discussed.  Both officials comment on the fact that the federal government is working with states to create state-tailored plans and seem clear that North Carolina’s Governor will be presented with options for expansion that can be taken to NC’s General Assembly.  No timeline is discussed, but NC’s legislature reconvenes in January 2015.

Click here to watch Health and Human Services Secretary Aldona Wos and Medicaid Director Robin Cummings finally confirm plans to do what advocates, providers and economists have been demanding for nearly two years: expand Medicaid.

News

State lawmakers won’t be making any major decisions on Medicaid reform before next year’s long legislative session, but Health and Human Services Secretary Aldona Wos wants to make it clear she opposes any plans that would move Medicaid outside her agency.

Secretary Wos reiterated Wednesday that such a move would sidetrack her agency from the work that has been done over the past 19 months.

“Such a decision would be disruptive. It would divert resources and human capital from the ongoing day- to-day operations of the division,” said Dr. Wos.

Earlier this month, Dr. Wos found herself defending the hiring of outside contractors to assist her agency with reorganization while she promoted plans that “flattened” the structure of the state Medicaid program, which provides healthcare for more than 1.5 million North Carolinians.

Click below to hear part of Wos’ remarks, or watch Wednesday’s full hearing here.
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News

North Carolina’s Health and Human Service Secretary Aldona Wos will be at the state legislature today, rolling out her plan to restructure the $18 billion state agency as well the state Medicaid program that provides healthcare for more than 1.5 million North Carolinians.

DHHS Sec. Aldona Wos

DHHS Sec. Aldona Wos

Wos, in a 14-page letter addressed to the heads of the Joint Legislative Program Evaluation Oversight Committee, reiterated to lawmakers that she came into her $1-a-year job to find the state’s largest agency in disarray.

“As you know, I inherited a department with a well-documented history of serious and chronic problems,” she wrote. “We have been on a path toward a sustainable department over the last 20 months and we have built the foundation for a stronger Medicaid program.”

She hopes the restructuring of Medicaid program will to fend off proposals in the legislature by Senate Republicans to move Medicaid, the massive $13 billion program that provides health care to low-income children, seniors and disabled residents – to its own standalone agency.

Wos, a wealthy Greensboro physician and prominent Republican fundraiser appointed by Gov. Pat McCrory in January 2013, has had a rocky tenure as the head of the DHHS, with controversies swirling over her granting big salaries and contracts to associates and McCrory campaign workers. Her first year on the job also saw botched rollouts of two technology projects that led to lengthy delays in medical providers getting paid for Medicaid services and in thousands of low-income families accessing food stamps

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Commentary

Health-Reform-SBFinding irony and contradictions in the arguments espoused by Obamacare haters is not a difficult thing to do. Heck, one of the nation’s most powerful opponents of the new law is trying to force its repeal even as he embraces its remarkably positive impact in his home state!

That said, a new issue brief from the Center for Economic and Policy Research points to an especially interesting and problematic finding for opponents who continue to lambaste the law as an “assault on freedom”: the law is actually enhancing freedom. It’s doing this for millions of average Americans in a vitally important way by expanding their choices when it comes to how, when and where they work. Here’s the introduction:

“Most of the discussion of the Affordable Care Act (ACA) has focused on the extent to which it has extended health insurance coverage to the formerly uninsured. This is certainly an important aspect of the law. However by allowing people to buy insurance through the exchanges and extending Medicaid coverage to millions of people,
the ACA also largely ends workers’ dependence on their employer for insurance. This gives tens of millions of people the option to change their job, to work part-time, or take time off to be with young children or family members in need of care, or to retire early. Read More

News

The Charlotte Observer had an article yesterday about the nonprofit public hospital system Carolinas Health Care cutting $110 million from its budget next year, largely in management positions that are currently vacant.

The large hospital system cited the need for cuts as stemming from decisions by both North Carolina and South Carolina politicians to turn down federal Medicaid expansion dollars, as well as other decisions made at the state and federal level related to Medicaid and Medicare. The $4 billion hospital system — which operates 40 hospitals in the Carolinas and Georgia — says it’s been left treating large numbers of poor patients unable to access health insurance or pay their health bills.

North Carolina is one of 21 states to opt out of the Medicaid expansion, which would provide health care for an estimated 400,000 low-income North Carolinians who are currently uninsured. (Click here for updated list of where different states stand on expansion).

From the Observer article:

[Carolinas HealthCare CEO Michael} Tarwater blamed much of the financial stress on cutbacks in state and federal programs. For example, he said North Carolina legislators have for a second year declined to accept federal funds to expand Medicaid. That contributed to the system’s unreimbursed charges, which rose to $668 million in the first half of this year, an increase of 9.4 percent over last year.

“We’re not treating this as a crisis … but it is a challenge,” Tarwater said. “I can assure you we have a solid plan, and we have the team in place to carry it out. I’m certain that we’ll emerge stronger and more competitive.”

 

You can read the entire article here.