Archives

Commentary

Medicaid expansionIn case you missed it, be sure to check out this story in the Charlotte Observer by Ann Doss Helms and Tony Pugh about North Carolina’s ongoing and self-destructive refusal to accept federal dollars to expand Medicaid to hundreds of thousands of North Carolinians in need. As the Helms and Pugh report:

North Carolina taxpayers could spend more than $10 billion by 2022 to provide medical care for low-income residents of other states while getting nothing in return, a McClatchy Newspapers analysis shows.

The Affordable Care Act tried to expand Medicaid to millions of low-income, uninsured adults. But many Republican-led states, including both Carolinas, opted out of the plan championed by President Barack Obama.

If the 23 states still rejecting Medicaid expansion stick with that decision, they’ll contribute $152 billion over 10 years to states that take the federal money, the analysis shows. North Carolina would be one of the top five contributors.

In other words, because of the refusal by Gov. McCrory, House Speaker Tillis and Senate President Pro Tem Berger to expand Medicaid, North Carolina is contributing to the utterly nonsensical situation in which it and other poorer states are subsidizing the provision of health care to low income people in wealthier states that have already expanded Medicaid.

The article also cites a pair of business economy experts for the proposition that the failure to expand is holding back the state’s economy: Read More

Commentary

Doesn’t it seem that the nation’s progress and momentum in implementing the Affordable Care Act (and, in particular, Medicaid expansion) is starting to resemble the slow but steady (and inevitable) progress on marriage equality?

Talking Points Memo has the story today of the latest conservative state to be talking openly of a plan to expand Medicaid — it’s our neighbor to the west Tennessee:

In a growing trend, Tennessee looks like it will be the next Republican-led state to move toward expanding Medicaid under Obamacare.

Right now, of course, North Carolina is in the “no” camp on both issues. The bet here, however, is that this won’t be the case come the 2016 election.

Click here and here to see two maps that reveal the trends.

Uncategorized

The N.C. Department of Health and Human Services announced this afternoon that an architect of a stalled Medicaid reform plan is leaving the state agency.

Margaret “Mardy” Peal, 43, was hired in August 2013 by Health and Human Services Secretary Aldona Wos despite having been out of the work force for more than a decade, according to a News & Observer article published shortly after Peal’s hire.

The job was not posted, and was a newly created position to look at privatizing the state’s complex $13 billion Medicaid program, which is funded with a mix of state and federal dollars and provides health care for low-income children and their parents, seniors and disabled residents.

Peal, who has a master’s in health education and lectured at East Carolina University’s medical school on patient care in the late 1990s, had donated $1,250 to Gov. Pat McCrory’s campaign, according to the N&O article. She also organized the Eastern North Carolina chapter of the Tea Party.

She made $95,000 a year in her DHHS position to help the agency develop a reform proposal for the state’s $13 billion Medicaid program. Peal’s hire last year came while Wos was facing criticism for giving big raises to several inexperienced McCrory campaign staffers.

The agency, at the urging of doctor and other medical provider groups, ultimately proposed parceling out Medicaid health care responsibilities to accountable care organizations (ACOs) around the state but the agency plan failed to get the backing of leading Senate Republicans who wanted to take Medicaid out from under DHHS and open it up to bids from managed care companies.

In a statement, state Medicaid Director Dr. Robin Cummings thanked Peal for her work and emphasized that the state agency planned on pursuing its approach to Medicaid reform.

“Working with doctors, hospitals and other healthcare providers and stakeholders across the state, DHHS will continue to pursue our Medicaid Reform plan,” Cummings said, according to a written statement.

In her Aug. 25 resignation letter (click here to read), Peal wrote that she was grateful for the experience working at DHHS but an unspecified opportunity in the private sector would allow her to spend more time with family.

“At this point in my family’s life, it is necessary that I spend a greater percentage of my time with them,” Peal wrote. “An opportunity presented itself that would allow me more time at home, and I have chose to pursue it.”

 

Uncategorized

The negative impact of the failure of state leaders to expand Medicaid under the Affordable Care Act is becoming truly gigantic. As the Asheville Citizen-Times reported over the weekend:

North Carolina will miss $51 billion in federal payments over the next decade unless lawmakers expand Medicaid under Obamacare, according to a new report.

Hospitals in the state would get $11.3 billion of that amount under an expanded system, the Robert Wood Johnson Foundation and Urban Institute say.

The report comes as hospitals across the nation are laying off workers. The health care sector cut 52,638 jobs nationally last year, making it second only to the financial industry in layoffs.

That’s $51 billion with a B, folks. For more details, check out this morning’s “Monday Numbers” over on the main PW site.

Click here to read a summary of the report.

Uncategorized

A new report from the Robert Wood Johnson Foundation and Urban Institute shows the financial folly of rejecting Medicaid expansion. Currently 24 states are refusing federal funds to cover more of the uninsured, although that number is quickly dwindling as more governors and legislators get approval to implement state-specific expansion plans. If North Carolina does not act soon we will find ourselves in lonely company.

Here are the numbers. On average, the Urban Institute finds that every $1 invested in Medicaid expansion will bring $13.41 in federal funds to the state. In North Carolina the 10-year cost to expand Medicaid is $3 billion, although the savings and cost offsets mean that the state would actually save money in the budget over that timespan. At the same time our state is losing nearly $40 billion over 10 years by not expanding Medicaid. Hospitals in our state stand to lose $11.3 billion over 10 years, which is why we are seeing layoffs and closures at hospitals across North Carolina.

This financial picture has convinced even rock-ribbed Republican governors across the country to champion expanding coverage in their states. Many of these political leaders from Arkansas to Iowa, Indiana to Utah, are proposing to increase coverage by applying for a Medicaid waiver that allows these states to use federal funding to craft creative alternatives to traditional Medicaid expansion.

Arkansas led the charge on this front by using expansion funds to buy private insurance coverage for low-income individuals and families in that state. And we see that Gov. Mike Beebe certainly hasn’t suffered by doing the right thing. He currently enjoys a 60 percent approval rating compared to 23 percent who disapprove of his policies. Despite being a Democrat his ratings are even above water with Republican voters. Compare this with Gov. McCrory who is having trouble cracking 40 percent in his approval ratings.

Gov. McCrory could add some polish to his image by expanding health coverage to 500,000 more people, bringing $40 billion in federal funds to the state, and boosting hospital bottom lines by $11 billion. Who knows, it may even help the legislature pick its approval ratings up off the floor.