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MedicaidThe endless 2015 legislative session appears, mercifully, to be nearing a conclusion after nine long months. With the passage of the budget early this morning, legislators are now free to wrap up final details and adjourn for the year. Unfortunately, one of those final details will be giving away the state’s award winning Medicaid program to giant, for-profit insurance companies. As Lynn Bonner reports this morning in Raleigh’s News & Observer:

“Legislators have agreed to privatize North Carolina’s $15 billion Medicaid program, a change that doctors and hospitals have been fighting for months, but which some Republican legislators have championed as a remedy for unpredictable spending.

Under House bill 372, three insurers would be given contracts to offer statewide Medicaid managed care plans. The state would have up to 10 contracts with “provider-led entities,” or groups of doctors and hospitals, that would enroll patients in regional managed care networks.

Rather than pay for each hospital visit or medical procedure as it does now, Medicaid would give the companies a fee for each patient when they enroll. The government would not be liable for cost overruns.”

In many ways. of course, this is a perfectly apt conclusion to the session. The 2015 session opened nine long months ago with one obvious and overriding imperative: North Carolina needed to follow the lead of 30 other states and expand Medicaid under the Affordable Care Act. Such an act would have saved thousands of lives per year, pumped billions of dollars into the state’s economy and strengthened an already highly effective program. The state’s feckless governor admitted these facts at times even as he manufactured excuses not to act.

Now, however, the decision has been made to, essentially, do the opposite. Rather than expanding the program to save lives, state leaders will heed the siren song of fat cat corporate lobbyists and give away this enormously valuable public asset to a handful of giant corporations that will, in turn, squeeze profits out of it by denying services to people in need.

The bottom line: More poor people will die, our economy will suffer unnecessarily and wealthy, out-of-state corporations will pad their profits. It’s hard to think of a concluding act that better symbolizes the awful 2015 session.

Commentary, Uncategorized

The North Carolina Justice Center launched radio and digital ads this week urging people to ask Gov. Pat McCrory to release a plan that expands affordable health insurance in our state.

We have the opportunity to tap federal funds to extend affordable insurance coverage to more than 500,000 people struggling to pay for care. Our tax dollars are sitting in Washington waiting to be used to boost rural health care in our state and save more than 1,000 lives every year.

We can expand Medicaid with this money or we can develop a state-specific plan to experiment with new coverage ideas. Conservative Governors in Arkansas, Iowa, Indiana, Montana, Utah, Tennessee and elsewhere have proposed specific policies. Gov. McCrory told news outlets at the beginning of the year that he was considering doing the same. The hold up, he claimed at the time, was the latest Affordable Care Act challenge at the U.S. Supreme Court. He would announce his support, or opposition, to expanding coverage after the high court ruled in King v. Burwell.

King v. Burwell came and went and still no word from the Governor.

The Governor and legislators all have access to taxpayer funded healthcare so they can afford to delay a decision. Many others in our state aren’t so lucky.

These 500,000 North Carolinians are mostly the working poor with jobs in construction and food service that do not provide health insurance benefits. They don’t currently qualify for Medicaid because eligibility is restrictive in our state. They can’t afford to buy private insurance. Now they are stuck and just need action from their elected representatives.

It starts with the Governor. He can change the dynamic by showing leadership and proposing a plan. Go to NC Left Me Out and share your story if you or a loved one are in the coverage gap. And then use the phone number listed to contact Gov. McCrory and ask him, “Where’s the plan to expand coverage?” We can’t wait any longer.

Commentary

Today’s Fayetteville Observer hits the nail on the head with this editorial condemning the state Senate’s plan to turn North Carolina’s Medicaid program over to giant, for-profit insurance corporations:

“The N.C. Senate’s drive to restructure the Medicaid program is making less sense all the time.

We understand lawmakers sometimes succumb to the urge to fix what’s not broken. But when they, and the voters, see mayhem coming, they usually back away.

We hope that’s happening this week, as members of the General Assembly get more evidence that our Medicaid management model is anything but broken.

According to just-released long-term review by the State Auditor’s office, the agency that administers the Medicaid program here is saving taxpayers a bundle – and providing improved medical outcomes at the same time.

The audit measured results achieved by Community Care of North Carolina from 2003 through 2012. The physician-led program has won national acclaim for its effectiveness in running the health-insurance program for the poor and disabled. Other states are copying the system, which has produced budget surpluses for the past two fiscal years.

Medicaid, funded jointly by the state and federal governments, covers about 1.4 million North Carolina residents. According to the audit, Community Care succeeded in managing medical conditions and keeping patients out of the hospital. That resulted in savings of about $78 per user per quarter, which adds up to saving state and federal taxpayers something approaching half a billion dollars a year.

Most lawmakers would likely agree that we’re talking real money there, yet the drive for privatization still has its hooks in the Senate, our legislative branch most driven by ideologues. Read More

News

Community Care of North Carolina saves the state’s Medicaid program money, by about $309 per patient, according to an audit released today by the State Auditor’ s Office.

The audit was conducted at the behest of the legislature, which asked for it in 2013 to see if the state was saving money by using CCNC, a provider-led entity that manages the health care of approximately 1.2 million of the state’s 1.5 million Medicaid recipients. Medicaid is a federally-mandated program that provides health care to low-income children, elderly and disabled people.

North Carolina lawmakers have opted not to expand Medicaid, which would offer health insurance to additional low-income adults not eligible for health insurance subsidies on the open market.

The State Auditor’s office, headed by Democrat Beth Wood, contracted with an outside medical research $279,457 to conduct the audit. Major findings included the $309 annual savings per patient (based on 2003 to 2012 data), as well as what were seen as improved health outcomes, a 20 percent increase in physician’s services (which is believed to prevent more expensive future care) and a 25 percent drop in inpatient admissions. The researcher saw no statistical difference in emergency room visits.

Click here to read the entire audit.

CCNC works by pairing Medicaid patients with a primary care doctor or office, which for an additional fee then helps manage individual patient’s care with the intention of cutting down on unneeded medical expenses and providing better care.

CCNC’s future in the state is murky, with the Republican-led House and Senate chambers currently trying to decide how the $14 billion Medicaid program should be managed, and whether it should be privatized. House members have been more open to keeping CCNC, while the Senate has proposed doing away with the state’s contract with CCNC and instead turning to managed-care health companies to take over the bulk of the state’s Medicaid cases.

There’s also been considerable turnover in CCNC itself. Several top leaders left the non-profit entity recently, for what CCNC described as a “downsizing.”

Commentary

Pat McCrory 4Sometimes, you have to wonder how Governor Pat McCrory prioritizes the issues to which he will devote his attention.

Right now, the General Assembly is in the midst of one of the most momentous — and potentially damaging — stretches in recent state history. An interminable and increasingly destructive budget impasse, the serious consideration of a radical series of constitutional amendments, a plan to sell off the state’s award-winning publicly-controlled system for delivering health insurance for people in need to Wall Street corporations and a proposal to expedite the privatization of public schools are all on the front burner on Jones Street. Add to this that the legislative session is about to go into double/triple overtime and one might reasonably conclude that now is THE time for the Governor to be exerting leadership and driving the agenda.

Unfortunately, this is not the case. Instead, here is what the Guv has apparently made his top priority, according to Raleigh’s News & Observer:

“Gov. Pat McCrory on Wednesday called on the state Senate to pass a historic tax credit plan that has languished in the legislature since March.

House Bill 152 would create a scaled-back version of the tax credit, which expired at the beginning of the year as part of a Republican-led tax reform effort. The new credits would pay property owners less than the original program, with an expected annual cost to the state of $8 million. The available credit would be larger in the state’s poorest counties.

The House passed the bill in a 98-15 vote on March 26, but the Senate referred it to the Ways and Means Committee, which never meets.

‘I’m getting impatient, that’s why I took off my tie,’ McCrory told a group of about 100 tax credit supporters. ‘We shouldn’t even have a fight about it. … We need action today. Go to the legislature!’

McCrory’s cultural resources secretary, Susan Kluttz, said she’s made 73 trips to 52 towns across the state to solicit support for the tax credits.”

You got that? At a time of great upheaval in which fundamental decisions are being made about the future of North Carolina, the Governor is spending vast amounts of his time campaigning for what is, at best, a tiny side issue. This isn’t to say that restoring the historic tax credits wouldn’t be a nice thing to do, but good grief! Seventy-three trips for a tax credit that amounts to spare change in a $21 billion budget?

C’mon Governor. We know General Assembly leaders frequently opine that you are all but irrelevant, but you could at least try to insert yourself into the debates that really matter. The historic tax credit campaign at a time like this is simply embarrassing.