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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.

 

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This morning consumer advocacy group Families USA released a report along with the NC Community Health Center Association and the NC Justice Center showing that most people who stand to benefit from closing our state’s health insurance gap are working. Many of these folks are in low-wage service jobs. The report also examines the top occupations in North Carolina where employees would benefit from Medicaid expansion.

There are 59,000 construction workers who would benefit from Medicaid expansion and 56,000 food service workers. When these employees are in good health we are all better off. Construction workers at home with a serious illness and food preparers with untreated diseases decrease productivity and threaten public health.

Chid care workers and home health aides are also disproportionately impacted by our state’s stance on Medicaid expansion, which means that the people who help nurture our children and tend to the elderly can’t take care of their own health needs.

It is a positive sign that Gov. McCrory says that he is keeping the door open to Medicaid expansion in the state. Still, this passive stance will not move us anywhere. If we are going to prevent unnecessary deaths, extend needed preventive care, and help the people who make our food and care for our kids then we need the Governor to lead.

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Joe Hauck Source: LinkedIn

Joe Hauck
Source: LinkedIn

The Associated Press had this report over the weekend about the slim amount of work product taxpayers received in exchange for $310,000 paid to a contractor with personal connections to N.C. Health and Human Services Secretary Aldona Wos.

Joe Hauck, who has since returned to his previous job working for a company owned by Wos’ husband, was one of several controversial expensive hires and personal services contracts Wos, a Greensboro physician and Republican fundraiser, used to build her executive team.

In the year Wos has led DHHS, several of her top hires have departed, including then-24-year-old McCrory campaign worker Ricky Diaz who earned $85,000 a year as  Wos’ communications director, and Carol Steckel, who worked as the state’s Medicaid director for eight months before leaving her $210,000-a-year job. Wos’ former chief-of-staff Thomas Adams received a $37,000 settlement payment after spending just a month on the job, despite state hiring practices that bar severance packages in such situations.

NC HHS Sec. Aldona Wos

NC HHS Sec. Aldona Wos

AP reporter Michael Biesecker first requested records related to Hauck in September and recently received a pair of memorandums from the agency no longer than three double-spaced pages as evidence of the 11 months Hauck spent working at the state agency.

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The head of the embattled N.C. Department of Health and Human Services will appear before legislators this morning to answer more questions about the agency’s most recent mishaps.

Aldona Wos, a Greensboro physician and wealthy Republican fundraiser, is expected to address the mailing of nearly 49,000 children’s Medicaid cards with private medical information to the wrong addresses as well as the recent disclosure that the U.S. Department of Agriculture may penalize the state for the bungled food stamps delivery program.

Gov. Pat McCrory has reiterated his support for Wos, telling media that Wos took over a department that had been in disarray under Democrats.

DHHS records show that the agency’s backlog has seen an uptick, with more than 30,000 households in December unable to access their food stamps vouchers.

Audio from today’s 10 a.m. hearing can be heard here, or Raleigh television station WRAL will live-stream today’s meeting here.

You can also follow me, Sarah Ovaska, on Twitter at @SarahOvaska.

 

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The state Medicaid system, and its very troubled billing system called N.C. Tracks, is the topic of a much anticipated legislative oversight committee hearing happening this morning. You can watch here, through a live stream offered by Raleigh TV station WRAL.

Also check out this story today from. N.C. Health News that found McCrory administration appointees at the N.C. Department of Health and Human Services removed explanations behind cost overruns in the state’s Medicaid system and other findings from a critical audit released in late January

That audit has been held up by Gov. Pat McCrory and DHHS Sec. Aldona Wos as a reason to open up the state’s $13 billion Medicaid program to private managed care companies.  Staff in place during the end of former Gov. Bev Perdue’s administration had responded to draft versions of the audit with explanations that many of the cost overruns were due to impractical funding levels set by the state legislature, and that the overhead cost comparisons to

From the N.C. Health News article:

Soon after taking control in Raleigh in early 2013, people hired by Gov. Pat McCrory to run the Department of Health and Human Services made strategic edits to the departmental response to State Auditor Beth Wood’s audit of the North Carolina Medicaid program.

Documents obtained by North Carolina Health News through a public records request show that in January, incoming Sec. Aldona Wos and Medicaid head Carol Steckel eliminated detailed explanations of alleged high administrative costs, management problems and budget overruns in past years.

The resulting document accepts the criticism in Wood’s assessment wholesale and paints the health care program that covers 1.6 million North Carolinians as “broken.”

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