Docs say NC leaders should expand Medicaid

Under the Affordable Care Act, Medicaid could be expanded to cover an additional 500,000 low-income uninsured people in the state – about one-third of the 1.5 million North Carolinians who have no health insurance.

The cost would be fully funded by the federal government for the first three years. For five years following that, the federal government would pay 90 percent of the cost, and the state would pay 10 percent. That’s a much more favorable cost share than regular Medicaid, for which the state pays one-third of the cost.

If lawmakers approve the expansion, it would bring a projected $15 billion into the state’s economy, creating an estimated 25,000 jobs in health care and related sectors by 2016.

While Republican leaders in other states have opted to accept the expansion, North Carolina lawmakers have not.

In fact, they've fast-tracked a measure to reject it, saying it puts the state budget at risk eight years from now when the federal money runs out.

Dr. Charles van der Horst, a professor at the University of North Carolina School of Medicine, said Medicaid expansion would save the state money, control costs for private insurers, help rural hospitals with high levels of uncompensated care, boost the state’s economy and save lives.

”Our unemployment is over 9 percent,” van der Horst said. “If I was a CEO of a company that was going to bring 25,000 new jobs to North Carolina, what do you think the legislature and the governor would say? And what do you think the voters will say that we’re turning this down?"

Turning down the expansion, he said, will mean higher insurance premiums for everyone,

"Those uninsured patients are still going to come to our emergency rooms. They’re still going to get admitted to our hospitals. Only who’s going to pay for it? You and me," he said. "The cost is passed through. Hospitals don’t print money."

"This is a fiscal issue – and it is fiscally irresponsible what they’re going to do. They’re going to drive up costs for all of North Carolina. It’s absolutely nutty," van der Horst said. "Ronald Reagan would be rolling, spinning in his grave if he heard what these Republicans are doing."

“What we do here now will have a ripple effect for years to come,” said workforce health expert Dr. Brenda Clary.

Clary said expanding Medicaid and creating a state health insurance exchange would “give North Carolina the power to allay suffering, to increase productivity in our state, and to rein in out-of-control health care costs as we age.”

“It’s really a travesty of justice, said Durham family doctor Dr. Mohan Chilukuri. “I call it malignant neglect – 500,000 lives at stake. This is really a dereliction of duty.”

“Our politicians talk about the importance of family values, the role of the Bible in their lives and fiscal responsibility,” van der Horst added. “This bill flies in the face of all these areas.”

Rep. Jim Fulghum, R-Wake, the only practicing physician in the General Assembly this session, attended the press conference.

Fulghum said he’s “terribly conflicted” about the measure and needs to learn more about its impact on the state budget. He thinks its progress in the House will be slower, but he doesn’t think House and Senate leaders will change their mind.

“I don’t think the votes are there,” he said, adding, “The tone today did not move the ball forward."

Fulghum said he was “saddened” by accusations that GOP leaders don’t care about the poor.

“The more we cut out some of the emotion and some of the accusations, the better we’ll be," he said.