Docs say NC leaders should expand Medicaid

Posted February 11, 2013

— A group of North Carolina doctors is calling on state lawmakers to accept federal support for Medicaid expansion.

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.”

Senate Bill 4 passed the Senate last week on party lines and is expected to be taken up Tuesday in a House Health Committee.

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.

“To accuse us of not caring about that does not help the situation," he said. “We do care. We do care about being honest with money, and I think the taxpayers sent us up here to do just that very thing.”

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


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  • Krimson Feb 12, 2013

    "it puts the state budget at risk eight years from now when the federal money runs out." = The GOP has no long-term budget solution and doesn't expect to be in power in 8 years.

  • oleguy Feb 12, 2013

    I was without Ins, for over 5 years,,When I went to the doc I paid cash,, Average visit cost me 94.00 bucks,, Now I am 66, the first and last visit over a year ago cost me over 260.00 out of pocket,, The govt also paid some, and I pay up front over 119.00 per mo. Insurance,,, I have since gone back to cash,, Medicare is a ripp off of our seniors,,,

  • andrewthomasregan Feb 11, 2013

    Funny, I would think better about the Democratic Party if they truly cared about the working poor and the middle class if they would only acted like they cared about us. Instead, they seem focused on the professional poor and illegal immigrants and then throwing even more of our money overseas. Deport illegals and save lots of money and have more to spend on our own people.

  • andrewthomasregan Feb 11, 2013

    It is disgusting the way the left always brings up Christian"faith" but would never think of involving the faith of other religions because a politician didn't agree with them on policy.

    Dr. Charles van der Horst is a bigot for attacking conservatives on their faith. Imagine if you were to bring that up for someone who is Jewish or Muslim.

  • ncfarmhand2 Feb 11, 2013

    I would be much more likely to believe that GOP leaders cared about the poor if only they would act like they care about the poor. What I see is them cutting benefits and educational opportunities for the poor and creating cuts for corporations and for the wealthy. If you are middle class and you really believe these men and women have your best interest in mind, I have some swamp land I'd like to sell.

  • heelsgirl05 Feb 11, 2013

    So....only a third of the uninsured people in this state will get medicaid under the new expansion when we were promised that ALL would be covered under the new affordable care act. Meanwhile my insurance has gone up by 50%. What am I paying for???

  • elvmat23 Feb 11, 2013

    The Medicaid expansion should be done,it makes sense to have a healthier citizenry! I can not believe that the State of NC wants to be this backward! These doctors are correct,but maybe they should have told of the actual people DYING because of delayed care. A testimonal from a parent or spouse who lost someone due to the lack of health care may have shook up these legislators to see the light...

  • heelzfan4 Feb 11, 2013

    I'd just like to share one more thing.... please read the excerpt from the Federal Judge's final ruling on the WakeMed Medicare billing/mismangement issue. He pointed out (in other parts of the article) that removing WakeMed's ability to bill Medicare (not medicaid) would basically cause wakeMed to close its doors - hurting so many needing healthcare in the community. Wakemed will be under close billing supervision for 5 years. So, why is this approach not feasible for the Medicaid expansion I ask you? ""The court has considered the threat that the provision of essential healthcare to WakeMed's patients would be interrupted and that the needs of the underprivileged in the surrounding area would be drastically and inhumanely curtailed should defendant be forced to close its doors as a result of the instant prosecution," Boyle wrote in his ruling."""

  • heelzfan4 Feb 11, 2013

    Morrigan - i don't believe i said anything about "sick children" as you so clearly pointed out. I suggest you re-read my post. I just want some compromise - and not see the poor and needy get shafted for the mismanagement. that's all I want.

  • Terkel Feb 11, 2013

    Here are some excerpts from Form DSS-8227, Economic and Family Services Section:

    "Anyone who wants to receive Medicaid, Health Choice...must tell us about their citizenship and immigration status." How folksy.

    "Anyone who wants to receive Medicaid, HC...must also give us their SSN...SSNs will NOT (emphasis theirs) be used to report anyone to the US Citizenship and Immigration Services." Come on it, it's OK, we won't snitch!

    "Anyone applying for only emergency Medicaid does not have to provide his SSN or information on his citizenship or immigration status." Still think illegals don't get Medicaid?