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9:29 a.m. • 6-19-13

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DOCS
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Docs say NC leaders should expand Medicaid

Published: 2013-02-11 16:12:00
Updated: 2013-02-11 16:27:18

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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I want proof that 25,000 jobs will be brought to NC. Not 24,999; not jobs "with American companies" who manufacture overseas and keep call centers there; not part-time, $8/ home health attendant jobs. Then I want to see all the calculations and ROI.

Won't hold my breath.

heelzfan, then WHEN do we address the mismanagement? Don't hold up sick children as human shields for some of the evil people at Medicaid.

"If lawmakers approve the expansion, it would bring a projected $15 billion into the state’s economy,.."

AFTER TAKING THE SAME $15 B OUT OF OUR POCKETS!!!

I'll agree totally that the Medicaid system in NC needs an overhaul. But honestly, its had significant problems back to the late 80s and early 90s - I know this because I have been in healthcare finance since then. You don't, however, pull the rug out from under helping more folks that need it, and totally refuse the expansion because of mismanagement issues. Let's see... what's more important - helping the uninsured and underinsured, or dealing with a mismanagement issue. Those who don't want this.... I hope you NEVER have a family member who has to sell everything they own - relying on Medicaid - when guess what??? - it WON"T be there! Come on folks - work out a compromise. Also - can't blame this on Obama, so don't try. These issues go back many years before Obama and Perdue were in office! Let's work together and help those in need! We might be one of them one day.

Being honest with money and caring about poor people's health are two different topics entirely. Mr Fulghum is wrong in asserting that since the GOP cares about one they must care about both. If it weren't for the federal government stepping in to create an exchange for NC this truly would be an affront to the poor- now it is just a poor monetary decision by the NC GOP.

Hmmmm... doing the same thing over and over while expecting different results -- must be the Democratic ticket.

Expand our current broken and corrupt system.... these "docs" are on the paycheck side of this equation. And if Uncle Sam chooses to stop investing in the expanded system... it will be NC taxpayers holding the massive bills. NO THANKS!

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