Editorial: Not expanding Medicaid - morally bankrupt, fiscally inexcusable

Posted April 26

Democratic legislators and health care advocacy groups hold an April 4, 2017, news conference calling on the General Assembly to move forward with Medicaid expansion. (Photo by Sharon Nunn)

A CBC Editorial: Wednesday, April 26, 2017; Editorial # 8153
​The following is the opinion of Capitol Broadcasting Company

The costs of failing to expand Medicaid in North Carolina continue to mount. As May approaches:

  • An estimated 500,000 needy North Carolinians are denied health care coverage;
  • As many as 4,015 have died since 2014 when the state could have expanded, for lack of health coverage;
  • 39,392 jobs haven’t been created;
  • $9.5 billion federal taxpayer dollars that would have come back to North Carolina, are instead paying to provide health care in other states.

The General Assembly has demonstrated feline-like quickness in passing laws to limit the governor’s authority, manipulate the courts or social policies like HB2. But it has shown sloth-like foot-dragging when it comes to making sure all North Carolinians have access to adequate health insurance.

In recent weeks some faint and potentially hopeful signs have emerged that the icy opposition of legislative leaders’ to expanding Medicaid eligibility may be thawing.

“For the first time since the passage of the ACA (Affordable Care Act), there is an opportunity to partner across party lines, chambers and branches of government to expand Medicaid in North Carolina for the benefit of the health and well-being of North Carolinians,” observed the N.C. Institute of Medicine in a report that compared three key Medicaid expansion proposals that have emerged in recent weeks.

A group of Republicans, led by Rep. Donny Lambeth (former president of Wake Forest Baptist Medical Center), have offered up a plan that would extend coverage to about 300,000 people while imposing a variety of demands and restrictions on those eligible for coverage. Far from adequate, it does represent a small crack in the formerly solid and intractable opposition. Still, House Speaker Tim Moore and Senate President Pro Tempore Phil Berger haven’t expressed any support for the legislation.

It must leap through three House committees before it even makes its way to a full House vote. There is no indication, amid the frantic pace of the current legislation cross-over deadline, that the bill has even been scheduled for a first committee hearing.

Plans submitted by Democratic legislators also continue to languish.

Gov. Roy Cooper is seeking public input in developing details for his proposal, including a series of four public hearings around the state in early May.

Seventy of North Carolina’s 80 rural counties have been designated “medical deserts” for their lack of primary care and seven rural hospitals are at risk of closing.

A sound and fair plan to provide health insurance to North Carolinians most in need is far overdue. Legislative leaders need to end their partisan opposition to expanding health coverage and work with Gov.Cooper now to end the stalemate.

It is hard to believe that anyone would play politics with people’s health care. But our General Assembly continues to amaze us. The lack of expansion of Medicaid is both morally bankrupt and fiscally inexcusable.


2014-16 Jan. -April 2017 TOTAL
Diabetics without medication* 81,132 9,016 90,058
Annual mammograms missed* 36,153 4,016 40,170
Deaths* 3,435 to 1,355 580 to 152 4,015 to 1,507
Federal Funding Lost** $9 billion $484.8 million $9.4848 billion
Jobs Not Created** 34,700 4,692 39,392

*Opting Out Of Medicaid Expansion: The Health And Financial Impacts, Health Affairs Blog
**The Economic and Employment Costs of Not Expanding Medicaid in N.C., Center for Health Policy Research, The George Washington University, Dec. 2014


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  • Chris Perdue Apr 26, 12:56 p.m.
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    Funny how when a couple of comments that make a good case against expansion are posted, the story always gets pulled from the front page.

  • Matt Smithe Apr 26, 9:47 a.m.
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    This is exactly the point. Liberals love to say that people who are against expansions of these types of programs are heartless and want to throw people off the cliff. The reality is, and this is from personal experience, that a significant number of people on Medicaid do not need to be using those benefits. They are perfectly capable of taking care of themselves. They are simply unwilling. Demonstrate that my tax dollars are being used to help the truly needy and you will find no resistance from me to provide these benefits. They don't want to do it because they either understand the reality or are ignorant of it.

  • Chris Perdue Apr 26, 8:50 a.m.
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    Medicaid was designed to take care of people that could not take care of themselves. Do you think it is fair for the citizens of NC through their tax dollars to pay for Medicaid for healthy able bodies men and women who choose not to work? Do you think they should have free coverage with no copays, deductibles, or Rx costs? Hard working middle class people do not have access to that type of coverage--why should people who have chosen not to be productive and game the system have better coverage than the middle class??

  • Chris Dye Apr 26, 8:30 a.m.
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    North Carolina would still be free to reduce its own contributions as well- and the citizens would be no worse off than they are now. How is this not clear to you?

  • Quid Malmborg Apr 26, 8:27 a.m.
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    Why would the Feds stop paying their part?

    Oh, right- Republicans.

  • Nick Holt Apr 26, 7:39 a.m.
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    Nothing is ever free. What happens when the Feds stop paying their part? NC would be on the hook for tens of millions of dollars. Also, let's keep creating jobs and maybe some of these people would get health insurance from their jobs.

  • Quid Malmborg Apr 26, 6:16 a.m.
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    View quoted thread

    Feel free to respond to the subject op-ed piece with a point-by-point analysis and rebuttal, and actually defend your own opinion (such as it is). Yeah, I know that is difficult.

  • Matt Smithe Apr 26, 5:18 a.m.
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    Still reveling in the echo chamber you have created? Please do feel free to open the editorials section to a non-liberal viewpoint. Don't like hearing differing opinions and having to actually defend your opinions? Yeah, I know that is difficult. It's ok, just keep on with your propaganda.