Lewis calls Medicaid vote "a plea for help"

Posted February 14, 2013

— Rep. David Lewis, R-Harnett, was the only Republican to vote against the bill banning the expansion of Medicaid Thursday. 

Lewis, who voted against the measure on second reading Wednesday, is no fan of the Affordable Care Act. He said he agrees, in principle, with much of what his GOP colleagues said about the bill and said expanding a troubled state Medicaid system would pose problems. 

Lewis described his third reading vote against the measure as  "a plea for help for rural health care." 

In a health committee hearing earlier this week, Lewis raised questions about the loss of "DISH" money, the bureaucratic slang for funding supplements that go to hospitals with a disproportionate share of patients who can't pay their bills and don't have insurance. 

The Affordable Care Act phases out DISH payments, but as part of a compromise on the federal level, proponents agreed to expand Medicaid so more patients would have health coverage. When the U.S. Supreme Court upheld the health care law last summer, however, it said states could not be forced to expand their Medicaid programs. 

Without extra Medicaid payments to make up for the loss of DISH payments, Lewis said, rural hospitals like the one in his district will suffer.

"I don't like the extortion that's being used to force states to take the Medicaid expansion," he said. "But I wanted to bring attention to the fact that, if that money goes away, many rural hospitals, including the one I represent, will go into the red." 

Nobody, he said, has been able to explain how the DISH money will be replaced. 

"It is significant," Lewis said, adding that hospitals could either be forced to close or slash many of the services they offer to help keep people healthy as a result of the loss of DISH money.


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  • unc70 Feb 15, 2013

    Much more likely that one of the Federal exchange options might look a lot like Medicare for All.

  • tigo7 Feb 15, 2013

    Mediciad and Medicare will probably be phased out as Obamacare takes over. With the reduction in Obamacare benefits that is going on now as it is being read, (after it was jammed down our throats) it will cover almost nothing and Americans will be looking at other countries for some kinds of healthcare but since obamacare is a tax it can be increased endlessly and now the government can shrink our benefits endlessly with NOTHING to STOP them.

  • teleman60 Feb 15, 2013

    When it's explained as clearly as by previous posters here, one must ask if the NC legislators are really just a bunch of juvenile delinquents or are they just playing them on tv...

  • dawgitall Feb 15, 2013

    Don't be fooled by Lewis' gesture. He voted no on the third reading. He voted yes every other time. He is simply trying to work the angles for his own political gain. He knew his vote on the third reading wouldn't matter so he was allowed to vote the way he did. Now he can go back to Harnett County and when he is called on what his party did to harm working families and the new hospital in Lillington and the economy in general he can claim that he opposed this measure. No Snookone, David Lewis isn't "a rare fine indeed" and he isn't "thinking about NC citizens ahead of party resentment", he is thinking about a run for Ellmer's congressional seat when / if she runs for the Senate. He is trying to cover his you know what with a meaningless vote on an already decided issue. The term snake in the grass comes to mind.

  • Snookyone Feb 15, 2013

    A decent republican is a rare find indeed. Thank you for thinking about NC citizens ahead of party resentment.

  • unc70 Feb 15, 2013

    The expansion of Medicaid to the working poor is a large, integral, and essential part of the ACA. The Act was designed to work as a whole, with only a few options left to the individual states (For example, whether to create state insurance exchanges or rely on Federal ones.). Supreme Court ruled the Act as Constitutional, but it narrowly ruled the expansion of Medicaid could not be mandatory on the states because Medicaid itself is an opt-in system for individual states, though all 50 now opt-in. But many Federal programs like DISH completely disappear. Oops!!

    The Federal gov will pay 100% for three years, 90% thereafter. The 10% that NC would then pay is more than offset by state and local tax revenues on the 90%, with the first three years to prime to pump. Almost no GOP legislator or appointee has a clue how all this ripples through the budget. Same loss w extended UI (100% Fed) Congress will curtail next year. Lower UI max $ is unrelated, Both harm 50-65yo workers.