Study calls for NC Medicaid expansion

Posted December 18, 2014

— North Carolina would create 43,000 jobs and draw down $21 billion in federal funding over five years if state leaders agreed to expand Medicaid as allowed by the Affordable Care Act, according to a new report conducted by George Washington University researchers and sponsored by the Cone Health Foundation and the Kate B. Reynolds Charitable Trust. 

"At county levels, if Medicaid is not expanded by 2016, Mecklenburg and Wake counties would crate about 4,500 fewer jobs each by 2020," says the report, which argues Medicaid expansion could drive down the state's unemployment rate. 

The Affordable Care Act, what some people call "Obamacare," originally required states to expand the Medicaid health insurance program to cover all those earning up to 138 percent of the federal poverty wage, which amounts to about $28,600 for a family of three. Above that income level, people can get federal subsidies to buy health insurance though online exchanges. However, a U.S. Supreme Court decision gave states the option of expanding Medicaid to those who aren't now eligible but don't earn enough to qualify for subsidies.

So far, 27 states and the District of Columbia have chosen to expand Medicaid. The federal government will cover 100 percent of the cost of expansion for those states in 2015 and 2016 Starting in 2017, states will need to chip in 5 percent of the cost for new patients and 10 percent starting in 2020.

In 2013, North Carolina lawmakers opted not to expand, saying the state's troubled system could not handle more patients and worrying that the federal government would expand how much states had to pay as time went on. That means many families and most low-income adults remain ineligible for coverage under the state's health insurance program for the poor and disabled. 

Problems with billing systems and cost projections have led to cost overruns so frequently that merely operating on budget was cause for Secretary of Health and Human Services Aldona Wos to say in September "we're ecstatic."

Despite Wos and Gov. Pat McCrory hinting that the administration may ask the General Assembly to consider some sort of Medicaid expansion, state lawmakers have repeatedly said they have no plans to expand

"We've still got work to do...That's not even on the table," Rep. Justin Burr, R-Stanly, said Wednesday.

Asked about the argument in the Cone-Reynolds report that expanding Medicaid could spur job creation, Burr said it wasn't convincing.

"The argument that we're going to take money from the taxpayers and create jobs, that's never worked for me," he said. 

Unsurprising, the Cone-Reynolds report argues that the bulk of the impact on jobs and the economy would come to the health care sector. Many doctors and hospitals currently provide uncompensated care that Medicaid expansion would cover.

"The lack of Medicaid expansion not only means that hundreds of thousands of low-income North Carolinians will remain uninsured, but also that hospitals, physicians' offices, clinics, pharmacies and other health care providers have less revenue and bear more uncompensated care," the report says.


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  • Matt Wood Dec 19, 2014
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    I love how you glossed over Forbes, a traditionally right-leaning and pro-business publication. Didn't quite fit your narrative, did it?

  • miseem Dec 19, 2014

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    So you are saying that your health insurance went up 7.5 times the previous amount? If you had been spending $200 a month, you are now spending $1,500 per month? Hard to believe, if you have exactly the same coverage. Or else, your income has dropped a lot this year. ACA has essentially brought in components of group coverage to level payments by all people enrolled. Until ACA came about, I never saw people complaining that their company group policy covered things they did not want and did not want to pay for. But now, it's ringing through the air all over the country. And many of the people complaining had policies that covered virtually nothing - $100 a day!! Double that if you have cancer!! type coverage. That will really help with those $5,000 a day treatments.

  • disgusted2010 Dec 18, 2014

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    Just what we want to hear, Great Britian, France and Bloomberg. One country that would be speaking German were it not for us, another that has surrendered to everyone else and a man who uses his billions to deny people their rights due to his elitist attitude.

  • AlbertEinstein Dec 18, 2014

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  • Olenc Native Dec 18, 2014
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    And spinning. The GOP is really good at spinning and not really saying much. Take Raphael27520 for example. What he wrote sounds good... it sounds strong. But it really doesn't mean anything. Hot air. Blowing smoke.

  • Gia Momoa Dec 18, 2014
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    Im sick of medicaid! What is it teaching society? Then on top of that I have to pay for these kids healthcare until their 18 years old. Can I at least have a picture of the family to put on my fridge.

  • jimcricket15 Dec 18, 2014

    "Please clarify. Obamacare cost you an additional 15%? Or your total federal tax bite is 15% of your income?"

    ObamaCare is costing me 15 percent of my (after tax) spendable income. Before Obamacare it was running me under 2 percent of my spendable income. ObamaCare is actually another tax. In addition to the outright taxes added by ObamaCare the bulk of my premium goes to coverage items I not only do not WANT, but can not possibly use. It is simply a transfer of money from me to other people that get subsidized. Just another highly discrimnatory Federal Program. By the way those of you talking about "Free Health Care" in other countries. It is not FREE and in fact is an extremely expensive form of insurance. People love to quote a "per head" amount, but that is not how it works. It is just government theft on a larger scale than occurs here.

  • miseem Dec 18, 2014

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    The main difference is that most policies being pushed by liberals are intended to help the poor and middle class, whereas most policies being pushed by the conservatives are intended to help the wealthy and corporations on the backs of the poor and middle class. So as far as thinking one side is better than the other, I guess it depends on which group you belong to - poor and middle class, or wealthy and corporate management.

  • raphael27520 Dec 18, 2014

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    Private University , really?, it does not get Federal Grant Research money , eh?
    No students with Federal Loans and Student Grant Aid huh ?
    A "Study" funded by a Government Grant with a predetermined outcome, Increase Federal Spending, Increase Government Program size and raise taxes on Working People "to spread the wealth" to the Welfare Class.

  • welfarequeen Dec 18, 2014

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    You are seriously deluded if you think that USA has the best health care. WHy don't YOU do some research online. You do know that the USA is the ONLY industrialized nation to not provide FREE health care?