Poll: NC voters back health care expansion

A new poll says voters would back efforts to close health insurance coverage gaps for lower-income North Carolinians. But the survey avoided asking what respondents thought about "Medicaid expansion."

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Health Care Costs
Mark Binker
RALEIGH, N.C. — A majority of Republican and unaffiliated voters would back efforts to expand health insurance to people caught in the "coverage gap" between Medicaid and the Affordable Care Act, according to a poll released Tuesday morning by backers of expansion efforts.
Conducted by the liberal-leaning Public Policy Polling, the survey of more than 2,000 North Carolina voters shows 72 percent overall would support expansion, including 62 percent of Republicans and 62 percent of unaffiliated voters surveyed.

"This poll shows that there is widespread, bipartisan support for closing the health insurance coverage gap," said Michelle Hughes, executive director of NC Child, the group that commissioned the poll and that has lobbied for Medicaid expansion. "We hope this sends a clear message to Governor McCrory and state legislators that all North Carolina voters will support an effort to expand health insurance coverage. This data should give comfort to conservative candidates who haven’t been sure what their constituents think on this issue."

Although NC Child generally pushes policies they see as being good for those under 18, the group argues that insuring parents leads to greater family stability and says that, when parents are insured, children are more likely to be covered as well.

When Congress passed the Affordable Care Act in 2010, it made expanding Medicaid to cover a large swath of uninsured individuals mandatory. A subsequent U.S. Supreme Court ruling said states should have an option of whether to expand, and North Carolina opted not to. That decision leaves about 350,000 people in a coverage gap because they don't qualify for Medicaid but aren't helped enough, if at all, by Affordable Care Act subsidies.

The wording of the poll may have helped garner more positive responses.

PPP told voters that the "legislature and Governor McCrory could fix the coverage gap by creating a special North Carolina plan in partnership with the Federal government." The survey then asked, "Do you think North Carolina should make a plan to fix the health insurance coverage gap, or not?"

It did not ask voters whether the state should "expand Medicaid" or "use Medicaid funding to expand health coverage." That was on purpose, according to Rob Thompson, a senior policy advisory of NC Child.

"It was a conscious decision on our part not to use the term 'Medicaid expansion,' which has become unnecessarily politicized," Thompson said. "We think, if North Carolinians know the substance behind the issue, they will support closing the health insurance coverage gap. I think the polling bears that out."

Thompson also pointed out that it's unlikely North Carolina's leaders would choose to do a simple expansion of Medicaid. Rather, McCrory and others have talked about doing a "North Carolina plan" if they were to expand coverage. While some lawmakers have have discussed Medicaid expansion as part of a broader reform of the system, McCrory and others, particularly Senate leaders, have cast a jaundiced eye toward anything that would add to North Carolina's Medicaid caseload.
How a poll question is asked does matter. For example, a 2014 Foundation for Government Accountability survey found only 34 percent of respondents supported expansion when asked, "If you knew Medicaid expansion was a key part of ObamaCare, or the federal Affordable Care Act, would you be more or less likely to support expanding Medicaid in North Carolina?"
More recently, a High Point University Poll found roughly half of North Carolinians supported expansion when asked, "The health care law is called the Affordable Care Act or ObamaCare. Should the state expand its Medicaid programs as allowed under the law?"

The legislative committees examining North Carolina's Medicaid reform process are schedule to meet next on Feb. 9.


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