When Medicaid expansion comes, NC shouldn’t respond


Editorials and other opinion content offer viewpoints on issues important to our community and are independent of the work of our newsroom reporters.


Special interest groups continue to pressure Republican leaders in the North Carolina General Assembly to expand Medicaid under Obamacare.


It’s an election year, which means that while other states are about to end their legislative sessions, North Carolina is still waiting for the start of its “short” legislative session.

It is common for oversight and review committees to meet between legislative sessions, and this year is no exception. However, one of those committees — the Joint Legislative Oversight Committee on Health Care Access and Medicaid Expansion — is poised to take North Carolinians down an entirely different and ominous path.

Special interest groups continue to pressure Republican leaders in the General Assembly to expand Medicaid under Obamacare, despite the financial burdens it will impose on taxpayers.

The Obama administration promised states that Washington would bear 100% of expansion costs for the first three years, then 90% after that — but how reliable is that guarantee from a $27 trillion indebted federal government? dollars, much of which is due to Medicaid?

Additionally, unexpected costs have been an ongoing issue for Medicaid. For example, expanding Medicaid in Louisiana was expected to cost about $1.4 billion a year. Instead, it cost taxpayers about $3.1 billion a year, more than double the Legislative Fiscal Office’s original estimates, according to the Pelican Institute for Public Policy.

A 2020 study by the John Locke Foundation found that expanding Medicaid in North Carolina would create a significant gap in the state budget. This funding gap of $119.3 million to $171.3 million in the first year alone is expected to be filled by new state appropriations, a tax increase on managed care plans, or an increase taxes on service providers.

Moreover, new calls for Medicaid expansion also arise as the state’s Medicaid program continues to evolve into a new model of managed care, the expansion of which would be confusing and disruptive.

North Carolina has been a leader in enacting free market reforms at the state level to improve people’s lives. Tax reforms over the past decade have reduced the burden on government and simplified the filing process for millions of Tar Heel families. The expansion of school choice has created opportunity in our state, and Obamacare’s rejection of Medicaid expansion has helped shield North Carolina from a critical aspect of health care management. health by the federal government.

Fortunately, the United States Supreme Court has ruled that the Biden-Pelosi-Schumer administration in Washington cannot force states to expand Medicaid. The General Assembly has already exercised our state’s rights, rejecting Medicaid expansion and the additional empty Obamacare promises that would accompany it by passing Senate Bill 4 – No NC. Exchange/No Medicaid Expansion – in early 2013. This bill prevented Governor Roy Cooper from unilaterally expanding Medicaid in its first week in 2017.

The General Assembly should continue to hold the line and ignore calls for Medicaid expansion.

Medicaid expansion would inexplicably hurt North Carolina’s most vulnerable. Medicaid is a program for the most disadvantaged residents. However, due to low Medicaid reimbursement rates for physicians, patients are already struggling to get doctor appointments, contributing to the program’s shockingly poor health outcomes. The expansion would add thousands upon thousands of able-bodied, childless, working-age adults to Medicaid, further compounding the problem of access to quality care for the most needy North Carolinians.

As former Wisconsin Governor Scott Walker – who rejected expanding Medicaid eligibility – said the wall street journal“Caring for the poor is not the same as taking federal government money to lock more people into Medicaid.”

Expanding Obamacare through Medicaid is a board game that’s bad for taxpayers and bad business for economically disadvantaged North Carolina families. When special interest groups come knocking after the start of the legislative session, the General Assembly should keep the door shut.

Donald Bryson is president and chief strategy officer of the John Locke Foundation, a think tank in Raleigh.

Comments are closed.