Patrick Conway: No safety net

February 15, 2013 

No safety net

Thanks to Senate President Pro Tempore Phil Berger for his statement of facts leading him to reject the expansion of Medicaid coverage to uninsured citizens in North Carolina (“The missing Medicaid facts” Feb. 14).

One fact weighed heavily in his rejection: That a large share of Medicaid recipients were previously on private insurance. The implication: If there is no Medicaid expansion, those individuals will remain privately insured. That implication doesn’t follow from this fact: Nearly all affordable private insurance is offered through employers. As we know, those employers downsized during the recession, or have eliminated healthcare benefits to contain costs. Low-income workers who lose their jobs and private insurance, could, under the proposed expansion, turn to Medicaid. . Medicaid would serve as a safety net.

We shouldn’t assume, as Berger seems to do, that individuals would choose Medicaid over affordable private insurance. For Berger’s implication to hold, private employers will have to agree not to fire or to reduce healthcare coverage for their low-income employees when the state rejects the Medicaid expansion. Without that, he is pulling away the safety net that protects many of our most vulnerable citizens. If he has such an agreement, he should publicize it – that will be a significant legislative achievement!

Patrick Conway

Chapel Hill

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