North Carolina’s Medicaid program ended the year with a $130 million surplus, and when Gov. Pat McCrory’s secretary of the Department of Health and Human Services resigned, McCrory praised Aldona Wos for fixing the program, which had seen serious problems in processing.
But McCrory still stops short of pushing ahead with an expansion of Medicaid that could enroll as many as 500,000 North Carolinians and provide them with potentially lifesaving health care. The expansion is possible under the Affordable Care Act, and the federal government would pay all the costs of expansion though 2016 and no less than 90 percent of the costs thereafter.
Attorney General Roy Cooper, expected to challenge McCrory for the governor’s office next year, has called on the governor to at long last support Medicaid expansion. Is he playing some politics? Sure he is. But that doesn’t mean he’s not right. And McCrory’s lame excuse for his hesitancy on expansion, awaiting a ruling from the nation’s highest court, is gone. The U.S. Supreme Court now has twice affirmed “Obamacare,” as the Republicans like to call it, and has ruled in the latest challenge to the law that those getting federal subsidies for care, which several hundred thousand North Carolinians do, can keep those subsidies even if they didn’t go through a state-run health insurance exchange. (North Carolina doesn’t have one.)
The governor must call for expansion. Twenty-eight states already have expanded Medicaid, and Alaska and Montana are preparing to expand. The governor’s hesitation about having North Carolina expand Medicaid is more likely a reflection of his fear of the Republicans in the General Assembly than concern that expansion won’t work. It has in other states. It would also create jobs.
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This isn’t just about compassion. It’s also about common sense. In what universe are government leaders not interested in helping less fortunate citizens, particularly when it costs the state nothing and boosts the state’s economy?
The answer is, the universe of the North Carolina General Assembly, where the Republican majority has conducted a war on the poor now for years. Cuts to unemployment benefits, shorter eligibility times and an outright rejection of Medicaid expansion on the nonsensical excuse that GOP leaders don’t trust the federal government to live up to the promise of paying for expansion.
Cooper’s playing politics? The more pertinent game is being played by Republicans.