In regard to your Feb. 28 editorial “N.C. could lose out on Medicaid”: There was much harm done by the North Carolina General Assembly leadership when it decided not to close the coverage gap for nearly half a million North Carolinians.
Thousands of people who could have been covered went without preventive care, hospitals, and health care providers continued to deliver care without compensation, and chronic illnesses for many went undetected and untreated. But we should be clear that the federal retreat from providing health care to all who need it through Medicaid – as will happen under current House proposals to limit federal Medicaid spending to a set amount – won’t be made better simply with expansion of Medicaid.
Under House Republican proposals to radically overhaul Medicaid, either by block grants or per-capita cap plans, North Carolina and all 49 states will not be able to serve all of those currently enrolled and those who could need health care coverage in the next downturn.
The goal of the proposed plans is to reduce federal spending over time for all states. In other words, the retreat of the federal government will take away a portion of the $66 that it currently provides for every $100 in Medicaid spending in North Carolina.
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If states are forced to shift to a Medicaid block grant or a per-capita plan, there will be cuts to: the number of North Carolinians who receive health services and the types of health care services that are available.
Furthermore, any cut in federal funding will shift costs to North Carolina and pose a risk to the state and its ability to meet the needs of its people. State policymakers, regardless of party, should be working with North Carolina’s Congressional delegation to make clear: North Carolina will not accept a retreat from the federal commitment to Medicaid that will ration care for our state’s most vulnerable residents.
Public Policy Analyst, NC Budget & Tax Center
The length limit was waived to permit a fuller response to the editorial.