Opinion

Stop the government takeover of health care. Reject Medicaid expansion.

Rev. William Barber, head of the NC NAACP, standing, prays over 13 protesters who participated in a die-in at under the rotunda of the NC Legislature Thursday afternoon, February 12, 2015. The protestors were rallying to protest the state’s continued denial of Medicaid expansion for hundreds of thousands of North Carolinians. The protesters were from the NC NAACP and the Forward Together Moral Movement.
Rev. William Barber, head of the NC NAACP, standing, prays over 13 protesters who participated in a die-in at under the rotunda of the NC Legislature Thursday afternoon, February 12, 2015. The protestors were rallying to protest the state’s continued denial of Medicaid expansion for hundreds of thousands of North Carolinians. The protesters were from the NC NAACP and the Forward Together Moral Movement. newsobserver.com

North Carolina has been a leader in enacting free-market reforms that are improving people’s lives. Four tax reform packages have reduced the burden of government and simplified filing for millions of Tar Heel families. The expansion of school choice has created a new opportunity for thousands of students. And the rejection of Obamacare’s Medicaid expansion has helped protect North Carolina from a critical aspect of the federal government’s health care takeover.

Unfortunately, the newly bolstered Democrat legislative minorities, Gov. Roy Cooper and special interest groups are now pressuring leaders in the General Assembly to such an extent that House Speaker Tim Moore (R-Cleveland) indicated he is open to Medicaid expansion in North Carolina.

Fortunately, the U.S. Supreme Court ruled that Washington cannot force the states to expand Medicaid. Former Gov. Pat McCrory and the General Assembly have already exercised our state’s rights, rejecting Medicaid expansion and the additional Obamacare empty promises that would come with it, when they passed Session Law 2013-5 in 2013.

Legislative leaders should now ignore renewed calls for Medicaid expansion — even when it comes from members of the Republican House Caucus, such as Rep. Donny Lambeth’s (R-Forsyth) Carolina Cares legislation.

The Obama administration assured states that Washington would pick up 100 percent of the expansion costs for the first three years, and then 90 percent thereafter. But how reliable is a guarantee from a federal government more than $21 trillion in debt, much of which is due to entitlement programs like Medicaid?

The problems with Medicaid expansion can also become systemic, particularly the unforeseen costs. The non-partisan Foundation for Government Accountability published research earlier this year which found that states that expanded Obamacare through Medicaid expansion have signed up more than twice as many able-bodied adults as promised. This enrollment deluge, combined with higher than forecasted per-person costs, has led to cost overruns of 157 percent.

The renewed call for Medicaid expansion in North Carolina also comes at a time when the state’s Medicaid program is switching to a managed care model and just recovered from multiple years of cost overruns which skyrocketed into the hundreds of millions of dollars.

Medicaid expansion would inevitably hurt the most vulnerable North Carolinians. Medicaid is a program meant for impoverished citizens. However, because of Medicaid’s low doctor reimbursement rates, patients already have a tough time getting a doctor’s appointment, which contributes to the program’s shockingly poor health outcomes.

Indeed, according to state Medicaid Annual reports, from 2003 to 2016, the number of physicians enrolled as Medicaid providers in North Carolina plummeted by more than 10,000, a drop of 28 percent.

An expansion would add hundreds of thousands of non-disabled, childless, working-age adults to Medicaid, which would further exacerbate the problem of access to quality care for the neediest North Carolinians.

A job, not Medicaid, is the best anti-poverty program. North Carolina should keep moving forward with the proven job-creating policies of controlled government spending, tax cuts, and regulatory reform.

Caring for impoverished citizens and families isn’t the same thing as locking more people into Medicaid. Medicaid is a safety net program. However, expanding Medicaid would dramatically change the purpose of the program and necessitate increased government spending and higher tax rates, which will likely make it more difficult for those that need a job to get one. Thus, Medicaid, instead of helping our indigent citizens, locks them into a vicious cycle of poverty and the safety net becomes a net trap.

Expanding Medicaid is a bad deal for everyone, except special interest profiteers. The General Assembly should not cave to political winds by trying to control healthcare through a law that was sold on deceit and has delivered countless broken promises. North Carolina should reject Obamacare’s Medicaid expansion once and for all.

Donald Bryson is president of the Civitas Institute.
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