Gov. Cooper’s right on Medicaid expansion

Gov. Roy Cooper proposed a plan Wednesday to expand Medicaid to provide health insurance for as many as 500,000 low-income North Carolinians.
Gov. Roy Cooper proposed a plan Wednesday to expand Medicaid to provide health insurance for as many as 500,000 low-income North Carolinians. ehyman@newsobserver.com

Gov. Roy Cooper now has signaled the Republican leaders of the General Assembly that he will not shy from confrontation on one issue he believes is vital to North Carolinians in need of health insurance coverage under Medicaid, the federal/state program for the disabled and lower income Americans.

Cooper says he wants to expand Medicaid immediately — though GOP lawmakers passed a law in 2013 that prohibited the executive branch from expanding the program under the Affordable Care Act. The governor will ask the federal government for special consideration to expand right away.

Under the ACA, states could expand Medicaid with the federal government picking up 100 percent of the costs through 2016 and in a slightly declining percentage until 2020, when the government would thereafter pay 90 percent of the costs. It is a bargain for states; it is a life-saving option for millions of Americans.

In North Carolina, it was estimated that perhaps as many as 500,000 more North Carolinians would have become eligible. But in a maddening, even cruel slap at lower-income people. Republicans in the General Assembly knee-jerked against President Obama and “Obamacare” and rejected the option out of hand. Former Gov. Pat McCrory of course bowed to their narrow-minded partisanship.

Cooper wants the state’s costs picked up by hospitals. That makes sense, given that hospitals will benefit from having so many more people covered by Medicaid instead of not being covered at all (because they make over the income limit for eligibility). Hospitals have supported Medicaid expansion, as have many physicians.

With more Medicaid coverage, fewer people would be going to emergency rooms for care they could otherwise get in a doctor’s office — thus freeing hospital emergency facilities to treat real emergencies and reduce the crowding that just about all hospitals have in emergency treatment areas. Emergency room care is tremendously expensive, of course, and so Medicaid expansion would cut costs not just for hospitals but for insured patients whose premiums are designed to help cover the cost of indigent care.

In declining to expand Medicaid, GOP lawmakers gave up tens of millions of dollars and thousands of jobs that would have been created to help run the expansion.

And for what? For nothing more than the opportunity to defy President Obama and reject his signature program — no matter the damage it did to the very citizens they represented. Their behavior was nothing short of a disgrace.

Gov. Cooper is doing what McCrory should have done long ago, but he lacked the conviction to do. The new governor is made of sterner stuff. GOP leaders are going to get that message loud and clear. It has been a long time coming, but it is welcome.