All the reasons NC must say yes to Medicaid expansion

The following editorial appeared in the Greensboro News & Record:

One of the best policy decisions North Carolina can make in 2015 is to expand Medicaid coverage. The foolishness of refusing to do so already is confirmed by the release of a detailed new study funded in part by the Cone Health Foundation.

The report is written by researchers from George Washington University. The startling findings should prompt a call to action in Raleigh.

By refusing to expand Medicaid eligibility, North Carolina passed up $2.7 billion in federal funding this year. Next year’s loss will be $3.3 billion. This spending would have supported 23,000 jobs this year, growing to 29,000 in 2015.

One hundred percent federal funding was offered through 2016. That would decrease to 95 percent in 2017 and 90 percent in 2020 and thereafter – still better than the 66 percent reimbursement North Carolina receives for Medicaid patients now.

Close to 300,000 state residents who currently are uninsured would become eligible for coverage in 2016, followed by nearly 180,000 more in 2017.

Because Medicaid expansion is part of the Affordable Care Act, North Carolina Republicans wanted no part of it. They offered plenty of excuses: North Carolina wasn’t able to administer a larger Medicaid program. The federal money might run out. More Medicaid spending will increase the federal deficit. People ought to get a job and pay for their own medical coverage.

One by one, other Republican-governed states are letting go of their excuses and giving in to reason. The latest governor to propose a Medicaid expansion is Bill Haslam of Tennessee just this week. He will face opposition in his legislature. So will North Carolina Gov. Pat McCrory if he follows suit. Yet he should use the new report to sell the idea.

It breaks down the benefits of Medicaid expansion county by county. It says Guilford County could cover 26,539 additional people by 2017, supporting 3,160 additional jobs by 2020 and generating nearly $2 billion in new economic activity from 2016 through 2020. Can we use that?

“We can’t afford not to expand,” said Cone Health Foundation President Susan Shumaker. The report’s nonpartisan analysis makes an economic and moral case for bringing more of the working poor into Medicaid coverage, she added.

The study found that states accepting Medicaid expansion have enrolled more people in medical insurance and reduced uncompensated care hospitals are forced to provide. They also are giving more people preventative care and managing their chronic health conditions rather than treating symptoms when they get really sick. Those states will end up with healthier populations and more productive workers.

North Carolina has strict Medicaid eligibility standards, ranking in the lowest quartile of states for coverage. It has a high poverty rate and unemployment greater than the national average. Incidences of some chronic diseases, such as diabetes, are rapidly increasing.

Leaders need to understand how the state’s economic growth is held back when so much of its population lacks access to reliable medical care. It doesn’t make sense to turn down billions of federal dollars that could be used beneficially. The Cone Health Foundation report makes a compelling case.

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