The folks in control of state government in North Carolina are having an increasingly difficult time justifying maybe the most ill-advised decision they have made in the last two years, the refusal to expand Medicaid and provide health care coverage for more than 400,000 uninsured adults in the state while creating tens of thousands of jobs in the health care industry.
What was already a clear and convincing case for the foolhardiness of that decision was made even stronger a few weeks ago with a the release of a report from the Urban Institute and the Robert Wood Johnson Foundation finding that North Carolina stands to lose almost $40 billion in federal money over the next 10 years.
Hospitals in the state are losing just over $11 billion in funding at the same time that many medical centers in rural areas are struggling to remain open and serve their communities.
An earlier study released by the N.C Institute of Medicine found that the state is also forgoing 25,000 jobs that would be created by Medicaid expansion.
And most importantly, several hundred thousand people who currently have no insurance will not be able to see a doctor without the fear of going bankrupt. The Urban Institute report found that the ranks of the uninsured have dropped by almost 40 percent in states that have expanded Medicaid and just 9 percent in states that have refused expansion.
The report, eye-opening but not surprising, garnered significant media attention across the state, some of which included confusing comments from state lawmakers who supported the rejection of Medicaid expansion.
The Charlotte Observer expanded on the story this week with a terrific in-depth account of the issues raised by the report and what’s at stake in North Carolina. It included comments from Senate President Pro Tem Phil Berger, one of the state officials most responsible for rejecting Medicaid.
Berger said that he was interested in “finding cost-effective solutions to ensure more North Carolinians are receiving high-quality health care,” though it hardly seems like it.
He gave the Observer two reasons why expanding Medicaid wasn’t part of that solution, that the federal government wasn’t being flexible enough in letting states develop their own version of expansion and that the cost to North Carolina could be much greater than expected if the federal government defaults on its commitment to fund 90 percent of it.
Berger’s comments about the lack of flexibility are absurd. They come as the Republican-led state of Pennsylvania just received approval for a Medicaid expansion plan developed by Gov. Tom Corbett and other Republican-led states like Indiana, Tennessee, Utah and Wyoming are pursing approval of their own conservative brands of expansion.
And the Republican governors of those states don’t seem overly concerned about the federal government defaulting on its Medicaid funding commitment either. If that is really Berger’s worry about expansion, you’d think he would express similar concerns about authorizing highways built with state and federal dollars or counting on the economic effect of military bases or even national parks.
Berger and his colleagues in the General Assembly did not reject Medicaid expansion because of some issues with flexibility or questions about federal funding. They did it because it is part of the Affordable Care Act that their political base demands they oppose to the illogical extreme.
And they did it because the ACA was created by President Obama. No Republican apparently can be seen agreeing with anything that President Obama does — at least in North Carolina.
In other states with Republican governors and Republican legislatures, more and more political leaders are starting to put their rigid partisan ideology aside, at least when it comes to figuring out how to provide health care and jobs for the people they represent.
Too bad Sen. Berger and his allies can’t seem to find the decency to do the same thing here in North Carolina.
Chris Fitzsimon is executive director of N.C. Policy Watch.