This week’s bad bill would subject half a million North Carolinians to an already overcrowded Medicaid system and strain its already skyrocketing and bloated budget. Senate Bill 730, sponsored by Sens. Ben Clark (D-Cumberland) and Gladys Robinson (D-Guilford), would expand the eligibility guidelines for North Carolina’s Medicaid program to 133% of federal poverty guidelines, as laid out in Obamacare. (There is also a House bill equivalent, HB 1083).
The goal of expanding Medicaid to hundreds of thousands of more NC citizens is sold as a compassionate way to provide access to medical care for low-income families. However, reality shows that this act would in fact be rather cruel and not compassionate.
For starters, being enrolled in Medicaid does not ensure quality health outcomes nor does it even ensure access to care. As pointed out in this article, “Any discussion of Medicaid should begin with its track record on patient health. On that score, Medicaid is an abject failure.”
As a recent ground-breaking study in Oregon showed, Medicaid enrollees don’t experience any better health outcomes than the uninsured, and often times experience even worse outcomes.
Research also shows that Medicaid patients – especially children – have far longer wait times to see a doctor or specialist and are more likely to be turned away for treatment by physicians. Trouble finding a regular physician leads Medicaid patients to utilize the highly expensive emergency room for non-emergent care at a higher rate than the uninsured.
Indeed, here in North Carolina, during a time when the Medicaid program expanded by 600,000 people, the number of physicians accepting Medicaid patients dropped by 11 percent. The Medicaid program is already overcrowded; who would the additional 500,000 patients under Medicaid expansion see when they are sick?
Lastly, there is the matter of cost. North Carolina’s Medicaid costs have exploded by 42 percent in the last decade, and per-patient costs of coverage are rising at nearly as high a pace. While the federal government has previously promised to cover most of the cost of the new Medicaid patients initially, the expansion will still be very costly to the state. A fiscal note attached to SB 730estimates that more than half a million people would be added to the Medicaid rolls, at a cost to the state of more than $660 million over the next seven years. This estimate is likely very low for a couple of reasons.
First, they project the per-patient cost of Medicaid coverage to increase at only about four percent each year. Given the rapidly rising cost of medical care and the tendency for Medicaid patients to rely more heavily on expensive ER care, this is likely a low estimate. This Kaiser Family Foundation report shows North Carolina’s Medicaid costs rising at 6.1 percent in recent years. Costs could quickly escalate to more than $1 billion.
Furthermore, there is no guarantee the federal government will cover its ends of the costs as promised. The feds’ portion of covering the new enrollees is estimated to exceed $16 billion over the next seven years in North Carolina alone. With the federal government still running near-trillion dollar deficits, one must question the wisdom of relying on federal funds for years to come. Indeed, the White House has already been backing off their original promise to cover 90 percent of the added Medicaid expenses. Even a small drop in federal support could impose substantial financial pressure on the state budget.
In sum, expanding Medicaid would not help the health outcomes of new enrollees, would sentence those enrollees to a broken and already overcrowded system with limited access to care, and end up costing North Carolina taxpayers billions of dollars. For these reasons, SB 730 is the week’s Bad Bill of the Week.
Expanding Medicaid would give low income working families access to health care. Billions of federal dollars would flow back to our state boosting our economy, creating jobs and be used to compensate doctors and hospitals for service rendered. The preventive parts of this program would take pressure off the emergence rooms across the state. I fail to comprehend small minded groups like Civitas Institute putting extreme ideology over humanity as being good politics.
Lonnie,
Read the actual article. Medicaid is overcrowded and does not provide access to medical care, but rather a wait list. And because Medicaid patients have so much trouble finding a primary physician, they use the ER more than even uninsured people. Try to get some facts straight before you comment. There is nothing humane about condemning more people to such a broken system that also produces inferior health outcomes.
Brain your article is wrong, Medicaid expansion is working in other states.
My questions to you are below.
1: Do you want those too poor for health care to go untreated?
2: Who paying for the use of the emergency room care the working poor use as a last resort now?
3: What about the billions of federal tax dollars that would return to NC if we expand Medicaid that would pay for those services now being provided to those working poor who don’t have the resources to pay?
4: Why would expanding medical practices and clinics to provide preventive and regular health care for the working poor served by expanding Medicaid not be good for the NC economy and create jobs not be a win win?
Lonnie,
Your spelling and grammar are wrong.
Anyway, to answer your “questions”.
1. No, that’s why I don’t want them stuffed into an already overcrowded Medicaid system – read the article!
2. You and I are through higher hospital bills. But putting more people in Medicaid means more people using the ER, which means we pay more.
3.The feds don’t have billions to pay for this – are you unaware of the national debt? What happens when the feds renege on what they will pay for (again-read the article)?
4. Expanding Medicaid would not mean more medical practices. Fewer doctors are accepting Medicaid patients – read the article!
Your article is still wrong, right wing propaganda.
Health care is a basic human right and the poor are not receiving adequate heath care under the status quo. When they do find treatment at the emergency room there’s no method of paying for such services, other than charging more to those with insurance. Expanding Medicaid will provide a method of payment for such services.
NC taxpayers have paid into the federal tax system and deserve to receive the services of the ACA of expanded Medicaid for the working poor.
Here is a little more factual information. http://www.aafp.org/news/government-medicine/20140528qakaisermedicaid.html
Ah yes, when you find yourself incapable of refuting someone else, just dismiss it as “propaganda.”
How is what I write “propaganda” but what you write not propaganda?
Anyway, there is no “human right” to “health care”. That implies that some humans (health care providers) are mere means to serving the ends of others (the patients demanding treatment). Such a mindset leads to very disastrous results.
Not only is the Civitas Institute on the wrong side of justice and humanity Civitas Institute is also wrong on the positive economic impact expanding Medicaid will have in NC.
Just what kind of society do you people lobby for, one of greed, inhumanity, uneducated, one of extreme property and crime? The world currently and historically has models for both of our social and economic systems. I offer Canada, Norway, Sweden, Finland and Germany as my model. My opinion for your model of Plutocracy/oligarchy greed, inhumanity, injustice and scapegoating can be found in the Jim Crow South, Augusto Pinochet’s Chile, or pre labor movement America when the robber barons ruled.
The cost of emergency room care for uninsured patients is partially paid by uninsured patients, partially absorbed by the hospitals, partially covered by state funds (state taxpayers), and partially added to the premiums of those with health insurance.
Emergency Room use increases by 40% or more when people go on Medicaid, as clearly shown by the Oregon study (and as common sense would acknowledge.) That ENTIRE cost is born by taxpayers, even though it does NOT improve medical outcomes, as shown in the Oregon Medicaid study and others.
Lonnie Webster: “I fail to comprehend small minded groups like Civitas Institute putting extreme ideology over humanity as being good politics.”
I fail to comprehend Progressive ideologues putting emotion and feelings over facts and reason while totally ignoring human nature and basic laws of economics.
The people who consider medical care a ‘basic human right’ said the same thing about the ‘right’ to home ownership. We know where that got us (…housing bubble, financial crisis, Great Recession. )
Dumping more people into a costly, inefficient, wasteful, overly-bureaucratic, broken system that has been repeatedly proven to not improve health outcomes is not the answer. (Even if it does allow Progressives to feel good about their so-called compassion for the poor.)
Adding hundreds of thousands to the Medicaid rolls with no provisions to increase medical care providers, aside from being a drain of tax dollars, is nothing more than a sop to the feel-good sensitivities of those who want everyone dependent upon government for all their needs.
Conservative, you’re confusing right wing propaganda with facts. The ACA has only been effect a few months, a better comparison would be Vermont, Massachusetts or better yet Canada.
http://blogs.marketwatch.com/encore/2014/05/28/is-health-care-reform-working-in-massachusetts/