The North Carolina Republicans’ rejection of the Medicaid expansion and their failure to set up state exchanges under Obamacare should be reason for firing. Decisions by Phil Berger, Thom Tillis and Pat McCrory left 500,000 North Carolinians uninsured, cost the state millions of dollars unnecessarily and caused much higher insurance rates than necessary. And they knew it would happen in advance, or should have.
In January, the legislature roared into session full of piss and vinegar after taking control of state government for the first time in over a century. They had a clear agenda and they weren’t going to let facts or the well being of the state get in the way. They were going to change North Carolina forever.
One of their targets was Obamacare. They hated the program even if they didn’t understand it. They weren’t going to have anything to do with it. They just wanted it to fail.
They would have been wise to pay more attention. The federal government offered a Medicaid expansion that was fully covered for three years and then funded at 90% thereafter. It was a key component to keeping costs low and seemed to be a no-brainer, since the funds did not come out of state coffers and yet offered insurance, in the case of North Carolina, to more than 500,000 people. But alas, the legislature rejected the offer, leaving those 500,000 people without health care coverage.
Then there was the state exchange. Obamacare was designed to give states as much control over the program as possible and allowing them to run the exchanges would achieve a large part of that. So, Wayne Goodwin and the Department of Insurance began the process of setting up the exchange. The feds would cover much of the cost development and implementation. If states rejected the idea, the feds would charge them for overseeing the operation of the exchange. Again, it seemed like a no-brainer.
And that’s the problem. Our legislators have no brains, just ideology. They knew, or should have if they had read the reports, that rejecting Medicaid and forcing the feds to run the exchange would cost North Carolina hundreds of millions of dollars. And they knew, or should have, that they would leave 500,000 people uninsured. And they knew, or should have, that doing both would cause North Carolinians to pay higher premiums.
It was all there. Either they didn’t read it or they didn’t care. I believe it was the latter. In their cynical view, they thought that any costs to the state or increased insurance rates would be blamed on Obamacare, not them. As for the uninsured people, they didn’t care. In their world they’re all “takers.”
So, the people we elected to run our state made a conscious decision to cost the taxpayers money, leave people uninsured and raise insurance rates just to score political points. They all should be fired. That’s what a business would do.