On Medicaid expansion, don’t let the perfect get in the way of the good

by | Sep 20, 2019 | Editor's Blog, Health Care

North Carolina is on the verge of a major political breakthrough. The state House is poised to pass a Medicaid expansion bill. Republicans call the bill NC Health Care for Working Families and deny that it’s real Medicaid expansion. If they can pass it, let them keep telling themselves that. 

Democrats don’t like it because it has work requirements and premiums. As it’s written now, recipients would pay 2% of the annual income in monthly installments. Democrats claim the requirements would cause additional red tape and expense while discouraging people from taking advantage of the program. They should suck it up and support the bill. 

While aspects of the bill may be hard to swallow for Democrats, they need to look at the big picture. This bill is really what compromise looks like. It will expand access to care to a lot of people who need it, but will also throw a bone to the people who blame poor people for their poverty. It’s clearly better than doing nothing. 

From a political angle, it gives wins to both Democrats and Republicans. Gov. Roy Cooper, whose message will drive the legislative races in 2020, can claim that he fulfilled a major campaign promise and give Democrats something to cheer about. Republicans can claim they’ve offered health care to far more North Carolinians and worked to save rural hospitals without giving in to the deadbeats. 

Whether they will admit it or not, Republicans probably see bringing the bill to the floor as a bit of an olive branch. The veto override seriously damaged trust between House Democrats and House Republicans. Before the override saga, Republicans tried to use the expansion bill as bargaining chip. They told Democrats they would debate the bill once the veto was overridden. Now, they’ve brought the bill up, showing good faith. 

Democrats should get behind the effort, even if they need to criticize its shortcomings. Bills can always be made better in the future. Our system was set up by the Founding Fathers to allow incremental change. Now is not the time to let the perfect get in the way of the good. 


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