So far, Pat McCrory and the legislature have rejected the Medicaid expansion that would offer healthcare to 500,000 North Carolinians because: 

  1. Medicaid is broken.
  2. they don’t trust the federal government to follow through on their commitment.
  3. it would be too expensive in the long run when the feds only pick up 90% of the cost. 
  4. all of the above.

The correct answer is 4. Since we are screwing so many of our citizens, we should examine these reasons. 

First, Medicaid is broken and Pat McCrory and Aldona Wos broke it. They criticized their  predecessors for budget overruns that were caused, at least in part, by cuts to the program by the legislature. Now, it appears that McCrory and Wos tried to use some accounting mumbo-jumbo to score money from–drumroll, please–the federal government! Unfortunately, the feds didn’t fall for it, leaving the program with a $60 million shortfall, money the senate included in their budget. Now, the senate, budget director Art Pope and DHHS are all pointing fingers at each other denying responsibility.  

Which leads to point b. Of course we can’t trust the federal government to follow through on their commitment if they are not even willing to let the states scam them out of additional money. I mean, we would never count on the feds to provide matching funds for other programs like, say, roads and  highways, would we? Would we? 

And then there’s that 10% of the cost that states will eventually be responsible for. McCrory and company say it’s too much money. Folks left without health insurance would disagree and so would most states. Even states as conservative as Arizona are jumping on the bandwagon. Why? Because it saves money. Treating people under Medicaid is a lot more cost efficient than forcing hospitals to eat the cost of the uninsured and passing the bill on to the rest of us.

There’s really no good reason for the state to reject the Medicaid expansion other than ideology. McCrory doesn’t really have any ideology but the state senate thinks we should all be on our own and reflexively rejects anything from the federal government unless it helps businesses (see road money). Besides, offering medical care to the poor and disabled just encourages them to stay poor and disabled. 

The GOP is conning itself by believing its own spin. They should expand Medicaid, bring needed jobs to the state, help people in need and save the state and our hospitals money. It’s the right thing to do.

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