This month, the Urban Institute and Robert Wood Johnson Foundation released a report assessing the financial impacts of North Carolina’s decision to forgo the Affordable Care Act’s optional Medicaid expansion.
Extending eligibility levels of our broken – yes, broken – medical assistance safety net would cost state taxpayers an additional $300 million per year, amounting to $3 billion to the General Fund books over the course of a decade. But because Medicaid is jointly funded, advocates brush that aside and are instead fixated on North Carolina losing out to roughly $40 billion worth of federal funds over the next ten years.
The argument goes that our citizens’ federal taxes are now paying for other states’ Medicaid expansions, without seeing any benefit themselves. Is North Carolina really “losing out”? The influx of federal funds is borrowed money. What’s really happening is that future generations are being taxed to broaden the safety net of our current generation, all the while adding more weight to our national deficit.
You can access the full report here.