Dick Morris estimated what Medicaid expansion would cost North Carolina taxpayers. His guess is wrong in two ways. First, state spending would increase about half that amount (description below). More importantly, taxpayers would bear the cost of both the state and federal spending. According to my quick math, the total cost of Medicaid expansion in North Carolina would be $3.3 billion, with $330 million paid from state taxes and the other $3 billion paid from present and future federal taxes.

This is in addition to the higher federal taxes that will be passed on to consumers, the loss of freedom in choosing health insurance and providers, and the higher cost of the insurance plans that will be available.

For those of you who are interested, I used data from the Kaiser Family Foundation’s statehealthfacts.org website to estimate these costs.

Children are already covered in some cases to 200% of poverty and pregnant women are covered to 185% of poverty. That leaves just childless adults, who are covered to 51% of poverty, and other groups, 65%. The number of people in these two categories is 750,00, including pregnant women. Medicaid spent $6.5 billion on acute care in NC in FY2007, 35% of that was state money – $2.4 billion. Spending on long-term care is another $3 billion, with $1.1 billion from the state. Eighty percent of that $3.5 billion in state money, and nearly all of the LTC spending was for adults leaving about $1.1 billion for acute care of adults.

Roughly 26% of North Carolinians are at 133% of poverty or less, but a quarter of them are children and already covered by Medicaid, so we’re looking at increasing the adult Medicaid population to 2.5 million people, roughly tripling the number of people on the program.

Let’s triple the $1.1 billion for acute care of adults, which gives us $3.3 billion. Ten percent of that is $330 million, or roughly half (55%) of Dick Morris’ estimate of $599 million. But again, the full $3.3 billion has to be paid by taxpayers somehow.