The 2015 legislative session has commenced, which means that the House and Senate will be hashing out their differences about how best to reform our state’s Medicaid program. The Senate is in favor of the state contracting with multiple managed care companies (MCOs) to manage North Carolina’s Medicaid populations. These MCOs will be held responsible for any cost overruns. The House, however, champions Accountable Care Organizations (ACOs) – a system made up of partnering provider groups and health systems that agree to provide medical care to populations of at least 5,000 Medicaid patients within a benchmark budget. Any savings or cost overruns will be split between providers and taxpayers.
Despite this divide, it looks as if the Republican-controlled legislature can agree that reform is not a precursor to Obamacare’s Medicaid expansion. Pro-Tem Phil Berger and Speaker Tim Moore officially announced that expanding Obamcare isn’t in the cards.
But the media report Governor McCrory being open to the idea in 2017, so long as medical benefits are linked to a work requirement. Other states with Republican Governors like Utah and Pennsylvania sought to link expansion with employment, but ultimately lost to the feds’ ruling:
U.S. Health and Human Services Department spokesman Ben Wakana said “encouraging work is a legitimate state objective” and the agency looks forward to continuing negotiations over Medicaid expansion. “However, work initiatives are not the purpose of the Medicaid program and cannot be a condition of Medicaid eligibility,” Wakana said.
It is certainly admirable that many states are rethinking their Medicaid programs, yet it’s unfortunate that more GOP governors believe that opting for Medicaid expansion on the condition of incorporating optional Republicanesque components like health savings accounts, cost sharing, or work training programs will reduce government dependence.
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