Last week I urged Orange County commissioners to read Becki Gray’s column about Medicaid and why North Carolina made the correct policy decision in saying no to expanding the program. No surprise — the commissioners have chosen to ignore facts and have passed the following resolution, according to a county email that lists “Meeting Highlights.”

Resolution Urging the Governor and General Assembly To Expand Medicaid

The Board adopted a resolution urging the North Carolina General Assembly and Governor McCrory to reconsider its decision not to expand Medicaid coverage under the Affordable Care Act to provide coverage for poor and low-income adults. 

 

Now, for some North Carolina Medicaid facts, courtesy of JLF’s Gray.

North Carolina’s Medicaid costs are the highest in the Southeast and among the highest in the United States. For the past four fiscal years, Medicaid spending has exceeded its budget by 11 percent.

Total Medicaid costs have gone up 90 percent in the last 10 years. Medicaid costs crowd out spending on other public programs, including education, salary increases for teachers and other public employees, and transportation.

The proposed Medicaid expansion would cost North Carolina taxpayers an extra $3.1 billion over a 10-year period. By 2020, the state would incur net costs of nearly $100 million, jumping to $119 million one year later.

Even though the federal government says it will pay 100 percent of the cost of new enrollees for the first three years and 90 percent by the 10th year of expansion, the expansion would not be free. The money would come from federal taxes; North Carolinians would pay for the additional coverage.

Moreover, the federal government does not always abide by its promises. In 1982, the feds promised to cover 40 percent of the program costs for the Individuals with Disabilities Education Act. Today, Washington provides only 17 percent of the funding. In addition, experts predict that states expanding Medicaid under Obamacare will have less flexibility and control over their Medicaid programs. 

 

And what about Medicaid’s performance in terms of patient health?

Medicaid’s “one-size-fits-all” health care results in poorer health outcomes. An Oregon study of uninsured people who were enrolled in Medicaid shows utilization of services increased and Medicaid recipients spent 35 percent more than those not on Medicaid. But of 53 performance measures most widely tracked for North Carolina Medicaid patients, 55 percent of them were worse in 2011 than in 2010. This was not a one-year occurrence: Health outcomes among Medicaid patients have been declining for years.