John Locke Foundation opposes Senate plan to proceed with Medicaid expansion

June 1, 2022

RALEIGH — The John Locke Foundation is standing against the N.C. Senate’s vote Wednesday to expand Medicaid. Expansion is the key element of House Bill 149, slated for a vote on the Senate floor later this afternoon.

“For years, most state senators have rightfully recognized that Medicaid expansion is bad medicine for North Carolina,” said Locke Chief Executive Officer Amy O. Cooke. “Their changed view is disappointing.”

“Data show that the D.C.-controlled health insurance scheme will leave North Carolinians with less health care access and higher tax burdens because it’s paid for through D.C. deficit spending, adding to inflationary pressures and driving costs even higher,” Cooke added.  

“The Senate’s Medicaid expansion bill includes some positive supply-side reforms, such as scaling back certificate-of-need restrictions and granting nurses full practice authority,” Cooke said. “We should exhaust those avenues before ceding control of North Carolinians’ health care to Washington, D.C.”

Locke President Donald Bryson urged state senators and their N.C. House counterparts to consider the state’s recent history with Medicaid. “It wasn’t that long ago that Medicaid’s massive, unpredictable cost overruns tied legislators’ hands during annual state budget planning,” Bryson said. “Good fiscal stewardship brought that problem under control. But the threat of Medicaid dictating the state’s budget choices looms again in the future.

“Larger-than-expected Medicaid enrollment spikes in other states, combined with today’s economic uncertainty, mean lawmakers could be setting themselves up for another long-term fiscal headache,” Bryson added.

Brian Balfour, Locke’s senior vice president of research, offered multiple reasons for lawmakers to reject Medicaid expansion today. “Expansion would make hundreds of thousands of additional North Carolinians dependent on government for their health care,” Balfour said. “Increased government dependency is decidedly not a conservative value.”

“Increased health insurance coverage will not mean increased access to care,” he added. “Plus, healthier people joining the Medicaid program almost certainly will crowd out services for more needy populations.”

“The federal government is broke and dysfunctional, and chasing short-term funding options from Washington, D.C. makes for bad long-term policy,” Balfour said. “There’s no question that lack of access to health care is an issue worthy of attention. But expanding Medicaid will only make the problem worse.”

“Instead, legislators should focus on market-based reforms, peeling back the many layers of government regulation that drive up costs and restrict supply.”