What do you call a bill
co-sponsored by 48
of 50 senators (S32)
and 102
of 120 representatives (H53)
? An accounting trick that makes a bad
precedent worse.

Last month, UNC Health Care System, East Carolina University, and the State
Department of Health and Human Services submitted a proposal to get more
federal money
for the government-affiliated hospitals. At the time, private
hospital administrators pushed the state to drop or delay the application.
(Also see Privatize
Bill Roper
).

Having failed to stop that bad idea, the state’s private hospitals are pushing
H53 / S32. They want to pay a new assessment to the state so they can reap more
Medicaid dollars. You read that right, Medicaid’s rules are so confused that
hospitals can pay a tax and get eight times that amount back. Lynn Bonner,
writing about the deal for the RaleighNews & Observer, assured readers, "While the proposal looks
like an accounting trick, other states, including Ohio and Illinois, have
similar programs." As though Illinois were a model of fiscal probity. The
flow of money projected under this arrangement:


Hospitals pay:    $216 million


State returns:     $173
million


Feds match:       $350
million


Hospitals net:     $307
million


State keeps:         $43
million


And the federal deficit grows


The legislature should reduce state funding to the university hospitals and
seek other ways to reverse the bad idea, not compound it. This is a backdoor
way for the state to borrow money, since the federal dollars are borrowed, and only a temporary fix.
When Roper got the state’s agreement on this, he warned that such
"innovative" ideas would not be around long. The president’s budget
proposal shows how right he is. The Wall Street Journal reports, "
$18 billion [in Medicaid savings] would come from ending mechanisms that state governments use
to boost Medicaid reimbursements from the federal government." But
the fact that a large bipartisan majority supports such brazen disregard for
common sense and fiduciary responsibility is also further indication of the
problems with ObamaCare, which will force 125,000
children
and thousands of adults to enroll in Medicaid under the individual
mandate.