Today’s a pretty big day in the state of North Carolina. Why? Well, today, Republicans in the NC General Assembly are introducing Senate Bill 4, a proposal to block the expansion of Medicaid and effectively deny access to affordable health care to over half a million residents of the state.
I know what you’re thinking – “wait, haven’t we had this conversation already?” Indeed, we have. When the Affordable Care Act (ACA) was signed in March 2010, it was the result of a consensus that it was finally time to address the issue of access to essential health care in this country – especially for those most vulnerable to the rising costs of medicine, the poor. The ACA extended coverage by two major mechanisms: a mandate for individuals in the middle-class and above to purchase insurance, and the expansion of Medicaid – a joint state/federal public insurance program targeted primarily for low-income children and their parents – to cover all individuals below 138% of the poverty line.
All was fine until the Supreme Court decision last summer. Most of us heard about the survival of the individual mandate – the cornerstone of the bill that generated the most heated opposition. But subtly lurking in the pages of that historic ruling was another major decision: the federal expansion of Medicaid was deemed coercive and unconstitutional. Though the federal government was willing to finance the vast majority of the costs of expansion for a decade, states now had the ability to “opt-in” to the program.
So, here we are – February 2013. Nineteen states are definitely participating (including 4 with Republican governors), ten are definitely not. North Carolina, a state under control by both a Republican legislature and governor, has remained one of the undecideds (until now), and it’s easy to see why. Medicaid expansion was projected to extend coverage to upto 650,000 low-income citizens, while actually generating $65 million in returns to the state. Yes, you read that right – the fact that the federal government is subsidizing over 90% of the expansion will allow the state to provide health insurance to its most vulnerable AND make money at the same time. As a plus, economic models have projected the move to support 23,000 jobs.
I may just be a random college student, but even I can recognize a good deal when I see one. So why would Republicans feel so passionately about denying Medicaid expansion? Well, conservative policymakers have suggested their fears stem from the long-term prospects of the expansion which, if the federal government eventually decreased its cost-share, could pose a major burden on state finances.
This is a valid concern, but its one that can be addressed. Recently, Arizona Governor Jan Brewer – a staunch conservative – announced her intentions to expand Medicaid across the state and planned to incorporate a “circuit-breaker” provision that would automatically shrink the size of Medicaid if the federal cost-sharing rate were to decrease to the point where it threatened the state budget.
That’s an example of real leadership. What we have in North Carolina is a failure to lead. This “debate” in the legislature today is not about what’s best for the people of this state – it’s an ideological tantrum being thrown over “Obamacare” and the existence of the welfare state waged by a few radical conservatives oblivious (or worse, indifferent) to the fact that hundreds of thousands of their citizens will suffer as collateral damage.
As Senate Bill 4 is likely to pass the General Assembly, the hope for extending access to affordable health care in this state rests on the shoulders of one man: Gov. Pat McCrory. Though he’s been shy to comment on Medicaid expansion (only stating that he’s been “studying” the impact of various options), he’s been boxed in by Republican action in the House and Senate.
Now, it’s gametime. Great moments call for great leaders willing to put their reputation on the line to stand up for what is right, and for what is just. Rarely is a decision of this magnitude that affects so many so directly made at the state level. As students and citizens, it is now up to us to convince Governor McCrory to make history and demonstrate the same courage shown by his Republican counterparts in Arizona, Nevada, New Mexico, and North Dakota.
If you’re a North Carolinian at heart, pick up a phone and call Governor McCrory at (919)-733-5811 and let him know you’re counting on him to deliver on his dream of a better North Carolina for us all – and that he could start by opposing Senate Bill 4.
I know what you’re thinking – “wait, haven’t we had this conversation already?” Indeed, we have. When the Affordable Care Act (ACA) was signed in March 2010, it was the result of a consensus that it was finally time to address the issue of access to essential health care in this country – especially for those most vulnerable to the rising costs of medicine, the poor. The ACA extended coverage by two major mechanisms: a mandate for individuals in the middle-class and above to purchase insurance, and the expansion of Medicaid – a joint state/federal public insurance program targeted primarily for low-income children and their parents – to cover all individuals below 138% of the poverty line.
All was fine until the Supreme Court decision last summer. Most of us heard about the survival of the individual mandate – the cornerstone of the bill that generated the most heated opposition. But subtly lurking in the pages of that historic ruling was another major decision: the federal expansion of Medicaid was deemed coercive and unconstitutional. Though the federal government was willing to finance the vast majority of the costs of expansion for a decade, states now had the ability to “opt-in” to the program.
So, here we are – February 2013. Nineteen states are definitely participating (including 4 with Republican governors), ten are definitely not. North Carolina, a state under control by both a Republican legislature and governor, has remained one of the undecideds (until now), and it’s easy to see why. Medicaid expansion was projected to extend coverage to upto 650,000 low-income citizens, while actually generating $65 million in returns to the state. Yes, you read that right – the fact that the federal government is subsidizing over 90% of the expansion will allow the state to provide health insurance to its most vulnerable AND make money at the same time. As a plus, economic models have projected the move to support 23,000 jobs.
I may just be a random college student, but even I can recognize a good deal when I see one. So why would Republicans feel so passionately about denying Medicaid expansion? Well, conservative policymakers have suggested their fears stem from the long-term prospects of the expansion which, if the federal government eventually decreased its cost-share, could pose a major burden on state finances.
This is a valid concern, but its one that can be addressed. Recently, Arizona Governor Jan Brewer – a staunch conservative – announced her intentions to expand Medicaid across the state and planned to incorporate a “circuit-breaker” provision that would automatically shrink the size of Medicaid if the federal cost-sharing rate were to decrease to the point where it threatened the state budget.
That’s an example of real leadership. What we have in North Carolina is a failure to lead. This “debate” in the legislature today is not about what’s best for the people of this state – it’s an ideological tantrum being thrown over “Obamacare” and the existence of the welfare state waged by a few radical conservatives oblivious (or worse, indifferent) to the fact that hundreds of thousands of their citizens will suffer as collateral damage.
As Senate Bill 4 is likely to pass the General Assembly, the hope for extending access to affordable health care in this state rests on the shoulders of one man: Gov. Pat McCrory. Though he’s been shy to comment on Medicaid expansion (only stating that he’s been “studying” the impact of various options), he’s been boxed in by Republican action in the House and Senate.
Now, it’s gametime. Great moments call for great leaders willing to put their reputation on the line to stand up for what is right, and for what is just. Rarely is a decision of this magnitude that affects so many so directly made at the state level. As students and citizens, it is now up to us to convince Governor McCrory to make history and demonstrate the same courage shown by his Republican counterparts in Arizona, Nevada, New Mexico, and North Dakota.
If you’re a North Carolinian at heart, pick up a phone and call Governor McCrory at (919)-733-5811 and let him know you’re counting on him to deliver on his dream of a better North Carolina for us all – and that he could start by opposing Senate Bill 4.
