Governor McCrory has finally taken a position. He’s against Obamacare. So 500,000 low income North Carolinians will have to keep getting their care in emergency rooms, or not getting it at all. Also, people eligible to purchase on the Health Insurance Exchange (marketplace) will have to rely solely on federal consumer assistance programs to help navigate enrollment. National model consumer assistance plans developed by our Department of Insurance will not be implemented, as Governor McCrory refuses to partner with the federal government on insurance.
Part of the stated rationale for rejecting involvement with the insurance exchange is lack of planning by the state. That’s true of Medicaid. However the state has done extensive planning on the exchange, and submitted a detailed plan for consumer assistance that was approved by the federal government. See: November 2012 Level One Exchange Establishment Cooperative Agreement Application.
McCrory’s statement, from his website:
“Throughout our first few weeks in office, we have done a thorough review of the advantages and disadvantages of expanding Medicaid in North Carolina and determining the right exchange option for our state. Headed up by our Secretary of the Department of Health and Human Services, this review included discussions with other governors, the White House, health care providers and N.C. legislative leaders. [It apparently did not include uninsured people, doctors, or hospitals.]
“This assessment included our existing systems, operations, potential new administrative costs and barriers, and the amount of control and flexibility North Carolina will have to reform the system. The results of our findings make it abundantly clear that North Carolina is not ready to expand the Medicaid system and that we should utilize a federal exchange. Our findings include:
1) In light of recent Medicaid audits, the current system in North Carolina is broken and not ready to expand without great risk to the taxpayers and to the delivery of existing services to those in need. We must first fix and reform the current system. [Translation: Here comes for-profit managed care. CCNC, we're coming for you!]
2) The potential long-term cost to the North Carolina taxpayer and needed flexibility for reform cannot be determined based upon the information and details provided to us by the federal government. [We don't believe anything the federal government says. As a matter of principle.]
3) There has been a lack of preparation within state government during the past year to build necessary and reliable systems to implement a state exchange. [one branch of state government that has been largely responsible for the lack of preparation: The General Assembly, which did not want to move forward on health reform as long as there was a chance the Supreme Court or presidential election would make it moot.]
4) Due to the ongoing political uncertainty of the federal budget deficit, there is long-term concern regarding the federal government’s continuing of its obligation for matching funds under the terms of the Medicaid expansion. [We are too dug in to include a provision to opt-out if funds end, even though that solution has been adopted by Gov. Jan Brewer and others]
“We are currently working with the General Assembly on technical language revisions to Senate Bill 4 to ensure full and timely funding for NC FAST. This information technology system must be implemented for existing Medicaid services. In addition, this technology also will help reduce fraud and waste. [Good luck with the feds, fellas. Can't imagine they're going to want to cut you any slack.]
“If it becomes clear that the current course of action is not in the best interest of North Carolina, our health care system and our citizens, we will work with the General Assembly to pursue other options in the future.”
We held out hope that Governor McCrory would be a moderate. Instead, he seems set in healthcare to toe the Tea Party line. That’s a shame for those in desperate need of healthcare.