Phil Berger: What's missing in N&O Medicaid stories and editorials

Senate President Pro Tempore Phil Berger explains in a letter to the editor, printed on tomorrow's editorial page and online now, why Republicans are rejecting the Medicaid expansion:

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The online headline of your Feb. 6 editorial “State Senate goes against federal health-care law” was accurate. Unfortunately, it missed the mark on why the Senate opted out of several expensive provisions of Obamacare.

Obamacare’s changes to Medicaid will cost North Carolinians close to a billion dollars through 2019. And that’s with “free” federal money covering a lion’s share of the costs. When the federal government realizes it is going broke and pulls its share of funding, North Carolina taxpayers will be saddled with the entire colossal bill.

The claim that Medicaid expansion extends government insurance coverage to 500,000 uninsured citizens across the state is not true, according to a study conducted by Harvard, Boston University and the U.S. Department of Veterans Affairs. Their researchers found that only 14 percent of new Medicaid recipients would come from the ranks of the uninsured, while as many as 80 percent are currently covered by private insurance. That’s as many as 400,000 people leaving private insurance and going to the government plan.

These projections about the abandonment of private insurance are scary – but they are consistent with Medicaid expansions of the past. Take the federally mandated State Children’s Health Insurance Program as an example of the threat of government subsidized health coverage to private insurance. The Congressional Budget Office estimated that up to 50 percent of SCHIP enrollees came from the rolls of the once privately insured.

North Carolina’s hospitals say they make money on privately insured patients but lose money on Medicaid patients. According to the Harvard study, with Obamacare’s Medicaid expansion moving a significant number of citizens with private insurance onto the government-run program, a serious financial threat is added to our already troubled health care system.

Finally, a damning audit of North Carolina’s current Medicaid program released in January found systemic failures including cost overruns of $1.4 billion, a failure to adhere to budgets and, most troubling, an inability or unwillingness to follow the law. The report confirmed what many already suspected – North Carolina’s Medicaid program can’t manage the 1.6 million people it is already supposed to serve. Adding 500,000 people to this system is foolhardy.

Senate Republicans are dedicated to improving health care outcomes and access in North Carolina. But counting on a federal government that is $16 trillion in debt to pay for the expansion of a Medicaid system that doesn’t work at the expense of the private insurance market is not the way to do it.

Phil Berger
Senate President Pro Tempore, Eden