Along with the roll-out of the Affordable Care Act came a deluge of information, including an overwhelming amount of half-truths and outright falsehoods. While dozens of states expanded their Medicaid programs under the ACA, the North Carolina General Assembly called the state’s Medicaid program dysfunctional, and voted to reject federal funds to bring health care to thousands of North Carolina families.
So is Medicaid dysfunctional? Here are five reasons why North Carolina’s program to provide health insurance to needy children and families works, and would work even better if the state accepted expansion support from the federal government.
It gives all residents access to world-class doctors and hospitals. North Carolina is home to some of the best medical facilities in the country. While some people fly thousands of miles to meet with our state’s top-rated medical professionals, many residents of this state need only look within their county for the best medical care available. Because of the wealth of great doctors, many Medicaid recipients have options, and do not have to settle for a substandard hospital or provider that takes the state-sponsored insurance.
In fact, families who use North Carolina Medicaid have access to most of the same doctors and practices available to anyone who has insurance from Blue Cross Blue Shield. Public hospitals such as UNC Healthcare and Charlotte’s Medical Center University Hospital take Medicaid patients, as do many of the doctors who practice there.
The flip side to this is that as North Carolina reduces its Medicaid funding and rejects the federal help, hospitals in some communities are forced to close. For some residents, even those without Medicaid, this means life-saving facilities are now farther away and overloaded with patients.
It’s flexible enough for the state to tailor it to North Carolina’s needs. Opponents of Medicaid often claim that it is a rigid, one-size-fits-all solution that doesn’t adequately meet the needs of North Carolina residents. While there are minimum standards set by the federal government, North Carolina’s Department of Health and Human Services has wide discretion as to how to implement the program locally.
Community Care is an award-winning program that serves more than 80% of North Carolina’s Medicaid recipients. It’s fully designed and run within the state, and the nurses and community helpers who work with it have the ability to take care of clients’ needs flexibly. Some visit patient homes while others give instruction about medical devices or conditions. By providing proactive and tailored care, this program saved the state more than $50 million in Medicaid costs last year alone.
It benefits the entire state economically. Healthy residents work more, work harder, and participate more in their communities. Mothers whose children receive adequate medical care miss fewer days of work and stay with companies longer. Many of the North Carolina businesses that employ the most workers pay low wages and rely on Medicaid to provide health coverage for these low-wage, low-hour employees. Ensuring families are healthy leads to less turn-over and more profits for local companies.
A recent study from the North Carolina Institute of Medicine showed that if North Carolina accepted funds to expand Medicaid to 500,000 more residents, the state would see long-term economic growth of more than $13 billion dollars. The same study showed the Medicaid expansion would also bring more than 25,000 jobs to the state, and would increase personal disposable income across the state by 30%.
It’s cost effective. Among its detractors, Medicaid has a reputation as an expensive program weighed down by bloat. The Center for Budget and and Policy Priorities in Washington found that couldn’t be further from the truth. On average, Medicaid programs cost 27% less for children and 20% less for adults than private insurance programs. This savings is due in part to the large pools of recipients and to the role government oversight plays in keeping costs low via frequent audits.
North Carolina spends $12 million annually to provide Medicaid to 1.5 million recipients. According to the state’s General Assembly Fiscal Research Division, this number is significantly lower than the spending done by nearby states, and it contradicts earlier reports that the state spends 40% more than the national average. State Attorney General Roy Cooper has called the rejection a partisan political maneuver and has said state lawmakers need to heed the economic benefits of expansion.
It enriches families’ quality of life. A U.S. Census study shows that 20% of North Carolinians are uninsured. For these families, a simple trip to the emergency room could mean the inability to pay next month’s rent. Thousands of families choose between a trip to the grocery store and a trip to the doctor for a check-up. Medical bills are one of the top reasons families choose bankruptcy, a decision that negatively affects debtors as well as the family’s credit score.
If North Carolina expands Medicaid, 500,000 more residents will be able to go to the doctor for a strep test, or will be able to treat their child’s asthma before it becomes an emergency. Families who know they have insurance won’t hesitate to engage in preventative services like smoking cessation programs and cancer screenings, programs which benefit their entire family long-term.
Like any large-scale program, North Carolina’s Medicaid isn’t without problems. A recent audit found that the software used to send Medicaid payments to doctors was failing to send funds and was experiencing other errors. All this indicates is that these issues should be addressed. There is no need to declare the entire system broken and ignore the benefits to North Carolinians.