Cooper moves on Medicaid expansion

Jan. 08--SANFORD -- North Carolina's new governor Roy Cooper plans to expand Medicaid to cover more uninsured North Carolinians, despite state law.

Cooper sent a letter to the Centers for Medicare & Medicaid Services in Washington, D.C. seeking federal approval to expand Medicaid. If the change is approved, if local matching money is secured and if state eligibility requirements are changed, more that a half-million North Carolinians could receive benefits beginning Jan. 2018.

"This is North Carolina common sense," Cooper said in a press release. "We can receive between $3 billion and $4 billion to pay for care that hospitals and other providers now give away. That will create jobs, bolster our hospitals, could save some rural hospitals and work toward more stable private insurance premiums."

The NC Hospital Association says the state's hospitals provide about $1 billion in care annually to residents who cannot pay for it. Hospitals would receive a significant share of additional Medicaid dollars that would come back to the state.

"I think the Medicaid expansion will be a significant economic boost," said Robert Reives II, N.C. Rep. "You're talking about adding jobs and economic factors that will run us up into $1 billion from a lot of estimates. Part of me is (for it) because it's the right thing to do, but I know that doesn't always resonate. We do have to think about those who are caught in that gap right now between the ACA and the ability to get private insurance. I really think that we've got to figure something out about that."

Cooper believes the contributions can be paid through a combination of savings in existing state expenditures due to the new federal funding and a local matching contribution. Hospitals would contribute a 5 percent local match that CMS requires. Depending on how many additional residents enroll in the expanded program, the hospitals' contribution could be between $100 million and $150 million in the first year.

"Factually, we're going to be paying for Medicaid for somebody from here on out," said Reives. "Right now, we are paying for Medicaid for 27 other states, and that makes absolutely no sense to me. I just can't find a practical reason to not do it. I've not heard anybody be able to tell me a good sound economic reason for why we turned it down. The only thing you consistently here is not to be involved in federal government. All these states work together to make us a great country. I can't see where it hurts."

Former governor Republican Pat McCrory approved a state law in 2013 declaring that North Carolina will not expand Medicaid and any proposals to do so must go through the General Assembly.

"I have not personally seen where it's against the law," said Reives. "I think they're saying the governor cannot make that unilateral decision."

The Cooper Administration says that the law that prohibits the governor from seeking to provide health care for low-income North Carolinians does not apply to this draft plan.

The state will accept comments for 10 days on North Carolina's notice of intent to amend its Medicaid plan. The Cooper Administration then will file a State Plan Amendment with CMS.

The documents filed are available on the North Carolina Department of Health and Human Services website at: http://dma.ncdhhs.gov/get-involved/nc-health-choice-state-plan.

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