RALEIGH – While state lawmakers technically opened the 2019 legislative session earlier this month, this week marks the true beginning of a long session that includes a complete re-work of the biennial state budget. The N.C. House and Senate kicked things off Wednesday on Jones Street, opening the door to filing legislation.
In both those chambers, Democrats filed legislation to expand Medicaid to offer the entitlement program to those in the ‘coverage gap,’ those able-bodied adults earning 133 percent of the poverty level. This has been a policy goal of North Carolina Democrats ever since the passage of Obamacare. It is a central plank in Gov. Roy Cooper’s 2020 re-election platform.
And a few Republicans appear to be trying to accomplish the Democrats’ goals for them, announcing plans to file their own bill aimed at those in the coverage gap, otherwise known as Medicaid expansion.
According to Dan Way of the Carolina Journal, Rep. Donny Lambeth (R-Forstyh), along with “Reps. Greg Murphy, R-Pitt, a doctor; Josh Dobson, R-McDowell, co-chairman of the Joint Legislative Oversight Committee on Health and Human Services; and Donna White, R-Johnston, a nurse, plan to file their Carolina Cares legislation again this legislative session.”
The original House Bill 662, while the sponsors play word games to pretend it isn’t, is Medicaid expansion. As Way put it in April 2017, “If it is modeled after a Medicaid expansion program, and is funded like a Medicaid expansion program, it is a Medicaid expansion program.”
The legislation would add up to 350,000 people to the State’s Medicaid rolls, offering them arbitrarily low premiums and co-pays as long as they have a job. The other “savings” come from the providers of healthcare eating the costs. It does not take an economist to realize that the more “free” things an industry is required to provide to certain groups, the higher the costs of those services for all the other groups.
Other states that have tried similar Medicaid expansion programs, whatever they choose to call them, and predictably were met with higher costs and lower efficiencies than they predicted.
Luckily the Republican leadership is not sold on the plan, hopefully recognizing it for the Big Government solution that it is.
It does, however, draw attention to the fact that many Republicans, in Raleigh and in Washington, D.C., are not grounded in the free market, limited-government principles they so often campaign on. Expanding Medicaid to get more people of government healthcare and bust the budget is consistent with Gov. Roy Cooper’s and Democrats’ view of government’s role, but it is completely antithetical to the political principles the Republican Party is supposed to stand for.
The problem often has something to do with hubris. Lawmakers with relevant professional backgrounds – in this case a doctor, hospital administrator, and nurse – get sucked into thinking they have a better Big Government solution because they are smarter about it. While real world experience is definitely a plus when evaluating policy, but the they forget that, no matter how novel their plan is, this is government’s role in the first place.
North Carolinians elected Republican majorities, districts elected Republican representatives, to combat Big Government schemes to redistribute wealth via taxes, or healthcare entitlements, or what have you. If this long session turns into a competition among Democrats and Republicans in who has the better way to expand Medicaid, we’re in for a bumpy ride.
Read more about the Carolina Cares (Medicaid Expansion) proposal from Republican House members from the here.