FOLDING? NC House Republicans Discussing ‘Type of Medicaid Expansion’ to Appease Cooper in Budget Battle

RALEIGH – Monday First in Freedom Daily reported on the current budget impasse, in which the Republican majority on Jones Street is stuck between a rock and a hard place after Governor Roy Cooper vetoed the biennial budget for not including Medicaid expansion. Because Republicans no longer enjoy a veto-proof majority, and Democrats are pretty well unified behind the governor, we wondered what Republican leadership may be preparing to fold on in order to make a deal.

Later Monday afternoon that question was answered as Republican House Speaker Tim Moore (R-Cleveland) told reporters that House leadership had agreed to take up the ‘Carolina Cares’ bill, or NC Health Care for Working Families. Moore described the bill as a type of Medicaid expansion that includes work requirements and taxpayer protections.

The legislation, House Bill 655, was discussed in the House Health Committee Tuesday morning. That committee is chaired by Rep. Greg Murphy (R-Pitt), who is also on the ballot Tuesday in the Republican primary runoff for the Third Congressional District race to fulfill the term of late Congressman Walter B. Jones in representing most of eastern North Carolina. Murphy, originally a primary sponsor and advocate of Carolina Cares, has faced criticism from the Right during his congressional bid that view the legislation as nothing more than Medicaid expansion by another name. He has since removed his name as a sponsor of the bill.

In defense of the bill advocates say it, in addition to having work requirements and some protections for North Carolina taxpayers, is not technically ‘Medicaid expansion’ because it would not add anyone to current Medicaid rolls. What it does do is a create a new roll of an estimated 300,000 people to qualify for health insurance coverage subsidized by federal taxpayer funds and hospital assessments.

Under the proposal hundreds of thousands of able-bodied individuals with jobs will get subsidized health insurance paid for by taxpayers and other purchasers of hospital services. All the thresholds are straight from Medicaid expansion standards as set out under ObamaCare.

The participants would be required to pay premiums equal to 2 percent of their household income, but all the other costs for health coverage of an hundreds of thousands of able-bodied working adults would be borne by federal taxpayers (everyone in NC that pays federal taxes), and “state and county funds,” which could mean North Carolina taxpayers again, except that the bill authors clarify where the General Assembly ‘intends’ to get that money.

In other words, the sponsors intend for hospitals and other providers to foot the bill for the remaining costs of the government healthcare expansion not covered by arbitrarily low participant premiums and taxpayers. On one hand, hospitals may view this as a good deal if they are already serving many in this same population that currently have no insurance at all, and thus incurring a bigger net loss on each patient versus if that patient had qualified for Carolina Cares.

Inevitably, though, many who would join the rolls of the proposed healthcare entitlement program will be giving up other private health insurance products in favor of a cheaper, taxpayer subsidized plan. For their part, the hospitals/providers would incur more assessment costs. And, because we know the laws of economics do not ignore healthcare markets, those costs will ultimately be borne by purchasers of private health insurance or those that pay out of pocket.

In this way, much like Medicaid expansion — or any expansion of subsidized healthcare –Carolina Cares would add to the already astronomical inflation pressures in medicine. In short, it makes health insurance and medical treatment more expensive for the rest of us.

So, there you have it; a Republican legislative majority seems to be clearing the runway for their own version of the expansion of taxpayer subsidized government healthcare after years of claiming principled opposition to Medicaid expansion under Obamacare. In this case, as in most cases, principle is now viewed as subordinate to pragmatism. Democrat Governor Cooper wants Medicaid expansion, Democrats in the General Assembly want Medicaid expansion, and, instead of standing firm on principle in the face of the political opposition, the Republican leadership of a Republican legislative majority appears ready to completely cave to the desired agenda of the Left.

Republicans, whose majorities on Jones Street have been deteriorating for a few cycles now, are hoping to bolster their numbers back to a veto-proof super-majority via 2020 elections. However, how do Republican state lawmakers expect their base to have any enthusiasm in supporting them if they are the ones facilitating a direct contravention of the limited government, free market, conservative principles that are supposed to be the foundation of the party?

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