Wednesday, August 7, 2013

Medicaid is North Carolina's Second Biggest Budgetary Item



North Carolina’s General Assembly received all sorts of attention during their last legislative session.  Liberal rags such as the Charlotte Observer and the New York Times criticized the republican’s budget that was deemed hostile to the poor.  A group of teat squawkers gathered in Raleigh on Mondays to protest, some were arrested.  Most of those were public employees.  One of their contentions as an outrage is the state’s refusal to expand Medicaid.  They would have you believe this program is a miniscule budgetary item.  It’s not.  As a matter of fact, it is the second biggest item that our government has to deal with.  To give you an idea of how large this program is, here is an excerpt from a Civitas Institute article:

·         A small program? Try this experiment: Walk down the street and think of every fifth person as a Medicaid recipient. That’s because nearly one in five North Carolinians is enrolled in the program.
·         Limited? Imagine that over eight years one city the size of Greensboro and another the size of Durham were added to North Carolina. Well, that’s how many people were added to the Medicaid rolls in one recent eight-year span.
·         Impoverished? Someone with a $490,000 house, jewelry, a good retirement account, a nice car and a business can still qualify for long-term care under Medicaid.
·         And good care?  Care may be good quality – if you can get it. Poorly designed cost-cutting measures have significantly reduced the availability of care to Medicaid patients.

The above was written in September of 2012.  However, libtards would have us believe that Republicans are cutting Medicaid spending in the coming fiscal year, when in fact it is being expanded, thanks to Obamacare.  Here is an excerpt from a Carolina Journal article:

RALEIGH — The new state budget includes a provision creating an advisory panel to rewrite the way the state delivers Medicaid services. It’s part of the Partnership for a Healthy North Carolina reforms championed by the McCrory administration. The budget adds more than $1 billion to Medicaid spending to cover what legislative leaders called cost overruns. 

The additional spending also accounts for mandates from the federal government as the Affordable Care Act, aka Obamacare, takes effect. One mandate is the so-called woodwork effect. Thousands of residents eligible for Medicaid who never enrolled now will sign up because of the mandate for individual insurance coverage. Another is the transfer of 51,000 participants from Health Choice, the subsidized program for low-income children, to Medicaid

You also won’t here from these liberal editorial boards the reforms being made to control the cost of Medicaid.

In addition, 11 components are mandated for inclusion in the advisory panel’s report to the General Assembly. 

Several of those include defining methodologies used to increase efficiency and reduce cost growth. DHHS also must detail how any pilot programs will improve current operations, setting forth the methodologies to show they are scientifically valid. 

The report must show how financial risks will be allocated and how private contractors will be held accountable for implementing the plan. 

The McCrory administration envisions three or four competing private managed care organizations would deliver Medicaid services, replacing the monopolistic Community Care of North Carolina model now in place.

The advisory panel further is tasked with developing Medicaid State Plan Amendments, Medicaid waivers, amendments to state law, and any other actions necessary to implement the reforms.

“What’s in the budget looks pretty much like what we came up with,” said State Rep. Marilyn Avila, R-Wake, who served on one of the House subcommittees working to negotiate with Senate counterparts to develop the Medicaid budget.

Medicaid reform is vital, and experiences in other states that already have gone that route demonstrate the need, she said.

“If you look at the numbers and the results, you have to say it’s got to be the direction to move in when you look at dollar savings,” Avila said.

“But to me, as important as the dollar savings are the outcomes. You look at the data where they’re doing those comparisons of outcomes for people on Medicaid versus other programs, people who are on self-pay, and things of that nature, and the Medicaid outcomes are really, really bad,” Avila said.

“And when you’re spending that kind of money, you would expect a much higher, positive outcome for your patients,” she said. Better outcomes are “to me, just as critical as the fact that they’re showing savings.”

Though criticisms are abound about NC republicans, no one mentions the role of the federal government. States have to negotiate with bureaucrats from Washington D.C.  But you’ll never hear a peep from the statist about that. 



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